SARS stands for severe acute respiratory syndrome . caused by a corona virus . major outbreak in south china in 2002 with fatality of about 10% and 800 deaths in a single outbreak.
sars stands for severe acute respiratory syndrome .
It is caused by a corona virus. its outbreak in 2002 in southern china led to 8000 cases and almost 800 deaths.there is a history of travel or close contact with a SARS patient.
SARS stands for severe acute respiratory syndrome . caused by a corona virus . major outbreak in south china in 2002 with fatality of about 10% and 800 deaths in a single outbreak.
sars stands for severe acute respiratory syndrome .
It is caused by a corona virus. its outbreak in 2002 in southern china led to 8000 cases and almost 800 deaths.there is a history of travel or close contact with a SARS patient.
Severe Acute Respiratory Syndrome (SARS) : Treatment and prophylaxis with Re...Dmitri Popov
Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003.Infection with the SARS virus causes acute respiratory distress (severe breathing difficulty) and sometimes death.
RESPONSE OF SALMONELLA TYPHI AND SALMONELLA PARATYPHI TO A NEW EFFERVESCENT C...EDITOR IJCRCPS
Typhoid is an epidemic disease in Sudan and causes morbidty for many people especially in tropical countries. Ciprofloxacin
hydrochloride tablets were the drugs of choice for the disease treatment used as alternative to chloramphincol. The present
research work aimed to study the response of Salmonella typhi and Salmonella paratyphi to a newly formulated effervescent
ciprofloxacin hydrochloride tablets as compared to five conventional ciprofloxacin marketed brands. Microbiological sensitivity tests
were carried out against Salmonella typhi and Salmonella paratyphi to detect the response of each drug. Comparison was held
between the drug formulations. The results showed that the response of Salmonella typhi to both drugs is less than that to
Salmonella paratyphi. This may be due to a genetic factor found in Salmonella typhi, in producing more polysaccharide as
compared to Salmonella paratyphi. Interestingly, the present research study revealed that the inhibition zones of the newly
formulated effervescent tablets are greater than those of conventional tablets. This may be an indication for more activity and
quicker response or action of the newly formulated drug.
Keywords: Salmonella typhi, Salmonella paratyphi, effervescent ciprofloxacin HCl tablets, conventional tablet brands,
microbiological sensitivity response, treatment activity response.
Severe Acute Respiratory Syndrome (SARS) : Treatment and prophylaxis with Re...Dmitri Popov
Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003.Infection with the SARS virus causes acute respiratory distress (severe breathing difficulty) and sometimes death.
RESPONSE OF SALMONELLA TYPHI AND SALMONELLA PARATYPHI TO A NEW EFFERVESCENT C...EDITOR IJCRCPS
Typhoid is an epidemic disease in Sudan and causes morbidty for many people especially in tropical countries. Ciprofloxacin
hydrochloride tablets were the drugs of choice for the disease treatment used as alternative to chloramphincol. The present
research work aimed to study the response of Salmonella typhi and Salmonella paratyphi to a newly formulated effervescent
ciprofloxacin hydrochloride tablets as compared to five conventional ciprofloxacin marketed brands. Microbiological sensitivity tests
were carried out against Salmonella typhi and Salmonella paratyphi to detect the response of each drug. Comparison was held
between the drug formulations. The results showed that the response of Salmonella typhi to both drugs is less than that to
Salmonella paratyphi. This may be due to a genetic factor found in Salmonella typhi, in producing more polysaccharide as
compared to Salmonella paratyphi. Interestingly, the present research study revealed that the inhibition zones of the newly
formulated effervescent tablets are greater than those of conventional tablets. This may be an indication for more activity and
quicker response or action of the newly formulated drug.
