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In 2003, another threat surfaced in the Far East - a virus with respiratory symptoms that sickens and kills.
The severe acute respiratory syndrome (SARS) virus first emerged in Hong Kong, where the majority of cases have been reported. Seven of the initial cases have been linked to a hotel in Kowloon. But the most of the infected have been family members or health care professionals caring for patients stricken with SARS.
SARS is a viral respiratory illness caused by a coronavirus called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. During the next few months, the illness spread to more than two dozen countries in North America, South America, Europe and Asia before the SARS global outbreak of 2003 was contained. This fact sheet gives basic information about the illness and what the Centers for Disease Control and Prevention has done to control SARS in the United States.
The SARS outbreak of 2003
According to the World Health Organization (WHO), 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died. In the United States, only eight people had laboratory evidence of the infection. All had traveled to other parts of the world, which had SARS cases.
Symptoms
In general, SARS begins with a high fever (temperature greater than 100.4 degrees F). Other symptoms may include headache, an overall feeling of discomfort and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After two to seven days, SARS patients may develop a dry cough. Most patients develop pneumonia.
How SARS spreads
The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose or eyes of people nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches the mouth, nose or eye(s). Also, SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.
On January 31, 2004, WHO announced a new case of laboratory-confirmed infection with SARS had been reported in China. This is the fourth SARS case (three confirmed, one probable) reported in China since December 16, 2003. For uncertain reasons, SARS has not caused significant human disease in 2005 or 2006 to date.
The most recent case occurred in a 40-year-old director of a hospital and practicing physician in Guangzhou, Guangdong Province, China. He became ill with SARS-like symptoms on January 7, 2004, and was admitted to a hospital with pneumonia on January 16 and placed in isolation. Previously reported confirmed cases include a 20-year-old woman who worked in a restaurant in Guangdong Province and became ill on December 25, 2003, and a 32-year-old man in Guangdong Province who had become ill on December 16, 2003. A fourth person (probable case) - a 35-year-old business man from the Guangdong Province who had onset of illness on December 31, 2003 - tested positive for SARS-CoV infection at a national reference laboratory in China and on preliminary serologic tests performed by WHO SARS International Reference and Verification Network laboratories in Hong Kong.
All four patients have recovered from their illness and have been discharged from the hospital. To date, none of the contacts of these cases has developed a SARS-like illness. The source of infection in these individuals has not been determined. Samples collected from cages that housed animals at the restaurant where the waitress with confirmed SARS worked have tested positive for traces of SARS-CoV, suggesting a possible source of infection. However, some evidence that animals transmit SARS-CoV to humans remains without clear-cut definition.
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External Sources
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The Centers for Disease Control and Prevention
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World Health Organization
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This article was reviewed and updated June 2007.
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