Apr. 5, 2003. 08:38 AM



AP Photo
Travellers wear masks in an attempt to ward off pneumonia at Baiyun International Airport in Guangzhou, capital of China's Guangdong provice, March 17, 2003.

RELATED LINKS

> More SARS coverage

> A SARS primer

> How world let virus spread (Apr. 19)

> Doctors to size up 'worst-case' outlook (Apr. 19)

> Cracking the SARS code (Apr. 12)

> Voices: Has SARS changed your routine?

> WHO Interim Report from China (Apr. 9)

> Health Canada: Public Health

> World Health Organization warning

> CDC: SARS warnings



A SARS primer
Research labs around the world look for cause; Wear a mask, stay home 10 days if you're exposed


NICK MCCABE-LOKOS
LIFE WRITER

The deadly outbreak of Severe Acute Respiratory Syndrome (SARS), an illness about which little is known, has left the public and the scientific community scrambling to learn how to deal with its effects.

Here are answers to some of the basic questions about SARS and its spread.

What are the symptoms?

A defining symptom of SARS that sets it apart from the symptoms of a cold or flu is shortness of breath.

"It starts with a fever, which becomes a high fever, mild respiratory symptoms, coughing and eventually shortness of breath and difficulty breathing, which then becomes severe and then needs medical attention," says Dr. Bhagirath Singh, scientific director of the Canadian Institutes of Health Research in London, Ont.

These symptoms develop as a package; a cough or fever on its own does not indicate SARS infection, Singh says. "Clearly, people who have fever, high fever, cough, should take precautions not to have other people exposed."

How fast do the symptoms develop and when are they a cause for concern?

Toronto Public Health says symptoms show up within 10 days of coming into close contact with an infected person.

Close contact means caring for, living with or having direct contact with the respiratory secretions and bodily fluids of a person with SARS.

Singh says some people who have returned from travelling in suspect areas (Southeast Asia, China) in the last two or three weeks have developed symptoms.

"As soon as people have a high fever, they should consult their doctor. There is no point in waiting for this to develop to a stage of infecting other people," Singh says.

Anything above 38 degrees Celsius (100.4 F) is considered a high fever.

While everyone does not respond at the same rate, he says, there should be concern if the fever is still high after three or four days and if there is shortness of breath.

Who is getting SARS?

It's not affecting the general population, at this point. It's striking those who have either had contact with people with the disease, people who have travelled to Southeast Asia, particularly China, and have come back in the past few weeks, Singh says.

Toronto Public Health says people whose symptoms show up within 10 days of visiting Guangdong province in China, Hong Kong, Vietnam (city of Hanoi), Taiwan and Singapore may have contracted the illness.

There are cases in Southeast Asia of children being exposed, Singh says.

"It seems to be affecting people who, I'm sure, are in a good health state." But people who have had organ transplants, have heart conditions or a weakened immune system are more susceptible to SARS, just like they are to any other illness, he says.

What is known about the source of SARS?

The outbreak started in China, where it sickened hundreds, and was carried to Toronto by Sui-chu Kwan, who was returning from Hong Kong. Kwan died of the disease March 5.

The outbreak has been traced to a 64-year-old medical professor who was believed to have carried the condition to Hong Kong.

How are infected people being treated?

"At this point, there is no known cure."

Toronto Public Health says patients with SARS are being isolated, treated with antibiotics and antiviral agents and are receiving supportive care. Hospital staff are using appropriate precautions.

According to World Health Organization (WHO) doctors, this is the usual sort of treatment when it isn't known what a patient is suffering from.

Dr. Andrew Simor, an infectious disease expert at Sunnybrook and Women's College Health Science Centre, told the Star that an antiviral agent called Ribavirin is being used to treat patients at Sunnybrook. But the WHO says that agent is being used with unremarkable results.

Singh says because the disease is so new, it's too early to treat infected people with antibodies from another person who has recovered from the illness. "Really, there is no obvious treatment at this point."

What are the chances that a person who contracts SARS will be killed by it?

The WHO says the illness has a mortality rate of 4 per cent. This is slightly greater than the mortality rate for West Nile virus in North America, which is not high.

A senior official from the WHO told Reuters that between 80 and 90 per cent of patients begin to recover after a few days, but a minority quickly become critical.

What precautions can people take?

"You should avoid visiting people if they have severe fever, colds," Singh says, adding that, "obviously, if you have (these symptoms), you should consult your doctor immediately so that there is no chance of spreading to your family or your close contacts."

Health Canada advises that people "should defer all travel until further notice" to the destinations listed above.

Is there any indication about what form the illness takes?

Eleven labs worldwide are working to figure out what causes SARS. The U.S. Centres for Disease Control and the WHO believe it is a corona virus, which causes the common cold and other, more serious, respiratory diseases. The National Microbiology Laboratory in Winnipeg thinks it could be a virus from the family that causes mumps and measles.

What should a person with symptoms do?

"The first contact should be their own doctor," Singh says. If that's not possible, they should go to the local emergency ward.

Toronto Public Health officials urge people who think they have SARS or may have had contact with a SARS case to call them at 416-338-7600 or seek medical attention. General questions about SARS can be answered by calling Telehealth Ontario at 1-866-797-0000.

The proper masks to wear to prevent the spread of SARS are N95 surgical masks. They are often used to protect against other highly transmissible respiratory infections such as tuberculosis. The mask should be changed twice daily. They can be bought at medical supply stores but have been flying off the shelves, so call before you head out to buy.

The Red Cross, in co-ordination with Toronto Public Health, will be delivering five days' worth of masks and thermometers to the people under quarantine in the city of Toronto.

If you have been exposed to SARS, remain at home, in isolation, for 10 days. Do not leave the house or have anyone visit.

During this period, wear a mask if another person is in the same room. Have people drop food off on your doorstep. Sleep in a room alone. Don't share your personal items.

Wash your hands frequently and take your temperature twice daily.
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