Severe Acute Respiratory Syndrome (SARS) (cont.)

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What is the prognosis of SARS?

During the pandemic, approximately 25% of people with SARS developed severe respiratory failure or ARDS. In the general population, people with SARS had approximately a 10% chance of dying. Deaths in children were rare. However, up to 50% of people with underlying medical conditions died; people over 50 years old also had a similar death rate. Unfortunately, many people who eventually recover from SARS have had pulmonary fibrosis, osteoporosis, and femoral necrosis and are disabled, according to reports from China.

Is it possible to prevent SARS?

Travelers to affected areas can protect themselves by taking simple measures that help prevent the spread of germs. Frequent hand washing with soap and water, or using an alcohol-based hand sanitizer, avoiding close contact with sick people, and not touching one's eyes, nose, and mouth can prevent the spread of viruses.

The SARS pandemic was brought to an end by simple public-health measures. In the health-care setting, suspected cases of SARS would be placed in airborne infection isolation rooms (AIIR) such that room exhaust is recirculated with high-efficiency particulate air (HEPA) filtration. While awaiting such a room or if not available, the patient should wear a face mask and should be isolated in a single-patient room with the door closed. The number of staff assigned to the patient, and the patient's movements outside of the isolation area, should be minimized. At entry to the isolation room, health-care workers caring for the patient should wear a gown, gloves, eye shield, and a fit-tested NIOSH-certified disposable N95 filtering face-piece respirator in the room; if the latter is unavailable, a surgical mask is worn if no other care provider is available. Hand hygiene must be performed with soap and water or use an alcohol-based hand sanitizer after discarding personal protective equipment in the room and exiting.

Mildly ill people may be cared for at home, with caregivers wearing face masks for direct care according to some clinicians, but severe illness requires hospitalization. However, other clinicians and public-health officials recommend isolation for anyone diagnosed with SARS-CoV.

The key to preventing another outbreak is to identify the first infected patients promptly before they have time to spread the illness more widely. People who have been exposed to an infected individual should be carefully monitored for fever or respiratory symptoms. Exposure is defined as living with or caring for an infected person, being within 3 feet of the sick person, exposure to bodily fluids, or direct physical contact. The Centers for Disease Control and Prevention does not mandate quarantine measures for exposed individuals who are otherwise healthy and allows this decision to be handled on a case-by-case basis. Local public-health authorities should be consulted promptly when the diagnosis is suspected. If a significant outbreak of SARS occurs again, people may be advised to maintain a distance from others in the community ("social distancing") by avoiding large gatherings or significant close contact with others. However, isolation (self-imposed or quarantine) methods have been effective in the prevention of SARS spread.

Medically Reviewed by a Doctor on 11/1/2013

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