Severe Acute Respiratory Syndrome

Excerpt

A new and rapidly progressive respiratory syndrome termed severe acute respiratory syndrome (SARS) was identified by the World health organization (WHO) in the Guangdong province of China as a global threat in March of 2003. SARS went on to spread globally over the following months to over 30 countries and became the 1st pandemic of the 21st century. It showed that the dissemination of an infectious microbe could be drastically increased in the era of globalization and increased international travel. The decade preceding the SARS outbreak featured the emergence of multiple novel pathogens, including H5N1 influenza, Hantavirus, Nipah virus, and Avian flu. However, SARS was unique among these as it had the ability for efficient person-to-person transmission. By the end of the outbreak in July 2003, 8096 cases were reported leading to 774 deaths with a case fatality rate of over 9.6%. SARS showed a unique predilection for healthcare workers, with 21% of cases occurring in these individuals.

The WHO, along with its international partners, including the centers for disease control and prevention (CDC), was able to identify within two weeks the etiologic agent. The agent was a novel coronavirus and was given the name SARS coronavirus (SARS-CoV). It was isolated in a number of SARS patients and suspected as the causative agent before ultimately being sequenced and fulfilling Koch postulates confirming it as the cause.

The number of secondary cases produced by one SARS patient is thought to be in the range of two to four though a few patients, including the original index case, were suspected to be “super-spreaders” spreading to up to hundreds of others. The mode of transmission for the virus was largely through respiratory inhalation of droplets. Treatment was primarily supportive, and no specific anti-virals were effective. Since mid-2004, no new cases of SARS have been reported. Until the recent COVID-19 pandemic, the global reach of SARS had been matched only by the 2009 H1N1 Influenza pandemic. Lessons learned from the SARS pandemic are currently used as a blueprint to fight the pandemic of COVID19.