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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• Severe acute respiratory syndrome (SARS) facts
• What is severe acute respiratory syndrome (SARS)?
• What causes SARS? How is SARS transmitted?
• What are risk factors for SARS?
• What are SARS symptoms and signs?
• How is SARS diagnosed?
• What is the treatment for SARS?
• What is the prognosis of SARS?
• Can SARS be prevented?
• Where can people get more information about SARS?
• Severe Acute Respiratory Syndrome (SARS) Index

SARS-CoV is detected using enzyme-linked immunoassays (EIA) or reverse transcriptase polymerase chain reaction (PCR) tests, which are available through state public-health departments. These tests are performed on a sample of respiratory secretions or blood. The tests are not perfect and may be falsely positive. A "false positive" result means that the test is positive but that the patient is not infected. Thus, these tests should be used only when the patient's history makes the SARS diagnosis likely. If a test is positive, it will be confirmed in a reference laboratory or by the Centers for Disease Control and Prevention.

Other tests may be abnormal, but they are not specific for SARS. The chest X-ray shows pneumonia, which may look patchy at first. Lymphocyte counts in the blood are usually decreased, and platelet counts may also be low. Serum lactate dehydrogenase (LDH) and creatinine phosphokinase (CPK) levels may be increased.

SARS should be considered in people with the appropriate symptoms who work with SARS-CoV in a laboratory or who have recent exposure to infected mammals in Southern China. No human cases of SARS have been reported since 2004, so it is extremely unlikely that a patient in the U.S. will have SARS. It is possible, however, that a new outbreak might occur. Therefore, SARS should also be considered when there is a cluster of unusually severe viral pneumonia that has no other explanation.

Patients with SARS often require oxygen and severe cases require mechanical ventilation. No medication has been proven to treat SARS effectively. In the 2002 outbreak, it initially appeared corticosteroids or interferon-alpha may have been useful, but this was not confirmed and remains controversial. In the test tube, some drugs from a group known as protease inhibitors appear effective against SARS-CoV, but these medications have not been studied in people with SARS.