SARS Update to Date

Medical Author: Frederick Hecht, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

April 1, 2003 -- The New England Journal of Medicine has released two articles and an editorial about SARS (severe acute respiratory syndrome), well before they were scheduled to appear in the Journal, because of their important public health implications. The articles and editorial are designed to help physicians caring for patients who may have SARS . They are as follows:

"A Cluster of Cases of Severe Acute Respiratory Syndrome in Hong Kong" by K.W. Tsang and Others. This article outlines the clinical features of SARS based on the cases of 5 men and 5 women in whom SARS was diagnosed between February 22 and March 22, 2003 in Hong Kong. Exposure between the source patient and subsequent patients with SARS ranged from minimal to close. The incubation period was 2 to 11 days. All patients had fever (temperature over 38°C or 100.4°F for over 24 hours), and most of them had dry cough, dyspnea (difficulty breathing), malaise, headache, and hypoxemia (low blood oxygen). Nine of the 10 patients also had lymphopenia (low lymphocyte count) . Chest films showed progressive air-space disease. Two of the 10 patients died of progressive respiratory failure. Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name.