SARS is the abbreviation for Severe Acute Respiratory Syndrome and means severe acute respiratory distress syndrome in German. It is an infectious disease that is caused by viruses. SARS first appeared in China in 2002.
What is SARS?
SARS (severe acute respiratory distress syndrome) is an infectious disease caused by a specific strain of virus, the coronaviruses. The disease is subject to mandatory reporting. The pathogen was discovered by the physician Dr. Carlo Urbani, who himself fell victim to the virus. The disease triggers severe respiratory distress and causes flu-like symptoms with fever, cough, hoarseness and sore throat. The symptoms occur suddenly and are very severe right from the start. SARS first appeared in China in 2002, and the first case was reported in Germany in 2003. At that time, almost 30 countries reported cases of the disease; however, the most frequent cases of SARS occurred in Thailand, China and Hong Kong. In total, around 8000 people were infected and fell ill, and around 800 of them died. There has not been another case of SARS since 2003.
Causes
The causes of SARS are viruses that were unknown until the outbreak of the disease in humans. They are the group of coronaviruses. Until now, this virus was known only from animals. It is believed that it was first transmitted to humans by a certain species of cat in China, whose meat is used as food there. But the disease can also be passed on by living very closely with covertly infected animals. At first, it was assumed that infection among humans only occurs through so-called droplet infection. In this case, the virus is transported via saliva, nasal secretions or other body fluids. However, since people who had no direct contact but only lived in the same house also became ill, it was concluded that the SARS virus can also spread through the air or water. The amazing thing is that the pathogen can apparently survive a period of 24 hours even without a host.
Symptoms, complaints, and signs
SARS is reportable according to the Infection Protection Act (IfSG) §6, paragraphs 5a and 5bif illness is suspected, an outbreak of illness occurs, or a death occurs because of SARS. The suspicion of SARS is fulfilled according to World Health Organization (WHO), if fever over 38°C is ascertainable, the illness shows signs of a pneumonia (a lung inflammation), the following symptoms are meant: Headache, aching limbs, dry cough, rarely chills) and at least one respiratory symptom occurs, thus a disturbance of the external respiration. Previous close contact with SARS-infected persons (within 10 days prior to the onset of symptoms), as well as a stay in regions where SARS is common, is also a suspicion of SARS. If these criteria are met and an x-ray indicates acute pneumonia or acute respiratory distress syndrome, or unexplained respiratory illness resulting in death, a probable case of SARS is present. SARS symptoms appear after an incubation period of two to ten days. Fever, chills, headache, fatigue, muscle pain (myalgia), and diarrhea then occur. Older people have more severe courses, although they may also be free of fever. Symptoms also include fever, dry cough, hoarseness, sore throat, shortness of breath, and low blood oxygen levels (hypoxemia). The clinical picture worsens markedly (exerzerbation) and may lead to respiratory failure.
Diagnosis and course
The incubation period of SARS is very short, lasting only two to seven days. The incubation period is the time that elapses between the moment of infection and the appearance of the first symptoms. The disease usually begins with a sudden high fever and a very strong feeling of illness. This is followed by flu-like symptoms such as headache, aching limbs, sore throat, hoarseness and cough. There may also be chills, diarrhea, loss of appetite and skin rash. Some patients are unable to move properly as muscles become stiff. States of confusion may also occur. SARS can be very mild or fatal. The diagnosis of SARS is suspected when the known symptoms are present in people who have been in the specifically affected countries. In the further course, however, the viral infection must be confirmed by a blood test.An X-ray examination as well as a computed tomography scan also contribute to making a reliable diagnosis of SARS.
Complications
Severe complications may develop from the symptoms of severe acute respiratory syndrome. If treatment is given too late or if the ill person is already physically very weak, the immune system can no longer effectively fight the pathogens itself. As a consequence, high fever and resulting circulatory problems occur. Prolonged diarrhea can cause the affected person to become dehydrated. The lack of fluids and nutrients usually results in further complications, such as impaired consciousness, dehydration and exhaustion. Shortness of breath and shortness of breath can lead to panic attacks and, in interaction with the initial symptoms, can lead to heart failure. In particular, children, the elderly and the sick are at risk of dying from the extreme physical stress. Treatment for SARS is relatively risk-free. However, the drugs administered can cause side effects. Antibiotics and the hepatitis C drug ribavirin in particular repeatedly cause symptoms such as skin rashes, cramping of the respiratory muscles and anemia. In combination with other preparations, further complications can occur. If the patient must be given intravenous fluids, this can lead to injury, aspiration, and allergic reactions in some cases.
