3. OBJECTIVES
By the end of session the students will be able to :
Define SARS
Discuss the causes and risk factors of SARS
Share clinical manifestation of SARS
Explain the role of nurse in prevention of SARS in hospital
and community setting .
6. INTRODUCTION
Severe acute respiratory syndrome (SARS) is a respiratory
disease in humans, in which the lungs inflamed and there is
difficulty in breathing which is caused by SARS coronavirus.
Between November 2002 and July 2003,an outbreak of
SARS in southern China caused an eventual 8098 cases
resulting in 774 deaths reported in 37 countries with the
majority of cases in china according to WHO.
7. EPIDEMIOLOGY
(A)DISTRIBUTION
BY TIME
it is rare respiratory disorder occur at different times in different
regions of the world
By Place
over crowding
poor hygiene
By Person
old age people , children
immunocompromised persons
9. FREQUENCY
SARS is a rare disease.
In June 2003, the incidence was 8422 cases with a case fatality rate of
11%
The case fatality ratio ranges from 0% to 50% depending on the age
group of the patient
Patients under 24 were less likely to die; those 65 and older were most
likely die.
10. PATHOPHYSIOLOGY
VIRUS is transmitted through close contact with an infected person.
Virus infect respiratory system causes all respiratory symptoms.
Complex processes leading to degradation of organs.
Primary target ;lung and intestines (epithelial cells,villi,alveoli)
Immune system; severe lymphocyte depletion.
14. SOURCE OF INFECTION
Clinical and subclinical cases.
Infective material
Fomites
Respiratory Secretions
Objects freshly contaminated by such discharge
15. MODES OF TRANSMISSION
Direct transmission
droplet infection
droplet nuclei
Indirect transmission
interaction with carrier
contact with body fluids with person with SARS
close contact ( kissing, hugging, eating or drinking in utensils with an infected
person
contact of mucous membrane with respiratory droplet (cough, sneeze)
16. INCUBATION PERIOD
The average incubation period for SARS is 4-6 days
Although rarely it could be as short as 1 day or as long as 14 days.
PERIOD OF COMMUNICABILITY
After onset of symptoms and maximum period of communicability is less
than 21 days.
17. CLINICAL FEATURES
Flu like symptoms
Fever
Muscle pain
Lethargy
Cough
Sore throat
Fever above 38 degree C (Common to all)
Shortness of breath
Pneumonia ( viral and bacterial)
Diarrhea
18.
19. DIAGNOSIS
CHEST X-RAY
Chest X-ray is not always uniform but generally appears as an
abnormality with patchy infiltrates.
ELISA
Immunofluorescence or PCR
VIRAL CULTURE
SEROLOGICAL TESTING
20.
21. TREATMENT
ANTIBIOTICS are ineffective as SARS is a viral disease
Treatment is largely supportive with Antipyretics .
Supplemental oxygen
Mechanical ventilation
Isolation in negative pressure rooms
There is No cure or protective vaccine for SARS
22. PREVENTION
Negative pressure rooms
Hand hygiene
Use of personal protective equipment (PPE)
Environmental cleaning and disinfection
Source control measures
Quarantine
Isolation
Keeping children with symptoms home from school
Washing the personal items of someone with SARS in hot water (eating
utensils,dishes,bedding etc.)
24. ROLE OF NURSE
Isolation of the patient suffering from SARS
Proper hand washing before touching and after touching the patient
Use of gloves and masks before a procedure.
Education of the patient and family related to disease causes and
management
Proper care of the patient in ICU or CCU units.
Monitoring and administration of medications
Monitoring to minimize complications
