April 12, 2003 – 9:00 pm
What is Severe Acute Respiratory Syndrome (SARS)?
SARS is a new illness that can lead to a severe form of pneumonia. It was first identified in late February and early March 2003 when people became ill in Hanoi (Vietnam), Hong Kong, Singapore, Toronto and Vancouver. Looking back, it is now believed that a large outbreak that began in November 2002 in Guangdong Province in China is also due to SARS. Guangdong Province is right next to Hong Kong in China. The largest number of cases of SARS have occurred in Guangdong Province and Hong Kong.
Who is at risk of getting SARS?
The following three groups of people are at risk of getting SARS:
People who have had close contact with a person who is sick with SARS.
People who have been at hospitals in the Greater Toronto Area where the virus has spread from person-to-person. To-date, these hospitals are Scarborough Grace and York Central.
People who have been in certain areas of the world within the last 10 days. The current areas of concern for SARS are: China including Hong Kong and Taiwan; Singapore; and Hanoi (Vietnam).
What are the symptoms of SARS?
The first symptom of SARS is usually a fever. The fever is usually quite high (greater than 38 °C or 100.4 °F) and begins suddenly. People with SARS may also have chills, headache, tiredness, sore muscles and sometimes a cough. Over the next 3 to 7 days cough, shortness of breath or difficulty breathing may develop. X rays of the lungs usually show signs of pneumonia. To be called a “suspect case of SARS” you need to have one of the risk factors discussed in question #2 AND a fever AND a cough, shortness of breath or difficulty breathing not due to any other cause.
How is SARS spread?
SARS is spread when fluids from the nose or mouth of the person sick with SARS enters the nose, mouth or eyes of another person. Only people who are sick with SARS can spread their infection to others. This usually occurs when the sick person coughs or sneezes. For spread to occur, close contact is needed with the sick person. Close contacts are those who live in the same house as the sick person, have cared for the sick person, or had face-to-face contact within 1 metre (3 feet) with the sick person.
It takes between 2 and 10 days for illness to develop after close contact with a person with SARS. In Canada, most of the people who first became sick with SARS had either lived with or provided health care for people with SARS. These people have then spread the infection to some of their close contacts.
What is the cause of SARS?
It is currently thought that SARS may be caused by a new virus in the “Coronavirus” family, although this remains uncertain. This family is called “Corona” because the viruses looks like a “crown” under the microscope. Viruses in this family also cause other respiratory illnesses. Because the cause of SARS is not known, there is currently no test to tell for sure that someone has SARS.
What is the treatment for SARS?
The specific treatment for SARS is not known. A drug against viruses and steroid-type drugs are being tried. However, it is unsure if these medications are providing any benefit. Good general nursing and medical care are very important. Antibiotics are often used in case the symptoms are due to a bacteria and not due to SARS.
How is the spread of SARS being stopped?
Almost all cases of SARS in Ontario have been confined to Toronto and the surrounding areas. Close contacts of people with SARS, such as family members and health care workers who cared for patients with SARS, are being asked to stay away from other people. This is called “quarantine”. They are staying away from others for 10 days after their last contact with the person with SARS. If they become sick in those 10 days, they will be seen by a health care provider to determine if they have SARS. If at the end of the 10 days they remain well, they can return to their normal activities, since they are no longer at risk of developing SARS. As well, people who have been in some health care facilities in the Greater Toronto area are being asked to quarantine themselves for 10 days after exposure. Currently, people who have been at Scarborough Grace Hospital from March 16-26, 2003 and York Central Hospital from March 16-28, 2003 are under quarantine.
What is happening in hospitals?
To stop the spread of SARS, sick people with SARS are being isolated in hospitals. Health care workers are taking precautions such as wearing masks, gloves and gowns when caring for these patients. As well, masks, gloves and gowns are being worn by staff in the intensive care units and emergency departments at all hospitals in Ontario as a precaution. Handwashing after all patient contact is also very important.
Most entrances to the hospital are closed and only some patients are allowed visitors. At the open entrances, staff, patients and visitors are being screened before they are allowed into the hospital. These people are asked to undergo a medical examination if they meet the following criteria:
Have symptoms of SARS (fever, headache, muscle aches, malaise, cough or shortness of breath)
AND
Have a risk factor for SARS (in the 10 days before they became ill they had been in China, including Hong Kong or Taiwan, Singapore, or Hanoi; have had contact with a person with SARS; or have been in a hospital that is closed due to SARS – Scarborough Grace and York Central).
Scarborough Grace and York Central hospitals have been closed since the end of March because there has been evidence of spread of the virus at these facilities.
What is happening in long term care facilities?
Visitors are being restricted to one per resident at one time. Staff, volunteers and visitors are being screened using similar criteria that the hospitals.
What is happening in doctors’ offices?
Doctors’ offices are also screening patients who come to their offices. People with risk factors for SARS and SARS symptoms are being sent to a hospital emergency department to be checked-out.
What should people who have trips planned to affected areas do?
As of April 2, 2003, Health Canada is recommending that people NOT travel to the following areas: China including Hong Kong and Taiwan, Hanoi (Vietnam), and Singapore. They also recommend that alternate routes be considered instead of having to stop over in these areas while travelling.
What should people do who are planning a trip to the Greater Toronto Area?
There is no Health Canada travel restrictions to the Greater Toronto Area. It is advised that social events involving hospital staff from the Greater Toronto Area be curtailed.
Should travellers returning from affected areas stay home from work or school?
No. There are no restrictions on returning travellers. People returning from China, Hanoi and Singapore should be receiving specific instructions on the airplane and/or at the airport. These instructions advise them to watch for symptoms of SARS, such as fever, cough, shortness of breath or difficulty breathing. Returning travellers are advised to call the emergency department right away should any of these symptoms develop.
What should I do if I experience symptoms that might be SARS?
Individuals with symptoms of SARS who have travelled to the areas listed above, or who have had contact with a SARS patient, or were at the Scarborough Grace Hospital from March 16-26, 2003 or York Central Hospital from March 16-28, 2003, should call their local emergency department or the Health Unit at 663-5317 ext. 2330; after hours 675-7523.
Additional information on SARS is available from the Middlesex-London Health Unit at 663-5317 ext. 2330. Our website also contains a SARS section – go to http://www.healthunit.com and then click on “Disease Prevention”.
