Severe acute respiratory syndrome (SARS) A respiratory disease in humans which is caused by the SARS coronavirus (SARS-CoV).

Outbreak of SARS SARS first appeared in China in February of this year. On about March 15th, 2003, the World Health Organization issued a Worldwide Disease Alert The epidemic of SARS appears to have started in Guangdong Province, China in November 2002. SARS has spread in China to at least 5 of its 10 provinces SARS has spread to Hong Kong, Singapore, Thailand, Korea, Vietnam and was spread to Canada, the US, Europe, and is now showing up in Brazil, Pakistan, and is now infecting people in about 20 different nations. SARS Epidemiology Coronaviruses are positive-strand, enveloped RNA viruses that are important pathogens of mammals and birds. This group of viruses cause enteric or respiratory tract infections in a variety of animals including humans, livestock and pets. SARS coronavirus (SARS-CoV), the causative agent of the syndrome. There is no vaccine for SARS Underlying Pathophysiology

 Coronaviruses cause diseases in pigs, birds, and other animals. A theory suggests that coronavirus may have mutated, allowing transmission to and infection to humans Cause Transmission of new type of coronavirus known SARS-associated coronavirus (SARS-CoV) Risk Factors: o Close contact with an infected person o Contact with aerosolized(exhaled)droplets and bodily secretions from infected person o Travel to endemic areas Signs and Symptoms Initial symptoms are flu like and may include: myalgia lethargy gastrointestinal symptoms cough sore throat a fever above 38 C (100.4 F) Shortness of breath

 Symptoms usually appear 210 days following exposure ! About 1020% of cases require mechanical ventilation. Diagnostic Exam Serum electrophoresis detects antibodies to coronavirus Gram Stain and culture of sputum isolate coronavirus Platelet count may be low Chest X-ray changes(infiltrates)may indicate pneumonia SARS-specific polymerase chain reaction test detects SARS-CoV Ribonucleic Acid(RNA) Confirmed positive PCR for SARS virus Antibody test for SARS Virus Virus culture enzyme-linked immunosorbent assay immunofluorescence assay polymerase chain reaction Treatment Isolation(for hospitalized patients) Strict respiratory and mucosal barrier precautions Quarantine(of exposed individuals) Mechanical ventilation(severe cases) Diet(as tolerated) Global surveillance and reporting of suspected cases Antivirals (Ribavirin)

 Steroids and antimicrobials Preventive Measures You should wash your hands frequently. You should avoid going to areas that are SARS zones. You should avoid being around anyone that is infected with SARS. You should eat right, sleep right, and have generally good health and exercise. Get yourself educated about SARS! Bird Flu / Avian Flu Avian Flu, also known as bird flu, an infectious disease of wild and domestic birds, caused by a range of viruses known as Type A influenza viruses. Variants of avian influenza viruses have also infected humans and a number of other mammals. Avian influenza viruses exist in wild populations of seabirds, shorebirds, and other wildfowl First identified in South African wild terns in 1961 Spread naturally among global bird populations over 4 decades 3 types of the influenza virus: A, B and C reflect differences in the M protein on the envelope that contains the virus A influenza viruses cause human and bird flu outbreaks contain 8-segment RNA strand segments break apart during replication to mix and reassort potential for constant evolution is built in

 sub-typed based on activity in envelopes glycoproteins: 1] hemagglutinin activity (H): 16 known varieties 2] neuraminidase activity (N): 9 known varieties Influenza A infects both mammals and birds and can cause epidemic as well as pandemic Influenza B and C infects only humans Shorthand names have an H and N number (H1N1) 1918 H1N1 virus killed 20 to 40 million people worldwide 1957 H2N2 and 1968 H3N2 viruses each responsible for more than 1 million deaths Now, in 2005, all eyes are focused on H5N1 bird flu Mode of transmission Spreads rapidly through exchange of mucus or feces, without creating sickness or death in these species Once transferred to domestic birds (chickens, ducks and turkeys),spreads explosively is frequently lethal Virus mutates rapidly in large groups of closely contained birds Has ability to jump to other species, such as pigs Transmission: invisible droplets sneezed or coughed into the air or on surfaces Signs and Symptoms fever cough sore throat, muscle aches

 Rapidly worsening condition Pneumonia Severe respiratory distress Treatment Vaccine Social measures Antiviral Medicines Amantadine Rimantadine Tamiflu Zanamavir Management

Be aware and stay informed Be prepared at home, school and work Get your annual flu shot Wash hands often Avoid contact with ill persons-birds-animals Stay home if you or your children are sick Eat only well-cooked poultry products