By John Messmer, M.D., Penn State Milton S. Hershey Medical Center
Over the past two years the public has been faced with fears about anthrax, the threat of smallpox and now a new disease to worry about -- severe acute respiratory syndrome (SARS). It has quickly become the health story of the moment, but SARS is actually an old virus with a new presentation.
What is it?
SARS is caused by a Coronavirus, a type of virus that has been identified since 1965, although its presence was recognized well before that. Under the electron microscope, the Coronavirus looks like a crown viewed from above, hence the name.
The Coronavirus usually causes respiratory infections. This new version which causes SARS has apparently had a change in its genes (this one has RNA rather than DNA) which makes its infection more aggressive. Respiratory viruses can move from human to animal and back mixing up the genetic material. This is how the influenza virus changes and scientists suspect this is what happened with SARS.
The disease apparently started in Southeast Asia. Most of the patients seem to have contracted it there or have been exposed to someone who was there. So far, a handful of people in Pennsylvania have been identified as having possibly contracted SARS but an actual diagnosis has not been confirmed. While a few reported cases of SARS may be frightening, it hardly qualifies as an epidemic.
How does it spread?
SARS seems to spread by close contact between people. Although its not known for sure, the disease may be like cold viruses which we pick up on our hands then touch our eyes, nose or mouth or like influenza virus which can pass through droplets in the air. Scientists are still studying whether the virus can spread other than by person-to-person contact.
What are the symptoms?
The early signs of infection are not specific. They include: fever, body aches, and mild respiratory symptoms. It progresses in 2-7 days to cough and shortness of breath and can become a severe pneumonia. It can be fatal in about 3 percent of cases, usually older people or those with heart disease or diabetes. So far, children under 15 have not been commonly affected. Most cases have involved people between the ages of 25 and 70.
How do I protect myself?
As with other respiratory viruses, clean hands are key. Wash or use an alcohol based hand sanitizer especially if in contact with people who might be ill. Don't touch your eyes, nose or mouth unless you have just washed your hands.
You have probably seen pictures of people in Asia with surgical masks over their faces. Surgical masks are not made to protect the wearer - they are designed to keep the wearer from spreading infection to anyone else. People who have returned from Southeast Asia or Toronto with a cold or fever should wear a mask until they are well. If you are in close contact with someone who may have contracted SARS, wearing a surgical mask is still a reasonable idea as is frequent hand-washing and other good hygiene practices.
Is there a test for SARS?
Not yet, but scientists are working on it. At this time, anyone with signs of SARS will be treated as in any severe pneumonia. Blood samples can be sent to special labs to look for the virus, but there is no readily available test.
How is it treated?
There is not a vaccine or specific treatment available yet for SARS but work is ongoing. Although the infection can be severe, it is not often fatal. While the disease has earned heightened world wide media attention, so far no one in the U.S. has died from the disease. It is preventable with a little knowledge.
Should I worry?
SARS is so new—and the center of so much media attention—that it's difficult to view it calmly. When Legionnaire's disease was first discovered, the lack of experience with it caused much fear. Similarly AIDS was the source of much anxiety until it was better understood. SARS seems about as dangerous as influenza. If we give it the same respect we give influenza, we can better manage our fear of SARS even as researchers and infectious disease specialists try to learn how to control the virus itself.
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For a complete summary of how Penn State is responding to the global SARS epidemic, including precautions taken and advice being provided to students, faculty and staff, go to http://live.psu.edu/story/2901
For a fact sheet on SARS provided by Penn State's University Health Services, go to http://live.psu.edu/story/2674
For a Q&A about SARS with specific information for the Penn State community, go to http://live.psu.edu/story/2673
For the latest SARS information and alerts from the Centers for Disease Control and Prevention (CDC), go to http://www.cdc.gov/ncidod/sars/
For the latest SARS information and alerts from the World Health Organization (WHO), go to http://www.who.int/csr/sars/en/
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Please be advised that information about SARS is changing daily. Please refer to the CDC Web site (http://www.cdc.gov) for the most up-to-date information about SARS.
Updates on the SARS infection are at http://www.who.int/en/ and
http://www.cdc.gov/ncidod/sars