Severe acute respiratory syndrome

The severe acute respiratory syndrome (SARS), or severe acute respiratory syndrome (SARS), also known by its acronym SARS (severe acute respiratory syndrome), is an atypical pneumonia caused by the SARS-CoV coronavirus that appeared by for the first time in November 2002 in Foshan, Guangdong province in China, that first month the first 66 cases were registered, the cases were doubling until it reached the peak of infections. It spread to neighboring Hong Kong and Vietnam in late February 2003, when there were 528 infected, and then to other countries through air or ground travel by infected people. The disease has had an average global mortality rate close to 13%, by the end of June 2003 it reached its peak with 8,448 infected.

The mortality rate varied in each country, which can be partially explained by differences in reporting. It should be noted that this rate does not take into account possible future deaths resulting from the disease or from unreported cases of SARS due to not showing known symptoms. On April 19, 2003, Harvard researcher Henry Niman updated the death rate to 18.2% for Canada and Hong Kong.

Coronavirus sculpture located at the UNAM Biomedical Research Institute, Mexico

The chances that people with SARS could remain 'asymptomatic,' meaning carriers could blend into the population without treatment, are small, according to officials at the SARS WHO (2003).

Although in March 2003 some scientists classified SARS as a paramyxovirus, the World Health Organization (WHO) and laboratories later classified this virus as SARS-CoV, a type of coronavirus not previously known in human beings. humans.

History

Outbreak in China

A chest X-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS.

The virus originated in Yunan province and the outbreak appears to have started in Guangdong province in November 2002, and in early April 2003, SARS began to receive increased attention in the world. official media. However, also in early April, allegations surfaced regarding unregistered cases in Beijing's military hospitals. After intense pressure, Chinese officials allowed international officials to investigate the situation.

At the end of April, important revelations came to light, when the Chinese government admitted having reported fewer cases than actually existed, due to problems inherent in the health system. After hiding the outbreak until it reached an international scale, two top Chinese officials have been ousted and systems are being adapted to improve disclosure and control in the SARS crisis. Since then, China has taken a much more active and transparent role in combating the SARS epidemic.^{[citation needed]}

Spread to other countries

On March 15, 2003, the WHO announced a global alert, followed by a health alert from the US Centers for Disease Control and Prevention (CDC). As of April 15, 2003, the WHO recognized 2,112 reported cases and 154 deaths. The WHO announced that up to that date local transmission of SARS had occurred in Toronto, Singapore, Hanoi, Taiwan, and the Chinese regions of Guangdong, Hong Kong, and Shanxi.

The Atlanta-based Centers for Disease Control and Prevention announced in early April its conviction that a rare type of coronavirus, possibly a type never seen before in humans, is the agent infectious agent responsible for the spread of SARS.

Minor sprouts

At the end of April 2003, some 500 people were under quarantine in Beijing and Anhui province. Laboratories that investigate the disease are also inspected.

probable cases of SARS by country or territory (WHO), 1 November 2002 - 31 July 2003

Country or region	Cases	Deaths	Latvian rate (%)
China	5327	349	7
Hong Kong	1755	299	17
Taiwan	346	37	11
Canada	251	43	17
Singapore	238	33	14
Vietnam	63	5	8
United States	27	0	0
Philippines	14	2	14
Thailand	9	2	22
Germany	9	0	0
Mongolia	9	0	0
France	7	1	14
Australia	6	0	0
Malaysia	5	2	40
Sweden	5	0	0
Italy	4	0	0
United Kingdom	4	0	0
South Korea	3	0	0
India	3	0	0
Indonesia	2	0	0
South Africa	1	1	100
Spain	1	0	0
Ireland	1	0	0
Kuwait	1	0	0
Macao	1	0	0
New Zealand	1	0	0
Romania	1	0	0
Russia	1	0	0
Switzerland	1	0	0
Total	8096	774	9.6

Propagation

The way the disease is transmitted is still not very clear, although it is suspected that it is transmitted mainly through direct contact between people. The virus can be spread by inhalation of droplets expelled by an infected person when they cough or sneeze, or possibly through contact with secretions on objects.

In addition, the WHO reports that there has been no case in which contact with products, animals or materials from areas affected by SARS has been a source of infection for people. Therefore, there are no reasons to believe that external contact with postal items (letters, packages, press, etc.) or goods arriving from areas affected by SARS constitute a risk to public health.

Symptoms and Treatment

The WHO recommends that suspected cases be isolated and defines a suspected case as a person who after February 1, 2003 presents a history of:

• high fever (purchase38 °C) (100.4 °F) and
• one or more respiratory symptoms, including cough, shortened breathing, shortness of breath, signs of hypoxia or a diagnosis of pneumonia and

• one or more of the following:
  • close contact with a person suspected of having SARS or
  • recent history of travel to SARS documented transmission areas.

A probable case is defined as a suspected case with the additional finding of pneumonia or respiratory syndrome by chest x-ray or autopsy.

With the availability of diagnostic tests for the coronavirus responsible for SARS, the WHO added the category of laboratory-confirmed SARS for patients who fall into the category of probable case, they did not yet have radiological changes, but they did have a positive test for SARS based on the named tests (ELISA, immunofluorescence or PCR).

Frequently the number of leukocytes and platelets is low. The first results suggest that there is a relative neutrophilia and a relative lymphopenia (relative because the total number of leukocytes tends to be low, that is, there is leukopenia). Other suggestive laboratory tests are an elevated lactate dehydrogenase (LDH) index and slightly elevated creatine kinase (CK) and C-reactive protein levels.

Symptoms usually appear 2-10 days (up to 13 days have been reported) after infection (in most cases symptoms appear within 2-3 days after infection). In about 10-20% of cases, symptoms are so severe that patients must be placed on a breathing apparatus.

Antibiotics are ineffective. Initially, the anecdotal use of steroids and the antiviral ribavirin as treatment was discussed, but recent experience does not provide any scientific evidence to support this hypothesis. The CDC is testing other antiviral drugs against coronaviruses to see if they can make specific recommendations.

As of 2017, there is no cure or protective vaccine for SARS that is safe and effective in humans. The identification and development of new vaccines and drugs for the treatment of SARS is a priority for governments and public health agencies around the world. world.

This graph represents the evolution of the person with probable infection, from various countries and the mortality ratios in the last 2 weeks.- .- Probably infected person = Accumulated case - Number of deaths- - Number of discharges. - Mortality ratio = Deaths / (Deaths + Discharges) - (Source: WHO WEB SITE. Updated 07/06/03)

Other denominations

• Severe acute respiratory syndrome (SARS).
• Atypical pneumonia.
• Asian pneumonia.