SARS Outbreak 2003 - essay from class
SARS, Outbreak 2003
Donna Lynn Crain
Severe Acute Respiratory Syndrome (SARS) is a viral respiratory infection caused by a coronavirus. The first known case of SARS was in 2003. SARS comes from the same family of coronavirus as the common cold ("CDC - Remembering SARS – 10 Years Later", 2013). The first case of SARS was known to be in Asia. The disease quickly spread to over twenty four countries before being contained, including the United States ("CDC - SARS - Severe Acute Respiratory Syndrome3", 2013). There is not yet certainty, but the CDC reports that SARS most likely originated from animals. An animal that looks like a cat, but is not in China called palm civets is a suspect. The animals were found with SARS, and their handlers were found to have SARS in their blood. The animals are meat eaters in China, where SARS originated ("CDC - Remembering SARS – 10 Years Later", 2013).
Updated data from 2013 indicates over 8000 known cases of SARS. 774 of those people died, giving SARS a death rate of 9.6%. 1706 of the SARS cases were healthcare workers. China had the most incidences of SARS with 5327 cases and 349 deaths. Hong Kong was next with 1755 cases, 299 deaths. Taiwan had 346 cases with 37 deaths, and Singapore totaled 238 cases, 33 deaths. North America reached 251 cases, with deaths. All the deaths in North America were in Canada (Trivedi, 2013). Below is a map showing SARS cases:
World map illustrating (SARS) distribution from the 2002-2003. The greatest number of SARS cases were in mainland China, Hong Kong, Taiwan, and Singapore (red). Toronto and Ontario, Ontario (yellow), was the fifth-ranked area. Green represents the other countries reporting SARS cases. Map and data from MedScape’s webpage Severe Acute Respiratory Syndrome (SARS).
In February of 2003 the SARS outbreak began. The CDC was called on to assist in containing this illness. The illness spread to people who had been overseas, or to those in contact with people who had been overseas. The disease was spread through airborne droplets. Friends and family of the sick, as well as hospital workers, contracted the illness. This epidemic was so large that the CDC initiated its first travel warning. The CDC also suggested that standard precautions such as hand hygiene could help slow the spread of the disease. The CDC also activated its Emergency Operations Center (EOC). The center sent many out assist in finding a cause, a means of stopping and a possible vaccination for SARS. It is thought that air travel was a major catalyst in spreading the disease across the globe. The CDC has since developed more efficient ways to alert airline passengers of possible communicable diseases when traveling overseas ("CDC - Remembering SARS – 10 Years Later", 2013).
Symptoms of SARS include fever, respiratory distress, productive cough, headache, dizziness, nausea, vomiting, muscle aches and diarrhea: all likened to the common flu with the exception of this illness can be fast and deadly. Complications of SARS include heart failure, respiratory failure, and liver failure ("Severe acute respiratory syndrome (SARS) - National Library of Medicine - PubMed Health", 2013).
Preventions for SARS were hand hygiene, N95 masks, isolation for patients with SARS, negative pressure rooms and antibiotics for the bacteria causing pneumonia, antivirals, steroids, and oxygen therapy ("Severe acute respiratory syndrome (SARS) - National Library of Medicine - PubMed Health", 2013). There have been no known cases of SARS since 2004 worldwide ("CDC - SARS - Severe Acute Respiratory Syndrome3", 2013).
SARS originated in China and traveled far. In the United States, the virus was spread from persons who had traveled overseas or had been in close contact with a traveler. In a small rural area with a community hospital, the disease could wipe out the entire county. Even with today’s knowledge, people are still seen to shake hands with someone walking up to their dining table in a restaurant and then continue handling their food. Unfortunately, some nurses go from patients rooms without hand hygiene; some even ignore the sign on the patient’s door reflecting isolation precautions. Another pitfall for spreading illness is not taking alert at the initial signs. Too often health care providers assume “it’s just the flu - or a cold.”
Graphics are included to illustrate how SARS could be transmitted to many people. When patients are placed in rooms together, SARS could infect other patients in the room if one of the patients has the disease. This can be done through droplets from sneezing or coughing. The disease can also be transmitted if a healthcare provider doesn’t wear personal protective items such as gloves, masks and gowns. A healthcare worker can carry disease on her hands or clothing. Providing care to patients without cleaning hands can also transfer disease from one patient to another. The healthcare provider is also at risk of catching disease if she is not diligent in wearing gloves, masks and gowns, as well as cleaning hands after patient contact.
Visitors in to see patients can carry disease in to the patients room, as well as catch disease from the patient. Visitors should wear protective items such as a gown, masks, and gloves as appropriate when visiting their friends or family in the hospital. The protective wear protects the patient and the visitor. When leaving the patient’s room, both staff and visitors should remove the protective wear, place in appropriate trash receptor and clean hands.
After a person has been exposed to a disease, he can carry it without knowing it. A person can then board an airplane, sitting in a closed space with other people. The person carrying the disease can spread it to others either by cough, or contact with the bacteria or virus on items frequently touched that have been contaminated.
Upon exiting the plane, the passengers have been exposed to SARS. Each person has potential to carry the disease, even if they do not become sick. Now the people the airplane passengers come in contact with are at risk for contracting SARS. An example could be a husband going home, and greeting his wife with a hug and kiss at the door, or sitting down for a family dinner and touching shared items. Another could be the business traveler going into the office for a meeting, and shaking hands with co-workers after sneezing on his hands. And the cycle goes on and on, infecting many people and being carried many places.
When an illness such as SARS is discovered in the community, it should be reported to the proper channels. Reporting early cases is vital to preventing an epidemic. According to the CDC, proper channels are through local health departments. The CDC offers contact information to notify of outbreaks on their website title Mandatory Reporting of Infectious Disease by Clinicians ("Mandatory Reporting of Infectious Diseases by Clinicians", 2001). The state of South Carolina designates DHEC as the controlling office of communicable diseases. DHEC lists diseases with how urgently they should be reported, and to who that disease should be reported to ("SCDHEC: Bureau of Disease Control", 2013).
Some common things to recommend to patients with asthma during bad air days are to limit outdoor exercise, if severe asthma present, limit time outside. If an asthma patient must be outside, suggest they wear a mask. Always keep the prescribed quick rescue inhaler handy. Asthma patients should keep track of air quality and know what to do when presented with compromising circumstances.
CDC - Remembering SARS ? 10 Years Later. (2013, April 11). Retrieved April 5, 2014, from http://www.cdc.gov/about/history/sars/feature.htm
CDC - SARS - Severe Acute Respiratory Syndrome3. (2013, April 16). Retrieved April 5, 2014, from http://www.cdc.gov/sars/
Mandatory Reporting of Infectious Diseases by Clinicians. (2001, May 2). Retrieved April 5, 2014, from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001665.htm
SCDHEC: Bureau of Disease Control. (2013). Retrieved April 5, 2014, from http://www.scdhec.gov/health/disease/reportables.htm
Severe acute respiratory syndrome (SARS) - National Library of Medicine - PubMed Health. (2013, January 28). Retrieved April 5, 2014, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004460/
Trivedi, M. N. (2013, September 30). Severe Acute Respiratory Syndrome (SARS). Retrieved April 15, 2014, from http://emedicine.medscape.com/article/237755-overview#a0156