Questions About Severe Acute Respiratory Syndrome (SARS)

A respiratory illness has emerged in recent months in Canada, China, Hong Kong Special Administrative Region of China, Indonesia, Philippines, Singapore, Thailand and Vietnam, presenting a worldwide public health threat. This atypical pneumonia has been named Severe Acute Respiratory Syndrome (SARS) by World Health Organization (WHO).

SARS is an infectious disease of the respiratory system characterized by atypical inflammation of the lungs (pneumonia). While the specific cause of SARS is unknown, CDC scientists have detected a previously unrecognized coronavirus in patients with SARS. These findings are preliminary and do not provide conclusive evidence that coronavirus is the cause of SARS. While the new coronavirus is still the leading hypothesis for the cause of SARS, other viruses are still under investigation as potential causes.

The Centers for Disease Control and Prevention (CDC) has been working with WHO since late February to investigate and confirm outbreaks of this severe form of pneumonia in Vietnam, Hong Kong, and parts of China. Currently there are no confirmed cases identified to date in the United States; however, there are suspect cases under investigation.

The origin of SARS has not been definitively identified at this time; however the disease is thought to be caused by a previously unrecognized coronavirus. It appears to be spread from person to person through droplet transmission when in close contact with a person with SARS. Medical personnel have been encouraged to implement airborne and contact infection control precautions until routes of transmission have been identified. SARS is an emerging disease. Knowledge about its clinical behavior, response to treatment, and modes and risks of transmission are continually evolving.

Early symptoms in patients with this SARS have included fever (>100°F), muscle aches, dry cough, shortness of breath or difficulty breathing. In some cases, these symptoms are followed by low blood oxygen, pneumonia, and occasionally acute respiratory distress and death.

Frequently Asked Questions

Q1. Where did Severe Acute Respiratory Syndrome (SARS) come from?
A1. SARS is an infectious disease of the respiratory system characterized by an atypical inflammation of the lungs (pneumonia). While a definitive identification has not been made, CDC announced that its scientists have detected a previously unrecognized coronavirus in patients with SARS. These findings are preliminary and do not provide conclusive evidence that coronavirus is the cause of SARS.

Q2. What is atypical pneumonia?
A2. Pneumonia is an infection of one or both lungs which is usually caused by a bacteria, virus or fungus. Atypical pneumonias appear different from ‘classic’ presentations of this infection and may be more viral in nature. Pneumonia is the sixth leading cause of death in the United States.

Q3. What is coronavirus?
A3. Coronaviruses are a group of viruses that are a common cause of mild to moderate upper-respiratory illness in humans. Coronaviruses can survive in the environment for as long as three hours. They are associated with respiratory, gastrointestinal, liver and neurologic disease in animals. These viruses have a halo or crown-like (corona) appearance when viewed under a microscope.

Q4. How is SARS transmitted?
A4. The disease appears to be spread from person to person through droplet transmission when in close contact with a person with SARS. For example, when someone sick with SARS coughs or sneezes, they disperse droplets into the air and someone else breathes them in.

It is possible that SARS can be transmitted more broadly through the air or from objects that have become contaminated. Coronaviruses can survive in the environment for as long as three hours. Close contact in this case is defined as having cared for, having lived with or having had direct contact with respiratory secretions and body fluids of a person with SARS.

Q5. What are the symptoms of SARS?
A5. Main symptoms and signs include high fever (>100.4°F/38°C), dry cough, muscle aches, shortness of breath or breathing difficulties. SARS may be associated with other symptoms, including headache, muscular stiffness, loss of appetite or tiredness (malaise).

Q6. What is the incubation period (i.e., time from infection to onset of disease symptoms) for SARS?
A6. The incubation period is usually 2 to 7 days, with 3-5 days being most common.

Q7. What has CDC recommended to prevent transmission of SARS in households?
A7. CDC has developed interim infection control recommendations for patients with suspected SARS in the household. The basic precautions include the following:

Q8. Is there a test for SARS?
A8. No "test" is available yet for SARS. And while coronavirus has not been definitively proven to be the cause of SARS, CDC, in collaboration with WHO and other laboratories, has developed two research tests that appear to be very promising in detecting antibodies to the new coronavirus.

Q9. What should I do if I think I have symptoms of SARS?
A9. If you are ill with a fever of over 100.4 °F (>38.0°C) that is accompanied by a cough or difficulty breathing, or that progresses to a cough and/or difficulty breathing, you should consult a health care provider. To help your health care provider make a diagnosis, tell them about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

Q10. What should I do if I have recently traveled to a country where cases of SARS have been reported?
A10. You should monitor your own health for 7 to 10 days following your return. If you become ill with a fever of over 100.4 °F (>38.0°C) that is accompanied by a cough or difficulty breathing, or that progresses to a cough and/or difficulty breathing, you should consult a health care provider. To help your health care provider make a diagnosis, tell them about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

Q11. What is the treatment for SARS?
A11. While some medicines have been tried, because the cause of the disease has not been definitively identified, no drug can, at this time, be recommended for prevention or treatment. Antibiotics do not appear to be effective. Symptoms should be treated by adequately protected health professionals.

Q12. How many cases of SARS have occurred in the U.S.?
A12. No cases have been confirmed to date in the United States; however, 85 suspect cases are currently under investigation.

Q13. Are there any travel restrictions related to SARS?
A13. A CDC travel advisory recommends individuals who are planning nonessential or elective travel to mainland China, Hong Kong, Hanoi, Vietnam, or Singapore consider postponing their trip until further notice. For additional information about travel advisories, check www.cdc.gov/travel, which will be updated as necessary. WHO recommends screening of air passengers departing from a small number of affected areas on flights to another country.

Q14. Is there any reason to think SARS is or is not related to bio-terrorism?
A14. Information currently available about SARS indicates that people who appear to be most at risk are either health care workers taking care of sick people or family members or household contacts of those who are infected with SARS. That pattern of transmission is what would typically be expected in a contagious respiratory or flu-like illness. There is no indication that SARS is linked to bio-terrorism.

This information has been compiled from materials provided by several federal agencies. For additional information or resource documentation, please reference the Web sites below.

http://www.cdc.gov/ncidod/sars/index.htm

http://www.who.int/csr/sars/en/

http://www.redcross.org