Keywords: Salmonella typhi, Salmonella paratyphi, effervescent ciprofloxacin HCl tablets, conventional tablet brands,
microbiological sensitivity response, treatment activity response.
emerging and re-emerging vector borne diseasesAnil kumar
this presentation in about emerging and re-emerging vector borne diseases and their spatial spread with reference to time, surveillance, monitoring and management program and other difficulties and suggestions for program
Bio303 Lecture Three: New Foes, Emerging InfectionsMark Pallen
New foes. In this lecture I will describe emerging infections, their epidemiology and ecology and the threats that they pose. I will focus on three case studies: SARS, pandemic flu (with help from Jennifer Gardy) and the German STEC outbreak of May-June 2011
REVIEW Open AccessMERS coronavirus diagnostics,epidemio.docxmichael591
REVIEW Open Access
MERS coronavirus: diagnostics,
epidemiology and transmission
Ian M. Mackay1,2,3* and Katherine E. Arden2
Abstract
The first known cases of Middle East respiratory syndrome (MERS), associated with infection by a novel coronavirus (CoV),
occurred in 2012 in Jordan but were reported retrospectively. The case first to be publicly reported was from Jeddah, in
the Kingdom of Saudi Arabia (KSA). Since then, MERS-CoV sequences have been found in a bat and in many dromedary
camels (DC). MERS-CoV is enzootic in DC across the Arabian Peninsula and in parts of Africa, causing mild upper
respiratory tract illness in its camel reservoir and sporadic, but relatively rare human infections. Precisely how virus transmits
to humans remains unknown but close and lengthy exposure appears to be a requirement. The KSA is the focal point of
MERS, with the majority of human cases. In humans, MERS is mostly known as a lower respiratory tract (LRT) disease
involving fever, cough, breathing difficulties and pneumonia that may progress to acute respiratory distress syndrome,
multiorgan failure and death in 20 % to 40 % of those infected. However, MERS-CoV has also been detected in mild and
influenza-like illnesses and in those with no signs or symptoms. Older males most obviously suffer severe disease and
MERS patients often have comorbidities. Compared to severe acute respiratory syndrome (SARS), another sometimes- fatal
zoonotic coronavirus disease that has since disappeared, MERS progresses more rapidly to respiratory failure and acute
kidney injury (it also has an affinity for growth in kidney cells under laboratory conditions), is more frequently reported in
patients with underlying disease and is more often fatal. Most human cases of MERS have been linked to lapses in
infection prevention and control (IPC) in healthcare settings, with approximately 20 % of all virus detections reported
among healthcare workers (HCWs) and higher exposures in those with occupations that bring them into close contact
with camels. Sero-surveys have found widespread evidence of past infection in adult camels and limited past exposure
among humans. Sensitive, validated reverse transcriptase real-time polymerase chain reaction (RT-rtPCR)-based diagnostics
have been available almost from the start of the emergence of MERS. While the basic virology of MERS-CoV has advanced
over the past three years, understanding of the interplay between camel, environment, and human remains limited.
Keywords: Middle East respiratory syndrome, Coronavirus, MERS, Epidemiology, Diagnostics, Transmission
Background
An email from Dr Ali Mohamed Zaki, an Egyptian
virologist working at the Dr Soliman Fakeeh Hospital in
Jeddah in the Kingdom of Saudi Arabia (KSA) an-
nounced the first culture of a new coronavirus to the
world. The email was published on the website of the
professional emerging diseases (ProMED) network on
20thSeptember 2012 [1] (Fig. 1) and described the first
reported case.
MIDDLE EAST RESPIRATORY SYNDROME CORONA VIRUS (MERS CoV)Dhruvendra Pandey
Middle East Respiratory Syndrome, countries affected by MERS virus, preventive and control strategies for MERS infection, recommendation for healthcare professionals and hospitals in case of MERS corona virus infection, time trend of different events in corona virus infection, MERS Cov is associated with camels, Saudi Arabia guideline for travellers to haj and umrah, MERS CoV Vaccine
Human Coronaviruses (HCoV) exhibit positive single stranded RNA genome with enveloped nucleocapsid. Coronavirus belongs to the family Coronaviridae, originated from avian and mammalian species causes upper respiratory tract infection in humans by novel HCoVs viruses named as HCoV-HKU1, HCoV-NL63 but predominant species is Middle East respiratory syndrome (MERS-CoV) across the world. HCoV-HKU1 sp. is associated with chronic pulmonary disease, while HCoV-NL63 causes upper and lower respiratory tract disease in both children and adults, but most recent one was MERS-CoV, which caused acute pneumonia and occasional renal failure. The novel coronavirus SARS-CoV-2 is a new strain that causes the Coronavirus Disease 2019 (COVID-19) as named by the World Health Organization. According to the recent world statistics report about the COVID-19 cases approx. 101,500 confirmed cases and 3,500 death cases appeared. And mostly, a case of infection with CoV was identified in Wuhan, China. Structurally viral genome constitutes of 2/3rd of replicase gene encoding ORFs regions and rest of the 1/3rd region of genome form the structural proteins. The aim of the study was to understand the viral genetic systems in order to facilitate the genetic manipulation of the viral genome and to know the fundamental mechanism during the viral replication, facilitating the development of antidotes against the virus.
