Severe Acute Respiratory Syndrome (sars)

GENERAL INFORMATION:

What is severe acute respiratory syndrome? Severe acute respiratory (RES-pir-ah-tor-e) syndrome (SIN-drom) is also known as SARS. This is a condition caused by a virus (germ) that damages the air sacs of the lungs. The lungs are the main organs of the respiratory system. They take oxygen from the air and allow carbon dioxide (gas) to escape from the body. With SARS, the lung tissues become inflamed (swollen) and fibrotic (scarred). The damaged air sacs do not allow oxygen to get into your bloodstream, which may cause respiratory failure. Respiratory failure means you cannot breathe well enough to get oxygen to the cells of your body. It may also cause a loss of function of other body organs.

What causes SARS? SARS is believed to have started as a disease of animals in China. Since then, it has spread to humans around the world. The SARS virus is related to other viruses that cause common colds and diarrhea (loose, watery stools). It may be found in saliva, sputum (spit), or discharge from the nose of infected people. The most common way that SARS may spread is by coughing or sneezing. It may also spread by shaking hands with an infected person who has not washed their hands or sharing utensils.

Who is at risk of getting SARS?

• Having close contact with someone who became sick within 10 days of returning from a SARS outbreak area.
  
  
• Living with, visiting, or caring for people that have SARS. Caregivers who have direct contact with infected people are at an increased risk of SARS.
  
  
• Traveling to areas where SARS has spread, such as mainland China, Hong Kong, Taiwan, or Canada.

What are the signs and symptoms of SARS? Signs and symptoms usually appear 4 to 10 days after you have been exposed to the SARS virus. The earliest and most common sign is a high fever and chills. Your body temperature might reach 100.4 degrees Fahrenheit (38 degrees Celsius) or higher. You may also have a headache, body aches and pains, and weakness. Coughing and shortness of breath may appear 2 to 7 days after the start of the first symptoms. Diarrhea, nausea (upset stomach), or vomiting (throwing up) are other symptoms. Crackling sounds may be heard by caregivers when listening to your lungs with a stethoscope.

How is SARS diagnosed? Caregivers may diagnose SARS based on your signs and symptoms and recent travel history. They may also want to know if you had a possible exposure to someone infected with SARS. You may also need one or more of the following tests:

• Blood gases: This test is also called an arterial blood gas or ABG test. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. The groin is the area where your abdomen meets your upper leg. Your blood is tested for the amount of "gases" in it, such as oxygen, acids, and carbon dioxide.
  
  
• Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Computerized tomography scan: This test is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your lungs. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the lungs, heart, and blood vessels show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
  
  
• Culture or assays: Respiratory fluids, such as mucus from the throat or nose, may be collected. A sample of your urine or bowel movement (BM) may also be sent to a lab for tests. These may show what germ is causing your disease and help caregivers know the best treatment for you.

How is SARS treated? There is no available medicine to treat SARS at this time. Caregivers may treat you depending on how bad your symptoms are. You may need one or more of the following:

• Medicines: You may be given medicines to relieve your fever, cough, and pain. Antibiotics or antivirals may also be given to fight germs. You may also need medicines to help decrease swelling in your lungs and help you breathe easier.
  
  
• Respiratory support: You may need extra oxygen, and sometimes a ventilator, to help you breathe easier.
  
  
  • Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if the mask or prongs bother you. Ask your caregiver before taking off your oxygen. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.
    
    
  • Endotracheal (ET) tube: An endotracheal tube may be put into your mouth or nose. It goes down into your windpipe to help keep your airway open and help you breathe. It may be hooked to a ventilator (breathing machine), and you may get extra oxygen through your ET tube. You will not be able to talk while the ET tube is in place.

How can SARS be prevented?

• When traveling:
  
  
  • Consider the risks of getting SARS before traveling to areas that have a public outbreak of SARS.
    
    
  • If you must travel to an area with a SARS outbreak, avoid being around large groups of people. You may also need to bring disposable (single-use) gloves or masks with you.
    
    
  • Wash hands often with soap and warm water. Germ-killing hand lotions or gels may also be used to clean hands when there is no water available.
  
  
• When caring for someone who has SARS:
  
  
  • Always wash your hands, especially before and after going into the room of a person infected with SARS.
    
    
  • Do not share beddings, linens, or eating utensils with a person who is infected with SARS.
    
    
  • Have the person infected with SARS wear a mask when others are in the room with him. If he cannot wear a mask, help him cover his mouth or nose when coughing or sneezing.
    
    
  • People who have been in close contact with an infected patient should be tested for SARS.
    
    
  • Place wet laundry in a plastic bag and use hot water and detergents (soap) when washing it.
    
    
  • Throw away paper tissue after it has been used to wipe or blow the nose.
    
    
  • Use alcohol or chlorine-based disinfectants (germ killers) when cleaning surfaces. Wear disposable (single-use) gloves, mask, and gown to protect yourself.

How can I prevent spreading SARS to others if I am infected?

• Avoid having visitors in your room, especially when you still have symptoms.
  
  
• Cover your mouth and nose with tissue when you sneeze or cough.
  
  
• Inform your caregivers that you may have SARS before they come in direct contact with you. This will warn them so they can protect themselves and their staff from the SARS virus.
  
  
• Stay away from others until your caregiver says you can no longer spread the SARS virus. You may need to stay home until you are free of SARS symptoms for 10 days or longer. Do not go to work, school, or other public areas until your caregiver says it is OK.
  
  
• Wash your hands before and after eating, touching things or people, and going to the bathroom.
  
  
• Wear a mask when other people are in the room with you.

Where can I get more information? Having SARS may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following for more information about SARS:

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta, GA 30333
  Phone: 1-404-6393311
  Phone: 1-800-3113435
  Web Address: http://www.cdc.gov
  

• World Health Organization
  Web Address: www.who.int
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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