SARS is a viral respiratory disease caused by the SARS coronavirus (SARS-CoV-1). It emerged in 2002-2003 originating in China and spread to over 25 countries. Common symptoms include fever, cough, and difficulty breathing. While there is no specific treatment, supportive care and isolation are effective. Lessons from SARS and COVID-19 show the importance of early detection, isolation, contact tracing, and international cooperation to control coronavirus outbreaks.

1. SEVERE ACUTE RESPIRATORY
SYNDROME
SUBJECT: COMMUNITY HEALTH NURSING
PREPARED BY BRIJESH ROHIT
(SECOND YEAR B.SC NURSING)
SIGMA INSTITUTEOF NURSING

2. Introduction
• There are many communicable diseases that may cause due to
bacteria, virus or fungus.
• Some of the diseases exist throughout the year in the
community where as some diseases outbreaks in a particular
period and threatens the community.
• SARS is the one such a disease which draw the attention of the
world in the year 2002-2003.
• Like the COVID-19, SARS is also caused due to a type of
coronavirus, called the SARS coronavirus (SARS-CoV or SARS-
CoV-1).

3. Defining the disease
• SARS is a viral respiratory disease of zoonotic origin caused
by SARS-CoV or SARS-CoV-1 virus, the first identified strain
of SARS coronavirus.
• SARS stands for Severe Acute Respiratory Syndrome.
• What is Syndrome?
According to Webster’s dictionary, syndrome is a group of
sign and symptoms that occur together and characterize a
particular disease or illness.

4. History and magnitude of the problem
• The disease triggered 2002–2004 SARS outbreak, which was
epidemic.
• The first case was traced to a health worker in China in late
2002,with rapid spread in Hong Kong, Singapore and Vietnam.
• In May 2005 the disease itself was declared eradicated by the
‘WHO’ as no cases have been reported worldwide since 2004.
• As of 2020, SARS-CoV-1 virus is considered eradicated in
humans. But as the virus also infects the animals it is possible
that it will re-emerged in the future.

5. Epidemiological triad
Agent Factor
Host Factor Environmental
Factor

6. (1) Agent factor(Biological agent)
• The causative agent is SARS-CoV or SARS-CoV-1, which is the
first strain of SARS-CoV.
• SARS-CoV species of coronavirus infects the humans, bats and
other mammals.
• It is enveloped and single stranded RNA virus.
• The SARS virus can survive for hours on common surfaces
outside the human body and 24 hours in human waste. The
virus can also survive at least for 24 hours on a plastic surface
at room temperature.

7. Electron micrographic image of SARS
coronavirus.

8. Source of infection
• The source of infection in most cases, is man himself who has
the diseases. He may be case or carrier.
• Through studies after the SARS outbreak, it was found that
bats are the major source of the coronavirus. And it was also
found that the virus jumped to humans through a intermediate
host which is turn out to be Asian palm civets.

9. (2) Host factor
• Age: Children are rarely affected by SARS. Most commonly in
adults and aged.
• Sex: Both sexes are equally affected.

10. (3) Environmental factor
SARS can occur in any season in crowdy areas and unhygienic
conditions are the high risk factors where it can spread easily.
➢ Incubation Period:
The incubation period for SARS is about for 4-6 days.

11. Mode of transmission (Chart)
Clinical manifestations (Flash Cards)

12. Diagnostic tests
(1) Molecular tests (RT-PCR):
Reverse transcription polymerase chain reaction (RT-PCR) is a lab technique combining
reverse transcription of RNA to DNA and amplification of specific DNA using
polymerase chain reaction (PCR).
Steps:
1. Sample is collected from the patient. After collection, the sample is sealed in a
tube and then sent to laboratory.
2. When a laboratory receives the sample, they perform a process called extraction,
which isolates genetic material from the sample including genetic material from
the virus if present.

13. 3. Then special chemicals and a PCR machine called thermal cycler,
which makes millions of copies of the genetic material. During this
process, one of the chemical produces a fluorescent light if SARS-CoV-1 is
present in the sample. This fluorescent light is a "signal" that is detected
by the PCR machine and special software is used to interpret the signal
as a positive result.
• Positive PCR results mean that there is genetic material (RNA) of the
SARS-CoV is present in the sample and this does not prove that there is
live virus present or that there is present in a quantity large enough to
infect another person.
• Negative PCR results show that the patient is not infected with the
SARS coronavirus.

14. (2) Antibody test
The test detect antibodies produced in response to the SARS
coronavirus infection. Different types of antibodies (IgM and IgG)
appear and change in level during the course of infection.
ELISA (Enzyme Linked ImmunoSorbant Assay): A test detecting a
mixture of IgG and IgM antibodies in the serum of SARS patients yield
positive results reliably at around day 21 after the onset of illness.
Positive antibody test results indicate infection of SARS-CoV.
Negative antibody test results indicate no detection of antibodies
after 21 days from onset of illness and hence indicate that no
infection with SARS-CoV took place.

15. (3) Cell culture
Virus in specimens (such as respiratory secretions, blood or stool) from
SARS patients can also be detected by inoculating cell cultures and
growing the virus. Once isolated, the virus must be identified as the
SARS virus with further tests. Cell culture is a very demanding test, but
currently (with the exception of animal trials) only means to show the
existence of a live virus.
Positive cell culture results indicate the presence of live SARS-CoV in
the sample tested.
Negative cell culture results do not exclude SARS but indicate that no
live virus is present in the collected sample for test.

16. Treatment
There is no specific treatment for SARS.
Antiviral medications and steroids are sometimes
given to reduce lung swelling but are not effective for
everyone.
Supportive care such as supplement oxygen or
ventilation may be prescribed if necessary.
In severe cases, blood plasma from someone
who has already recovered from SARS may also be
administered. However, there is not yet enough
evidence to prove that these treatment are effective.

17. Preventive
Measures
Because there is no confirmed treatment
or cure for SARS, it is important to take as
many preventive measures as possible.
The preventive measures for SARS control
are early detection and protective
measures that includes:
1. Prompt identifications of persons
infected with SARS, their movement
and contacts.
2. Effective isolation of SARS patients in
hospitals.
3. Appropriate protection of medical
staff treating this patients.

18. Preventive measures(Continued)
4. Screening of international travelers in the airports and
shipping ports.
5. Timely and accurate reporting and sharing of information with
government and other authorities.

19. Nursing
Management
• Isolation of suspected cases.
• Barrier nursing with personal protective
equipment.
• Strict handwashing and avoidance of
touching the eyes, nose and mouth.
• Administer antipyretics and other drugs as
per prescription.
• Keep ready ventilators for emergency use.
➢ Health Education:
• Education regarding preventive measures.
• Advice to hold handkerchief
while sneezing or coughing.
• Advice about sanitary measures.
• Educate about high nutrition.

20. Conclusion
From SARS to COVID-19: What lessons have we learned?
The emergence of SARS-CoV-1 and SARS-CoV-2 suggests that
coronavirus will pose a lasting threat to humans and that the
current epidemic will eventually be brought under control. The
collective memory of SARS and SARS-CoV-2 may gradually fade
but we must not forget the lessons learned from the SARS and
current COVID-19 outbreak.
At the same time, nations and communities need to work
together to fight such outbreak to shorten hospital stays and
reduce the consumption of healthcare resources and we must
prepare for the next pandemic.

21. Thank You!