MERS-CoV infection causes severe respiratory and substantial nonpulmonary organ dysfunctions and has a high mortality rate. Community acquired and health care–associated MERS-CoV infection occurs in patients with chronic comorbid conditions
9. November 16, 2002 – February 14, 2003 305 cases and 5 deaths from unknown acute respiratory syndrome clinically consistent with atypical pneumonia (“chlamydial pneumonia”) ???? Anthrax, pulmonary plague, leptospirosis, avian influenza ??? Guangdong Province, China The Weekly Epidemiological Record (WER) 7/2003 The Weekly Epidemiological Record (WER) serves as an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the International Health Regulations and on other communicable diseases of public … Weekly Epidemiological Record (WER)
15. Effect of Travel and Missed Cases on the SARS Epidemic Spread from Hotel M, Hong Kong Hotel M Hong Kong Guangdong Province, China A A H,J A H,J Hong Kong SAR 95 HCW >100 close contacts United States 1 HCW I, L,M I,L,M K Ireland 0 HCW K Singapore 34 HCW 37 close contacts C,D,E C,D,E B B Vietnam 37 HCW 21 close contacts F,G Canada 18 HCW F,G 11 close contacts
27. Published at www.nejm.org April 10, 2003 (10.1056/NEJMoa030747 ) A Novel Coronavirus Associated with Severe Acute Respiratory Syndrome Thomas G. Ksiazek, D.V.M., Ph.D., Dean Erdman, Dr.P.H., Cynthia Goldsmith, M.S., Sherif R. Zaki, M.D., Ph.D., Teresa Peret, Ph.D., Shannon Emery March 24, 2003
28. Published at www.nejm.org April 10, 2003 (10.1056/NEJMoa030747 ) Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome Christian Drosten, M.D., Stephan Günther, M.D., Wolfgang Preiser, M.D., Sylvie van der Werf, Ph.D., Hans-Reinhard Brodt, M.D., Stephan Becker
29. Phylogenetic tree of the SARS-associated coronavirus (Source: S. Günther, Department of Virology, Bernhard Nocht Institutel )
30. SARS-associated coronavirus (SARS Co-V) Glycoprotein spikes High error rate in RNA polymerase during replication
31. Coronaviruses, Hosts and Diseases Antigenic Group Virus Host Respiratory Enteric Other I HCoV-229E human X TGEV pig X PRCoV pig X FIPV cat X X X FECoV cat X CCoV dog X II HCoV-OC43 human X ?? MHV mouse X X X RCoV rat X X HEV pig X X BCoV cattle X X III IBV chicken X X TCoV turkey X * Coronaviruses are highly species-specific
32. The genome sequence of SARS Co-V reveal that the novel agent does not belong to any of the known groups of coronaviruses. It is neither a mutant, nor a recombinant between known Co-V (Ludwig et all. 2003) X1 X2 X3 X4 X5 N M E 20,001 30,000 0.5 1.0 1.5 2.0 2.5 3.0 4.0 5.0 6.0 9.0 25,000 S RNA 6 1 2 3 kB RNA 5 RNA 4 RNA 3 RNA 2 8.3 kb 4.5 kb 3.4 kb 2.5 kb 1.7 kb S ORF 1b ORF 1a N M E A B C 1 5,000 10,000 15,000 20,000 25,000 30,000 SARS-CoV Genome Organization and mRNA Synthesis
44. Transmission The SARS Co-V is not easily transmissible (tQ 2.1-3.3; flu tQ > 20) droplets
45. Close community: healthcare workers, military populations, travel groups, religious gathering, or funerals with close interactions (kissing, hugging). Superspreaders ? Transmission
52. Total SARS Cases and % Healthcare Workers by Location Total No. SARS cases % HCW % HCW
53. The world – “global vilage” 83 000 000 visitors to China each year
54. “ Peripatetic” – acquiring infection in one part of the world, but being diagnosed in another
55.
