1 / 29

Severe Acute Respiratory Syndrome (SARS)

Severe Acute Respiratory Syndrome (SARS) . Epidemiology & Clinical Management. WHO Western Pacific Regional Office April 18, 2003. Epidemiology & Clinical Management. Background Chronology Epidemiology Case Definitions Clinical Picture Clinical Management Summary - SARS. Background.

Download Presentation

Severe Acute Respiratory Syndrome (SARS)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Severe Acute Respiratory Syndrome (SARS) Epidemiology & Clinical Management WHO Western Pacific Regional Office April 18, 2003

  2. Epidemiology & Clinical Management • Background • Chronology • Epidemiology • Case Definitions • Clinical Picture • Clinical Management • Summary - SARS

  3. Background • Approximately 3293 cases in 22 countries as at 16 April 2003 • At least 159 deaths • A significant number of cases have been in health care workers

  4. Chronology • SARS, an atypical pneumonia of unknown aetiology, was recognized at the end of February 2003 • The World Health Organization (WHO) is coordinating the international responses to provide epidemiological, clinical and logistical support as required

  5. Chronology • 11 February :Chinese health officials reported “atypical pneumonia” in Guangdong Province, China; 305 cases/5 deaths (Nov02–Feb03) • 19 February :Hong Kong confirms human infection ofInfluenza H5N1 • 5 March : Outbreak in Hanoi recognized • 12 March :Hong Kongreports SARS outbreak • 14 March :Singapore reports 3 SARS cases • 15 March : The disease spread to outside Asia (Canada, Germany)

  6. Chronology WHO initiates : • Global Alert (12 March) • Travel Advisory (15 March, 2 April) • Enhanced global surveillance • Global Outbreak Alert and Response Network • Specific Global Networks (Lab, Case Management, Epidemiology)

  7. Chronology Activities since then : • travel advisories have been issued indicating non-essential travel to affected areas should not occur. • The global laboratory network has diagnosed the probable cause.

  8. Epidemiology • Cause : New Corona Virus • Recent evidence of new corona virus identified with aetiological co-factors ? involved • Highly infectious

  9. Epidemiology • Means of transmission • Evidence of person to person transmission • Close contact with body fluids (especially respiratory droplets ) • Contaminated hands, clothes, equipment; environment may also be important

  10. Epidemiology • Incubation period • 2 –10 days and up to 13 days in exceptional cases • Onset and duration of infectivity unknown • Organism survival in environment • Duration unknown • Other corona virus are known to survive for up to 4 hours

  11. Case Definitions A person presenting after 1 February 2003 with a history of: Suspect SARS Case • High fever >38 0C • AND • One or more respiratory symptoms including cough, shortness of breath or breathing difficulty • AND one or more of the following: • Close contact, within 10 days prior to onset of symptoms with a person diagnosed with SARS; • History of travel, within 10 days prior to onset of symptoms to an affected area (see archive of Affected Areas at http//www.who.int./csr/sars/en/).

  12. Case Definitions Explanations: Close contact : having cared for, lived with, or had direct contact with the respiratory secretions or body fluids of a suspect or probable case of SARS. Affected area : an area in which local chain(s) of transmission of SARS is/are occurring as reported by the national public health authorities.

  13. Case Definitions Probable Case A suspect case with chest X-Ray findings consistent with pneumonia or respiratory distress syndrome (RDS) OR A suspect case with an unexplained illness resulting in death, with autopsy examination demonstrating the pathology of RDS without an identifiable cause.

  14. Clinical Picture – Onset / Presentation • Sudden onset of high fever with myalgia, chills, rigors and a non-productive cough • Most cases have bilateral pneumonia • ~ 90% begin to recover from day 6 or 7

  15. Clinical Picture – Onset / Presentation • Rapid deterioration in 10% (+/-) of cases • Acute RDS • Require ICU admission & mechanical ventilation • Case fatality rate: ~ 4% • No specific treatment available

  16. Clinical Picture – Management • SUPPORTIVE TREATMENT • Antibiotic Therapy : to cover causative organisms • Prophylactic Antibiotic Therapy : to prevent secondary bacterial infection • Maintain oxygenation : • intubate and ventilate as necessary

  17. Clinical Picture – Management • SUPPORTIVE TREATMENT • Avoid interventions which may cause aerosolisation of • respiratory secretions: • Bronchoscopy • Nebulised bronchodilators • Chest physiotherapy • Gastroscopy • Any procedure / intervention that may release respiratory secretions

  18. Clinical Picture – Management SUPPORTIVE TREATMENT In severe cases corticosteriods and ribavirin have been used, however there is no evidence to support their general or routine use at this stage.

  19. Summary – SARS • Multi - Country Outbreak • New Pathogen: • Corona Virus family • Clinical Picture: • Fever and respiratory symptoms • ~ case fatality rate currently 4% • Transmission: • Close contact with symptomatic case(s) • Contaminated hands and objects

  20. Summary – SARS • Prevention & Control: • Identification • Isolation of suspect and probable cases • Tracing & Monitoring of close contacts • Barrier nursing techniques for all suspect and probable cases • Public Education • Health care workers are currently at greatest risk therefore : • barrier nursing techniques are essential.

  21. Barrier Nursing Techniques Barrier nursing techniques are designed to prevent either : • The patient infecting other people (routine B/N) or • The patient beinginfectedby others (reverse B/N) Strict routine barrier nursing must be used for all SARS patients.

  22. Can You Now Answer These Questions? • What is SARS? • What causes SARS? • When and where was SARS first reported? • How many cases have been reported to date? • What is the main transmission route for SARS? • How infectious is SARS? • Who is at risk from SARS?

  23. Can You Now Answer These Questions? • What are the clinical symptoms? • How should SARS patients be managed? • What should you do if some-one is exposed to the SARS virus? • How should you manage the close contacts of a person with SARS? • What steps should you take to minimise the risk of spreading SARS?

  24. Take Home Messages • New member of the Corona Virus family • Evolving disease : • Incubation period, Prodrome, Lower respiratory phase • Patient management, including isolation • Prevention & control

  25. Epidemiology & Clinical Management We hope YOU have learnt something about SARS : • Its Epidemiology • The Clinical Picture • Clinical Management – so far • Preventing & Controlling Transmission Thank you for listening.

More Related