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During this millennium, SARS has been identified as the first novel infectious disease. The disease came from Southern China in the late 2002. It is worth noting that the disease has an exceptionally high morbidity and mortality rate.
After originating, the disease affected close to eight thousand people within a period of six months. Approximately eight hundred people died. This emphasizes the need for immediate, relevant, and effective curative and preventive measures.
As a result, there is an imminent threat as far as respiratory medicine is concerned, as well as a challenge regarding the administration and development of antiviral drugs.
The disease is caused by SARS- CoV, a novel SARS- linked coronavirus (Ignatius et al, 2004: 1734). Carlo Urbani reported the first cases of the disease in Vietnam. Later, SARS was reported in China, Germany, USA, and Canada.
Incubation and Infection Period
The approximate incubation period of the disease is 2- 10 d. A 1 d incubation period was reported in three cases in Singapore, and four cases in China. It is not yet established whether the transmission route determines the incubation period.
Until today, there have been no cases of viral transmission before the onset of symptoms. There are no transmissions after the tenth day of fever.
Transmission is more common from critically ill patients, as well as those undergoing through extreme clinical weakening. This happens during the 2nd week of sickness (Groneberg, Hilgenfeld & Zabel, 2005: 8).
Efficiency and Route of Transmission
Basically, SARS is not precisely transmissible; approximately four secondary cases arise from primary ones. The infection is rarely transmitted by children. The infectious disease is basically transmitted via respiratory droplets.
This occurs when there is a close contact with a critically ill patient in household and hospital settings. It is worth noting that aerosol generating processes increase transmission of SARS in hospital settings. So far, there have been no reports on transmissions through water, food, vertical, and blood.
The oral- fecal route should not be underestimated, since there are several coronaviruses transmitted via this route (Grinblat et al, 2003: 804).
Signs and Symptoms
The clinical progression of the disease adheres to a typical pattern. The initial stage starts two to seven days subsequent to the incubation, and is similar to a flulike prodrome. It lasts for three to seven days, and has the following features; severe fever, anorexia, malaise, myalgias, chills, headache, and fatigue.
In a number of cases, other characteristics include coryza, sore throat, production of sputum, vomiting, nausea, diarrhoea, and dizziness. The second stage involves characteristics linked to the lower respiratory tract.
These include dyspnea, dry cough, progressive hypoxemia, and respiratory failure, which necessitate mechanical ventilation (Joseph et al, 2003: 2438).
If an individual is suspected of SARS, initial tests include blood cultures, pulse oximetry, and sputum gram tests (Rentz, 2003: 110).
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Treatment, Vaccines and Management
Majority of the patients with SARS develop immunity for the virus, which enables them undergo through the infection. This proves that the hope of developing a secure and effective vaccines.
The options for developing the vaccine are whole killed, live- attenuated, recombinant subunit, recombinant vectored, and epitope- based vaccines (Skowronski et al, 2005: 370).
According to the Centre for Disease Control, proven and suspected SARS patients should be given similar treatments as grave, community- acquired pneumonia.
Moreover, the patient should be isolated and offered serious treatment. Mechanical ventilation should be provided if necessary. Extensive communication with relevant stakeholders should be initiated.
Grinblat, L, Shulman, H, Glickman, A, Matukas, L & Narinder, P 2003, “Severe Acute Respiratory Syndrome: Radiographic Review of 40 Probable Cases in Toronto, Canada”, Radiographic Review of SARS, vol. 228 no. 3, pp. 802- 808.
Groneberg, DA, Hilgenfeld, R & Zabel, P 2005, “Molecular mechanisms of severe acute respiratory syndrome (SARS)”, Respiratory Research, vol. 6 no. 2, pp. 8.
Ignatius, TS, Yuguo, L, Tze, WW, Wilson, T, Andy, TC, Joseph, HW, Dennis, YC & Tommy, H 2004, “Evidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virus”, New England Journal of Medicine, vol. 350 no. 3, pp. 1731-1739.
Joseph SM, Kwok, YY, Albert, DM & Klaus, S 2003, “The Severe Acute Respiratory Syndrome”, The New England Journal of Medicine, vol. 349 no. 1, pp. 2431-2441.
Rentz, EJ 2003, “Viral Pathogens and Severe Acute Respiratory Syndrome: Oligodynamic Ag for Direct Immune Intervention”, Journal of Nutritional and Environmental Medicine, vol. 13 no. 2, pp. 109- 118.
Skowronski, DM, Astell, C, Brunham, RC, Low, DE, Petric, M, Roper, RL, Talbot, PJ, Tam, T & Babiuk, SL 2005, “Severe Acute Respiratory Syndrome(SARS): A Year in Review”, Annu. Rev. Med., vol. 56 no. 3, pp. 357–381.