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Preface

Summary

1. Timeline

2. Virology

3. Transmission

4. Epidemiology

5. Prevention

6. Case Definition

7. Diagnostic Tests

8. Clinical Presentation and Diagnosis

9. SARS Treatment

10. Pediatric SARS



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Summary

Severe Acute Respiratory Syndrome (SARS) is an acute respiratory illness caused by infection with the SARS virus. Fever followed by a rapidly progressive respiratory compromise is the key complex of signs and symptoms, which also include chills, muscular aches, headache and loss of appetite.

Mortality, initially believed to be around 3 %, may well be as high as 15 %. The WHO estimates that the case fatality ratio of SARS ranges from 0% to 50% depending on the age group affected: less than 1% in persons aged 24 years or younger; 6% in persons aged 25 to 44 years; 15% in persons aged 45 to 64 years; and greater than 50% in persons aged 65 years and older (WHO Update 49).

The etiologic agent of SARS is a coronavirus which was identified in March 2003. The initial clusters of cases in hotel and apartment buildings in Hong Kong have shown that transmission of the SARS virus can be extremely efficient. Attack rates in excess of 50% have been reported. The virus is predominantly spread by droplets or by direct and indirect contact. Shedding in feces and urine also occurs. Medical personnel, physicians, nurses, and hospital workers are among those commonly infected.

In the absence of effective drugs or a vaccine for SARS, control of this disease relies on the rapid identification of cases and their appropriate management, including the isolation of suspect and probable cases and the management of their close contacts. In the great majority of countries, these measures have prevented imported cases from spreading the disease to others.

At present, the most efficacious treatment regimen for SARS is still subject to debate. For patients with progressive deterioration, intensive and supportive care is of primary importance. Immunomodulation by steroid treatment may be important.


 

 
 
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