Introduction

• SARS was initially reported in southern China, but at this time there are reports from several regions including Asia, Europe and Australia. In February 2003, the World Health Organization (WHO) announced the first SARS outbreak, which ended in July 2003.
• A virus known as SARS-associated coronavirus causes the illness.

Risk factors for SARS

• Close contact within the previous 10 days with a probable case of SARS.
• Recent travel within the previous 10 days to a WHO reported “affected area” in Asia.
• Recent travel or visit within the previous 10 days to a defined setting that is associated with a cluster of SARS cases (e.g. hospital )

SUSPECT CASE if 4 of the following criteria are present :-

• A person presenting with fever (oral temperature over 38’C)
• One or more symptoms of cough, shortness of breath, difficulty breathing. (Infants and young children may have non specific complaints such as lethargy, irritability and loss of appetite)
• One or more of the following :
  • Close contact (having lived with or had face-to-face contact, or having had direct contact with nasal secretions, phlegm and/or body fluids of a person with SARS)
  • Recent travel within 10 days of onset of symptoms to a WHO reported “affected” are in Asia.
  • Recent travel or visit within 10 days of onset of symptoms to a hospital where there are SARS cases.
• No other known cause of current illness

PROBABLE CASE

• A person meeting the suspect case criteria and lung infections of unknown cause.

Symptoms and signs

It takes 2 to 7 days to develop this illness after exposure to the SARS virus. Infants and young children

• Fever over 38 degrees celcius
• Cough, shortness of breath, breathing faster than usual
• Loss of appetite
• Lethargy, irritability

Older children

• Fever over 38 degrees celcius
• Cough, difficulty breathing, shortness of breath, breathing faster than usual
• Loss of appetite
• Headache, feeling tired, body ache
• Diarrhoea

Sometimes the headache may resolve, and fever, chills and shakes start shortly after that. The cough, shortness of breath and rapid breathing may not start for 2-3 days later.As the illness progresses, about 20-30% of children may develop lung infections.

Spread of SARS

• When a person with SARS coughs or sneezes without covering his or her mouth.
• Kissing, hugging, or sharing eating utensils
• Touching an object with germ droplets, then touching the mouth, nose or eyes.
• It is not known if SARS can spread more broadly through the air.

Test for SARS

• PCR test (method of detecting the genetic contents of a virus) can detect SARS virus in blood, stool, nasal discharge.
• SARS virus antibody test after infection, in blood. (Antibodies are substances made by the body’s immune system to fight a specific infection).
• Virus growth and isolation. (For a viral culture, a sample of fluid or tissue that may be infected is placed in a container along with cells in which the virus can grow. If the virus grows in the culture, it will cause changes in the cells that can be seen under the microscope)

Treatment

• Initial treatment for lung infection with antibiotics.
• No specific antiviral agent is available although ribavirin has been used.

For Further Information

• your doctor
• local health clinic
• Center for Disease Control and Prevention, www.dph.gov.my or at tel : 03-88833888

Frequently Asked Questions (FAQ)

• What should I do to protect my child?
  • Wash your child’s hands regularly with soap and warm water.
  • Follow public health recommendations in a SARS affected area.
  • Your child can safely attend school, daycare and social events as there is no indication of spread in the community.
  • If your child has been exposed to someone who is not ill but has traveled to an area affected by SARS, you do not need to isolate your child.

Consult your local health clinic doctor or paediatrician. It is important to contact your doctor by telephone ahead of time, rather than just showing up at the clinic. Please tell your doctor about about all recent travels, including to regions where cases of SARS have been reported and whether your child was in contact with SARS or a person with complaints consistent with SARS. If your child is old enough, provide a mask to wear to protect others.

The Center for Disease Control and Prevention, Ministry of Health, Malaysia has worked closely with the World Health Organization (WHO) and other global partners to address the SARS outbreak.

• What should I do if I believe my child has SARS?
• What’s being done about SARS ?

References

• Paediatric Approach to SARS , Hospital for Sick Children, Toronto, Canada.
• Severe Acute Respiratory Syndrome ( SARS ) Fact Sheet, Children’s Hospital of Pittsburgh.
• Respiratory Disorders ‘ Severe Acute Respiratory Syndrome ( SARS ) Fact Sheet, Lucile Packard Children’s Hospital at Standford.
• Severe Acute Respiratory Syndrome ( SARS ) General Information, Canadian Paediatric Society.
• Children and SARS , About : Paediatrics, U.S.A.
• FAQs about Severe Acute Respiratory Syndrome ( SARS ), Center for Disease control and Prevention, U.S.A
• SARS : What Parents Need to Know , KidsHealth, Nemours Foundation, U.S.A.