Emerging Infectious Disease (3): Severe Acute Respiratory Syndrome

Chen-Yang Hsu, MD; Li-Pin Chang, MD; Tzong-Luen Wang, MD, PhD

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Abstract --First recognized in late February 2003, severe acute respiratory syndrome (SARS) was successfully contained in less then 4 months. SARS is responsible for the first pandemic of the 21^st century. After first appearing in Gunagdong in mainland China, it spreaded to 29 countries, affected more than 8000 patients and caused 774 deaths. The major clinical features include persistent fever, myalgia, malaise, dry cough, headache, and dyspnea. Common laboratory features include lymphopenia, thrombocytopenia, raised alanine transaminases, lactate dehydrogenase, and creatine kinase. Fever is the most common symptom on presentation, however, older subjects and patients with comorbids may have atypical symptom. The combination of compatible clinical, radiological and laboratory findings should alert the physicians on making the diagnosis of SARS. Management of SARS focuses on prevention and containment of spreading. Treatment protocols including antiviral agents, steroid and ventilator use are still controversial. In the absence of a vaccine, the most effective way to control a new viral disease such as SARS is to break the chain of transmission, which is accomplished via good basic public health measure and infection control measures.