International experts in infectious disease and epidemiology consider it likely that there will be a recurrent outbreak of severe acute respiratory syndrome (SARS) or other newly emerging and serious transmissible respiratory pathogens, according to the published conclusions of a workshop on the highly infectious disease. Writing in the first issue for March 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine, an expert panel developed recommendations concerning the care and treatment of patients with SARS based on prior clinical experience. According to the report, 8,098 persons in 29 countries developed probable SARS between November 1, 2002, and August 7, 2003. The heaviest burden of illness was felt in China, Hong Kong, Taiwan, Singapore, Viet Nam, and Canada. About 23 to 32 percent of SARS patients become critically ill, with acute lung injury affecting 16 percent of all patients with SARS and 80 percent of critically ill patients with the disease. The worldwide fatality rate among all SARS outbreaks was 9.6 percent, but those suffering from SARS-related critical illness died at a 50 percent rate. Worldwide, children were relatively protected from this severe illness. The report notes that the first symptom of SARS is often fever followed by diffuse muscle pain (myalgia), headache, nonproductive cough, and breathlessness (dyspnea). Rapid breathing (tachypnea) and rapid heart rate (tachycardia) are also common early symptoms. Lower respiratory problems, including cough and shortness of breath, typically begin 2 to 7 days after symptoms onset. The average time from exposure to symptom onset is approximately one week. Infection from patients to healthcare workers in the hospital has been a "prominent and worrisome feature of SARS outbreaks. In Singapore and Toronto, healthcare workers have accounted for half of all SARS cases and 20 percent
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Contact: Cathy Carlomagno
ccarlomagno@thoracic.org
212-315-6442
American Thoracic Society
1-Mar-2005