Pediatric and Adult SARS

• Main Authors: Leung, Chi Wai, Lai, Thomas S T
• Format: Book Chapter
• Language: English
• DOI: 10.1017/CBO9780511547454.073

INTRODUCTION Severe acute respiratory syndrome (SARS) is an often fatal infectious respiratory disease with prominent systemic symptoms. It is caused by a novel coronavirus, SARS coronavirus (SARS-CoV), which was responsible for a global outbreak from November 2002 to July 2003. SARS-CoV probably has its origin in Southern China and is a zoonosis that initially affected wild animals, possibly bats, and subsequently spread to exotic animals. The virus can be identified by reverse transcriptase polymerase chain reaction (RT-PCR) in blood, plasma, respiratory secretions, and stool. Specific antibody is detected in acute and convalescent sera from patients by indirect fluorescent antibody (IFA) testing and enzyme-linked immunosorbent assay (ELISA) targeting the surface spike (S) protein. EPIDEMIOLOGY During the 2002–2003 SARS outbreak, a cumulative total of 8096 probable cases, with 774 deaths, were reported from 29 countries and areas. A global case-fatality rate of 9.6% was recorded at the end of the outbreak. The total number of health care workers affected was 1706 (21.1% of all probable cases). Interestingly, the severity of the syndrome appears to have been greater in adults and adolescents than in young children. No mortality was reported in children worldwide. The incubation period of SARS generally ranged from 2 to 10 days. The primary mode of transmission appears to be direct mucous membrane (eyes, nose, and mouth) contact with infectious respiratory droplets and/or through exposure to fomites.