Information about SARS and its symptoms

Severe acute respiratory syndrome (SARS) (formerly known as atypical pneumonia) has become a worldwide epidemic. The epidemic has spread all over the world. According to WHO statistics, as of April 14, the number of SARS cases in the world has accumulated to 2 1 country 3 169, with deaths 144. Especially in Chinese mainland (14 18 cases with 64 deaths) and hongkong (1 190 cases with 47 deaths).

This is a syndrome, not a specific diagnosis. Pneumonia and adult respiratory distress syndrome caused by other reasons must be checked and ruled out first.

At present, SARS cases are mainly transmitted by droplets, and most of the infected people are relatives who have close contact with the cases and medical staff who are responsible for nursing. Its main symptoms are fever, dry cough, headache, muscle pain and respiratory infection.

Clinical symptoms of SARS

According to the WHO announcement, the clinical symptoms of SARS are as follows: most of them occur at the age of 25 ~ 70, and a few patients are younger than 15. The incubation period is usually 2 to 7 days, but it may be as long as 10 days. The disease usually begins with fever (> 38℃), usually high temperature, sometimes chills and chills; Fashion is accompanied by other symptoms, including headache, burnout and muscle pain. Some patients will have mild respiratory symptoms when they get sick. There is usually no rash and neurological or gastrointestinal symptoms, but some patients will have diarrhea when they have a fever. After 3 ~ 7 days, he entered the lower respiratory tract and began to cough without phlegm, or his blood oxygen was too low due to dyspnea. There are 10 ~ 20% patients whose respiratory diseases are so serious that intubation and ventilator are necessary. The mortality rate of those who meet the current definition of suspected and suspected SARS cases in the World Health Organization is about 4%.

The risk of infection in the incubation period (2 to 10 days) and the prophase (1 2 days) is quite low. When the symptoms appear completely, the risk of infection is the greatest (lower respiratory period), especially when severe cough, shortness of breath and hypoxemia occur. 90% patients will have flu-like symptoms for about 6-7 days during their illness, and then fully recover.

◎ How is SARS spread?

A. Aerosol spreads through mucus or other body fluids.

Dr Julie Gerberding, an official in charge of the CDC, said that in fact, most cases were infected through contact with patients at home, or medical staff had close contact with infected people or their body fluids, which indicated that SARS was spread through droplets of mucus or other body fluids. It is very difficult to identify droplets, which must be very close to droplets and have a certain spread range. For the sake of safety, CDC advises medical staff and others to wear masks when they are in close contact with patients, and according to the treatment guidelines, suspected SARS patients must be isolated. At present, cases are mainly caused by close contact with people infected with SARS. Close contact refers to contact or contact with the patient's body secretions (nose, urine, feces).

B. airborne

The possible transmission pipeline is only far away from the above droplet infection.

C. fecal-oral route

Possible communication channels, the spread of the case of Taoda Garden Club in Hong Kong may be closely related to this.

◎ What pathogen caused it?

According to the CDC (Center for Disease Control), "coronavirus" was isolated by cell culture, but its characteristics are obviously different from the other three known genera of Coronaviridae, and it is likely to be classified as the fourth genus. The virus also appeared in lung and kidney tissues of patients in non-recovery period; Three patients who were able to obtain serum in acute phase and recovery phase were identified as "non-existent" and "existent" antibodies respectively. These evidences quite support the hypothesis that novel coronavirus is the pathogen of SARS.

The SARS storm swept the world, which has been proved to be caused by the variation of coronavirus. Parents should understand that the severity of SARS will increase or decrease with the variation of coronavirus. At present, the Department of Health has asked the United States to test and control the virus. As long as the gene sequencing and comparison are completed, the suspected infected person can be diagnosed correctly and the panic of SARS can be eliminated. Recently, the CDC of the United States completed the sequencing of the SARS virus gene map.

There are about 20,000 to 27,000 pairs of coronavirus genomes, and the Department of Health takes the key 400 pairs of genomes as "primers". It is found that the coronavirus of SARS is different from the common human coronavirus, and the degree of variation is 30% to 40%, but the report in the United States says that the degree of variation is 50% to 60%.

How to determine the diagnosis of SARS?

SARS is a new infectious disease, and its diagnosis is based on epidemiological data, clinical and laboratory test data, not just the results of a single test.

1. Chest X-ray:

Chest X-ray examination may be normal during the precursor symptoms of fever and even the whole process. However, in most patients, the respiratory phase is characterized by early local infiltration to more extensive, patchy and interstitial infiltration. Chest X-rays of some patients with advanced SARS can show that some areas are solid.

2. Laboratory inspection:

In the early stage of the disease, the number of lymphocytes usually decreases, and the total number of white blood cells is generally normal or decreased. When respiratory diseases are the most serious, more than half of patients will have leukopenia and thrombocytopenia, or the platelet count is normal but slightly lower (5-65438+ million/microliter).

So far, there is no detection method for the final diagnosis of SARS cases in the world, and from the detection results of related SARS cases at home and abroad, some cases show the phenomenon of coexistence of multiple pathogens, so it is not appropriate to take the detection results of coronavirus molecules as the basis for "confirmed cases" and its prevention and control measures before fully understanding the pathogenic mechanism.

◎ Can you recover? How to treat it?

The vast majority of cases (96%) successfully passed the observation period and recovered completely without respiratory complications. Treatment methods include various antibiotics to treat known bacterial atypical pneumonia. In many areas, antiviral drugs such as oseltamivir or ribavirin, oral or intravenous steroids, and other antimicrobial drugs are used together. The use of immunoglobulin has also been recorded in Taiwan Province province. But so far, the most effective treatment has not been found.

The mortality rate is about 4%, especially those over 40 years old or with potential diseases (such as coronary heart disease, diabetes, asthma, chronic lung disease), which are more likely to lead to death.

Who should be isolated at home? What should I pay attention to?

Only people who have been in contact with SARS patients should be isolated at home, even if they have no symptoms. From the first day of contact to the tenth day, you should be isolated at home.

Isolation at home should take the following precautions:

Stay at home, don't leave home, and don't let anyone visit you. There is no need to isolate family members unless they are diagnosed with SARS.

Please wear a mask when you are in the same room with another family member.

* Change masks as instructed. Family members do not need to wear masks.

* Please don't * * use personal items such as towels, cups or tableware with others.

* Wash your hands often.

* Sleep in separate rooms.

* During these ten days, take your temperature twice a day. Don't use the thermometer with other family members.

* If any family member has a fever (over 38℃ or 100.4℉), muscle aches, fatigue, dry cough, shortness of breath, severe headache or feels unwell, please call the Department of Health immediately.