Severe Acute Respiratory Syndrome

News of an unidentified and potentially fatal respiratory infection spreading from South East Asia has sent shivers down the spine of many health professionals. For some it rang warning bells of the long heralded arrival of a new form of flu that might have the potential to repeat the epidemic that killed millions around the world in the early 20th century. For others it brought back memories of the early days of HIV and AIDS, when unusual and severe lung infections were one of the major features of a mysterious new illness that couldn't be explained by the medical knowledge of the day.

The syndrome first appeared in the Guangdong province of China in November 2002 but was not reported to the World Health Organisation (WHO) at that time. Then one of the doctors who had been treating people with the syndrome, a Chinese professor of respiratory medicine, became ill. Travelling to Hong Kong, he carried the highly contagious virus that causes SARS with him, leading to an explosion of cases in the province towards the end of February 2003.

Since then, in just a few weeks, international air travel has spread it around the world. By the end of March 2003 a total of 1,622 cases and 58 deaths had been reported .

Cases have been reported in China, Canada, Italy, Thailand, the UK, the USA and many other countries. In four of these countries, including the UK, there have only been 'imported cases' in travellers from abroad, with no known local transmission. This means that the disease is not spreading in these countries and residents of the country are not at risk.

But despite early reports that the outbreak had peaked and the number of those infected was falling, new reports (including an outbreak in a Hong Kong apartment block) are causing renewed concern. In the USA, the Center for Disease Control and Prevention (CDC) has said that the new developments may point to what could become a much larger epidemic.

Now SARS is almost under control. China has reported no new cases in last two weeks.

What causes Severe Acute Respiratory Syndrome (SARS)?
Severe Acute Respiratory Syndrome (SARS) doesn't seem to be related to influenza, and it certainly has nothing to do with HIV, but scientists have yet to pin down exactly what infectious organism is to blame.

The prime suspect at the moment is a type of virus called a coronavirus which is known to cause respiratory infections. But scientists who have sequenced the DNA of the virus say that it is not identical to known coronaviruses seen before, and it may be a new strain. Alternatively there may be a combination of different infectious organisms, especially in severe cases.

Researchers in Hong Kong have developed a test to rapidly identify cases of SARS based on a coronavirus test, and have recommended that the syndrome is renamed 'coronavirus pneumonia' or CVP.

What are the symptoms of SARS?

The symptoms of SARS are the typical symptoms of a severe respiratory infection. There have only been a few cases of SARS reported in the UK so far, so if you have symptoms like these it is far more likely that you don't have SARS but instead have a more typical form of pneumonia usually seen in this country . However if you have recently returned from abroad, particularly South East Asia where the outbreak began, you may be at risk.

For SARS to spread there must be close contact with an infected person. Most of those who have developed SARS in South East Asia have been either hospital workers caring for SARS patients, or close family members based in those countries. However, because of the speed of international travel, cases have rapidly spread around the world. SARS appears to be less infectious than influenza, and the incubation period is short, from 2-7 days.
Symptoms of Severe Acute Respiratory Syndrome

The main symptoms of SARS are:

  1. High fever (> 38°C).
  2. Dry cough.
  3. Breathing difficulties or shortness of breath.
  4. Headache.
  5. Muscular aches and stiffness.
  6. Loss of apetite.
  7. Malaise or tiredness Confusion.
  8. Rash.
  9. Diarrhoea.

Top Tips

  • If you or one of your family develop symptoms of breathing problems of any sort, talk to your doctor as soon as possible.
  • Try not to worry too much about SARS - it is still very rare especially if you haven't been abroad recently.
  • If you have recently travelled, particularly to countries like China or Hong Kong, you may be at greater risk.
  • The Department of Health now recommend that people travelling to Hong Kong Special Administrative Region of China and Guangdong Province, China should postpone all but essential travel until more is known about SARS. There is not yet any need to cancel or change travel arrangements to any other country.
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