Severe Acute Respiratory Syndrome (SARS) (cont.)

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How is SARS diagnosed?

SARS-CoV is detected using enzyme-linked immunoassays (EIA) or reverse transcriptase polymerase chain reaction (PCR) tests, which are available through the CDC. These tests are performed on a sample respiratory secretions or blood.

These tests are performed only when the patient's history makes the SARS diagnosis likely and usually in consultation with infectious-disease subspecialists, state and local public-health authorities, and the Centers for Disease Control and Prevention. If a test is positive, it will be confirmed by the CDC. Other tests may be abnormal, but they are not specific for SARS. The chest X-ray shows pneumonia, which may look patchy at first. Typically, infiltrates have the appearance of "ground glass" on computed tomography scans but may progress to frank consolidation or "white out." 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 people or mammals in Southern China. No human cases of SARS have been reported since 2004 in the United States, so it is extremely unlikely that a patient in the U.S. will have SARS without a history of such exposure. It is possible, however, that a new outbreak might occur. Therefore, SARS (along with other similar viruses) should also be considered when there is a cluster of unusually severe viral-like pneumonia that has no other explanation.

What is the treatment for SARS?

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Patients with SARS often require oxygen, and severe cases require mechanical ventilation. Severely ill patients should be admitted to the intensive-care unit. No medication has been proven to treat SARS effectively, and treatment is largely supportive and directed by the patient's clinical condition. In the 2002-2003 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. Management is aided by infectious-disease, pulmonary, and critical-care subspecialists. Medical caregivers need to follow strict policies on gloves, masks, gowns, and other protocols to avoid becoming infected.

Medically Reviewed by a Doctor on 11/1/2013

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