Severe acute respiratory syndrome (SARS): epidemiology, diagnosis and management

SARS is a serious respiratory illness that frequently runs a rapidly progressive downhill course. In just 6 weeks it has spread to all continents of the globe. At the time of writing more than 7000 cases have been reported worldwide and over 500 have died. The primary mode of transmission appears to be by droplets. Good supportive care and the judicious use of ribavirin and steroids result in recovery in over 90% of patients, but randomised controlled trials are needed to define the roles of these treatments. Success in controlling the disease relies on early identification of suspect cases, proper isolation, and meticulous infection control measures. Development of sensitive and specific rapid diagnostic tests is underway. Since February 2003 the world has been hit by a highly contagious respiratory infection which frequently results in rapidly progressive respiratory failure. In late 2002 and early 2003 there were reports of outbreaks of atypical pneumonia of unknown aetiology in Southern China. Initially the condition primarily affected close contacts of the patients and healthcare workers who looked after them. With increasing recognition of this unusual infection, the US Centers for Disease Control and Prevention termed the condition “severe acute respiratory syndrome” (SARS).1 Over the past few months the global medical community has worked together to achieve an unprecedented speed of progress in our understanding of SARS. Here we review the current knowledge of the epidemiology, clinical presentation, and treatment of this devastating condition. The outbreak in Hong Kong began when an infected doctor from Southern China checked into a hotel on 21 February 2003. His symptoms of a respiratory tract infection had apparently started almost 1 week before his arrival in Hong Kong. He passed on the infection to eight key persons who had either stayed at the hotel as guests or who …