56. Person- to - person transsmision: within two rows of seats
57. An unsuspected SARS case with transmission to health care workers could shut down in a short period of time any health care system within days, resulting in an economic and public relation disaster
62. Common Clinical Findings in Patients with SARS Range (%) Finding 17-34 70-95 30-50 40-60 20-30 70-94 30-40 Laboratory Leukopenia Lymphopenia Thrombocytopenia Prolonged aPTT Increased ALT Increased LDH Increased CPK 38-90 60-83 Physical Examination Rales/Rhonci Hypoxia
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68. Day 5 - CXR showed left lower zone consolidation became more obvious. Day 7 - Patient became hypoxic & required subsequent intubation. CXR showed bilateral widespread airspace infiltrates . Changi General Hospital, Singapore Courtesy of Dr Augustine Tee 24-year-old Filipino nursing aid from nursing home with one week history of fever, dry cough and myalgia Day 1 - CXR showed subtle left lower zone airspace infiltrates
69. Figure 1 - CXR (7 days after admission) showed ill-defined air space opacification in periphery of right lower zone Figure 2 - CXR (2 days later) showed progression of air space opacification in right lower zone and a new finding of similar changes in left mid and lower zones after initial treatment Figure 3 - CXR (after another 4 days) showed marked resolution of the consolidative changes in both lungs after treatment Case 1: A 31-year-old health-care worker presented with 2-day history of fever, chills and myalgia.
70.
71. HRCT Features of SARS Multiple confluent areas of consolidation in the middle lower and both lower lobes Ill-defined consolidation with air-bronchogram in apical segment of right lower lobe
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75. Currently, there are no specific clinical or laboratory findings which can distinguish with certainty SARS from other respiratory illnesses at the time of presentation Early recognition will depend on the astute clinician’s ability to combine clinical and epidemiologic features !
76. SARS is biphasic illness 85% of patients developed fever and diarrhea after a mean of 9 days
89. April 29, 2003; Lancet: Hon et al The first report on SARS in children
90. Young children develop milder form of the disease with less-aggressive clinical course than in teenagers and adults
91. Children: reservoir for many respiratory diseases (flu, RSV…) Children: massive exposure (kissing…) infected without clinical presentation Children: absence of mortality
92. SARS: where are the pediatric cases? Philip A. Brunell Chief Medical Editor May 2003 To date there is no evidence to support the thesis that there is widespread unrecognized illness in children. At this time, it is safe to say that our pediatric patients with respiratory illnesses without an epidemiologic link do not have SARS. That does not means we should stop looking.
93. Section of Pediatric Emergency Medicine Pediatric SARS Lance Brown, MD MPH FACEP Does it strike anyone else as odd that SARS is a viral pneumonia that strikes adults harder than kids? The worldwide numbers from the May 21, 2003 World Health Organization tally show 7,956 cases, 4,085 individuals who have recovered from the disease, and 666 deaths. The United States is officially listed as having 66 cases and no deaths. Unfortunately, I could not find specific numbers for children in either the CDC or WHO Web sites. The percentage of cases involving children has been reported to be 2% in Canada , 2.4% in Sinapore , and 14% in the United States . What I would really like to see is the Chinese pediatric data. There are a few possibilities including: 1) children get the disease, but it is manifests itself so mildly that the children don't come to medical attention; 2) children have more resistance to getting the infection for some reason; 3) children just haven't been exposed as often as adults; 4) bad data ; 5) luck
96. Treatment among SARS children i.v. ribavirin Ventilatory support Oxygen requirement
97. Severe acute respiratory syndrome in children: experience in a regional hospital in Hong Kong. Chiu WK, Cheung PC, Ng KL, Ip PL, Sugunan VK, Luk DC, Ma LC, Chan BH, Lo KL, Lai WM. Department of Pediatrics and Adolescent Medicine, United Christian Hospital, Kwun Tong, Hong Kong. chiuwkv1@netvigator.com Pediatr Crit Care Med. 2003 Jul;4(3):279-83 .
98.
99. 2 -year-old boy presenetd with febrile convulsion and cough. CXR in admission showed air-space opacities in left mid and lower zone.