Handouts SARS and Bird Flu

7/29/2019 Handouts SARS and Bird Flu

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Severe acute respiratory syndrome (SARS)

A respiratory disease in humans which is caused by theSARS coronavirus (SARS-CoV).

Outbreak of SARS

SARS first appeared in China in February of this year.

On about March 15th, 2003, the World Health

Organization issued a Worldwide Disease Alert

The epidemic of SARS appears to have started in

Guangdong Province, China in November 2002.

SARS has spread in China to at least 5 of its 10

provinces SARS has spread to Hong Kong, Singapore, Thailand,

Korea, Vietnam and was spread to Canada, the US,Europe, and is now showing up in Brazil, Pakistan,and is now infecting people in about 20 differentnations.

SARS Epidemiology

Coronaviruses are positive-strand, enveloped RNAviruses that are important pathogens of mammalsand birds.

This group of viruses cause enteric or respiratorytract infections in a variety of animals includinghumans, livestock and pets.

SARS coronavirus (SARS-CoV), the causative agent of

the syndrome.There is no vaccine for SARS

Underlying Pathophysiology
http://en.wikipedia.org/wiki/Guangdonghttp://en.wikipedia.org/wiki/Chinahttp://en.wikipedia.org/wiki/Chinahttp://en.wikipedia.org/wiki/Guangdong


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Coronaviruses cause diseases in pigs, birds, and

other animals.

A theory suggests that coronavirus may have

mutated, allowing transmission to and infection to

humans

Cause

Transmission of new type of coronavirus known

SARS-associated coronavirus (SARS-CoV)

Risk Factors:o Close contact with an infected person

o Contact with aerosolized(exhaled)droplets and

bodily secretions from infected person

o Travel to endemic areas

Signs and Symptoms Initial symptoms are flu like and may include:

myalgia

lethargy

gastrointestinal symptoms

cough

sore throat

a fever above 38 C (100.4 F)

Shortness of breath


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Symptoms usually appear 210 days followingexposure

! About 1020% of cases require mechanical

ventilation.

Diagnostic Exam

Serum electrophoresis detects antibodies to

coronavirus

Gram Stain and culture of sputum isolate coronavirus

Platelet count may be low

Chest X-ray changes(infiltrates)may indicatepneumonia

SARS-specific polymerase chain reaction test detects

SARS-CoV Ribonucleic Acid(RNA)

Confirmed positive PCR for SARS virus

Antibody test for SARS Virus

Virus culture

enzyme-linked immunosorbent assay

immunofluorescence assay

polymerase chain reaction

Treatment

Isolation(for hospitalized patients)

Strict respiratory and mucosal barrier precautions

Quarantine(of exposed individuals) Mechanical ventilation(severe cases)

Diet(as tolerated)

Global surveillance and reporting of suspected cases

Antivirals (Ribavirin)


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Steroids and antimicrobials

Preventive Measures

You should wash your hands frequently.

You should avoid going to areas that are SARS zones.You should avoid being around anyone that is

infected with SARS.

You should eat right, sleep right, and have generally

good health and exercise.

Get yourself educated about SARS!

Bird Flu / Avian Flu

Avian Flu, also known as bird flu, an infectious disease ofwild and domestic birds, caused by a range of virusesknown as Type A influenza viruses. Variants of avianinfluenza viruses have also infected humans and anumber of other mammals.

Avian influenza viruses exist in wild populations ofseabirds, shorebirds, and other wildfowl

First identified in South African wild terns in 1961

Spread naturally among global bird populations over4 decades

3 types of the influenza virus: A, B and C reflectdifferences in the M protein on the envelope thatcontains the virus

A influenza viruses cause human and bird flu

outbreaks

contain 8-segment RNA strand segments break apart during replication to mix and

reassort

potential for constant evolution is built in


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sub-typed based on activity in envelopes

glycoproteins:

1] hemagglutinin activity (H): 16 known varieties

2] neuraminidase activity (N): 9 known varieties Influenza A infects both mammals and birds

and can cause epidemic as well as pandemic

Influenza B and C infects only humans

Shorthand names have an H and N number

(H1N1)

1918 H1N1 virus killed 20 to 40 million people

worldwide 1957 H2N2 and 1968 H3N2 viruses each responsible

for more than 1 million deaths

Now, in 2005, all eyes are focused on H5N1 bird

flu

Mode of transmission

Spreads rapidly through exchange of mucus or feces,without creating sickness or death in these species

Once transferred to domestic birds (chickens, ducksand turkeys),spreads explosively is frequentlylethal

Virus mutates rapidly in large groups of closely

contained birds

Has ability to jump to other species, such as pigs

Transmission: invisible droplets sneezed or coughed

into the air or on surfacesSigns and Symptoms

fever

cough

sore throat,

muscle aches


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Rapidly worsening condition

Pneumonia

Severe respiratory distressTreatment

Vaccine

Social measures

Antiviral Medicines

Amantadine

Rimantadine

Tamiflu

ZanamavirManagement

Be aware and stay informed

Be prepared at home, school and work

Get your annual flu shot

Wash hands often

Avoid contact with ill persons-birds-animals

Stay home if you or your children are sick Eat only well-cooked poultry products

Handouts SARS and Bird Flu

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