When should you see a doctor?
Anyone suffering from SARS should see a doctor as soon as possible. The disease cannot be cured, but therapy can provide relief. However, the danger in Severe Acute Respiratory Syndrome is primarily in possible concomitant infections of a bacterial nature. These can be cured by the administration of antiobiotics. In addition, antibiotics are also used for prevention. A comprehensive control of the lungs by a specialist (or in a specialized hospital) is urgently necessary. In addition, SARS always carries a high risk of infection, so the necessary medical measures may include quarantine. The symptoms of severe acute respiratory distress syndrome are serious enough to prompt sufferers to see a doctor anyway. However, respiratory distress due to severe throat irritation does not necessarily mean that SARS is present. The disease is rare and there are only a few known outbreaks. At present, only people who work with the virus in laboratories are at acute risk. In addition, when typical symptoms appear, a differential diagnosis is also useful. For example, it must be ruled out that it is the MERS virus, for example.
Treatment and therapy
To date, there is no known specific treatment for SARS, so initially therapy is focused on symptom relief. Success has been achieved with the broad-spectrum antibiotic ribavirin, which is also used to treat hepatitis C. It is able to fight several different pathogens. Cortisone is also administered to treat any bacterial infections that may occur as a result of the viral infection. In addition, a mixture of several other antibiotics is also given. Patients infected with the SARS pathogen must be kept in an isolation ward with an airlock because of the extremely high risk of infection. Clinic staff are required to wear protective gowns, breathing masks, goggles and gloves when treating patients. Research is now underway to develop a vaccine for SARS, but none has been developed to date. SARS last occurred in 2003. Since no new case has been reported since then, it is assumed that the SARS virus no longer exists.
Prevention
As a preventive measure against SARS, it was recommended to avoid large gatherings of people, especially in China, Thailand and Hong Kong, which were heavily affected by the disease at the time. Respirators, such as those worn by doctors during surgery, were also advised. Frequent hand washing provides additional protection.
Aftercare
Medical follow-up for severe acute respiratory syndrome is difficult because there are neither many options for targeted treatment nor extensive knowledge about the disease. Therefore, follow-up care mostly consists of sparing SARS survivors. The disease debilitates those affected to varying degrees, so treatment and appropriate follow-up vary from case to case.Thus, there were many cases of people suffering from SARS in which the symptoms were only mild. Accordingly, they recovered quite quickly and no longer required medical follow-up. In some cases of acute respiratory syndrome, however, symptoms are very severe and debilitating. In about ten percent of all cases, the infected person also dies. In severe cases, a recovery period is required after recovery. Lung and bronchial tissue attacked by the virus and by secondary bacterial infections needs some time to regenerate. People who have had SARS should therefore avoid overexertion as well as polluted air for some time. In addition, it is possible that the corona virus that causes SARS also attacks the spleen, nerves, and spine. Appropriate follow-up may be appropriate for SARS patients who also have other symptoms besides breathing and lung problems.
Here’s what you can do yourself
Severe acute respiratory distress syndrome is a highly contagious disease. Therefore, when infection is known in the social environment, sufficient protective measures should be taken to safeguard against possible transmission. The syndrome must be reported if infection is known. Therefore, cooperation with a physician is immensely important at the first irregularities and health impairments. Since the symptoms include an elevated body temperature, an adequate amount of fluids must be consumed. The body is at risk of dehydration if a fever persists. Since dehydration can become a life-threatening condition, several liters of water should be consumed daily. The disease places a great burden on the patient and the social environment. Therefore, it is especially important to remain calm. Panic should be avoided at all costs. The sleep hygiene of the affected person should be checked and optimized. Stress and hectic activity should be kept away from the patient. The organism needs all its strength and energy for the healing process. For this reason, disturbing factors and situations of emotional stress should be reduced to a minimum. The symptoms of the disorder can easily be mistaken for influenza. However, since a fatal course may occur, a diagnosis should be obtained from a physician as soon as possible. Spontaneous cure or recovery based on alternative healing methods is not expected.