In early 2003, a mysterious, frightening, severe pneumonia-like outbreak appeared in Asia, and quickly began to spread across the globe. Between February and July 2003, 8,096 people from 26 countries contracted this new disease, identified by Dr. Carlo Urbani as a coronavirus named SARS, or Severe Acute Respiratory Syndrome (Preble, 2015). A coronavirus is a virus that is similar to pneumonia, in the fact that it causes infection in the respiratory tract. SARS is caused by the coronavirus SARS-coronavirus (SARS-CoV), which is closely related to the virus that causes the common cold. Before SARS, the viruses were not known to be dangerous in humans, although they caused severe disease in animals. Because of this, scientists originally believed that SARS crossed from animals to humans (Lau and Chan, 2015). However, research now reveals that it evolved from one or more virus strains into a new virus.
Coronaviruses are found in several species of animals, such as pigs, rabbits, cat, mice, rats, dogs, and chickens, turkeys, whales and humans (McIntosh, 2017). They can cause veterinary diseases in animals, and both upper and lower respiratory tract infections in humans.
The near absence of SARS-CoV antibodies in individuals not infected with SARS shows that SARS-CoV was not of much importance in humans prior to the outbreak in 2003. According to researchers, data shows that animals in markets in China during that time may have been the source of human infection, and the SARS-CoV viruses were not found in animals before arrival in markets (McIntosh, 2017).
Bats have been known to have a wide range of other coronaviruses, which posed the suggestion that bats may have been responsible for the outbreak. SARS infection was not very common before the animals in the market, but it is assumed that they were more and likely the host, therefore, the proximity of humans and livestock may have caused the transmission to humans.
When an infected person individual sneezes or coughs, the infected particles spray the air. A person can then be infected with this disease simply by breathing in or touching those particles (McIntosh, 2017). The SARS virus is able to live and remain active on surfaces, such as the hands, for up to 6 hours in droplets and up to 3 hours after the droplets have dried (Lau, 2015). While most of the early cases of SARS were spread solely through close contact, the virus is also known to spread via the hands and other objects that may have been affected by droplets. Airborne transmission is a real possibility in some cases (Preble, 2015). The live virus has been discovered in feces of affected individuals, and the SARS virus is able to live up to 4 days in stool. This virus is also able to live several months, or even years, when temperatures are below freezing.
Symptoms of SARS can occur as early as 2-10 days after contact. Sometimes, the symptoms appear even sooner. If an individual has active symptoms, he or she is considered contagious, but it is currently unknown whether or not a person is contagious before symptoms occur (McIntosh, 2017). The onset of SARS usually begins with flu-like symptoms. The most common symptoms include shaking and chills, dry cough, fever greater than 100.4, headaches and muscle aches (Preble, 2015). Less common symptoms include a productive cough, diarrhea, dizziness, nausea and vomiting, runny nose, and sore throat.
SARS can be diagnosed by either of three tests: PCR analysis, serologic testing, and viral cultures. PCR analysis detects genetic information from the virus that may be found in secretions of the nose, blood specimen, and stool samples (Lau, 2015). Another test, viral culture, actually grows the virus from the nasal secretions, blood specimen, and stool samples to identify the virus (McIntosh, 2017). This test is able to determine whether or not the live virus can exist in those samples. The third test, serologic testing, is a blood test that detects which antibodies are related to SARS virus (Preble, 2015). In order to diagnose SARS, a doctor will ask a series of questions, complete a physical exam, and suggest certain tests in order to rule out other possible causes.
Transmission of SARS-CoV is from person to person. This mainly occurs during the second week of the illness, which is the stage of infection in which respiratory secretions and stool, are at its peak (Preble, 2015). It is also the time in which severe cases begin to deteriorate.
It is reported that most human-to-human transmissions took place in health care settings in which infection control precautions were not practiced. However, when the precautions were implemented and practiced, the outbreak ended.
Because SARS is a viral infection, no treatment is available, but providers work to relieve the symptoms while the body works to fight the virus. Sometimes, hospitalization may be required for those patients in need of intravenous fluids, medications, or any other intensive care. Researchers have not yet found a medication that could treat SARS, although extensive research continues. They are also working to develop a vaccine that could completely prevent SARS from resurfacing.
SARS virus has been tested against different antiviral medications to see if an effective treatment could be found. Although there are multiple compounds that show antiviral activity, alpha interferon is the only one sufficient enough for immediate clinical evaluation. As information about the SARS virus infections are being researched, prescription drugs are being manufactured to target the virus’s vulnerable points. To prevent the virus from cohabiting in human cells, scientists have developed a project called an entry inhibitor.