SARS

Mareike Müller is a freelance writer in the medical department and assistant doctor for neurosurgery in Düsseldorf. She studied human medicine in Magdeburg and gained a lot of practical medical experience during her stays abroad on four different continents.

More about the experts All content is checked by medical journalists.

SARS (severe acute respiratory syndrome) is an infectious disease caused by viruses that can be fatal. It first performed in southern China in 2002.In addition to other symptoms such as fever, the main symptoms of the patients are breathing difficulties. There is no drug treatment of the cause of the disease, only the symptoms can be alleviated. Here you can read everything you need to know about SARS.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. J17U04

SARS: description

SARS is the abbreviation for "severe acute respiratory syndrome". The name already describes some of the symptoms that patients with SARS have: "Respiratory" means that the disease affects the respiratory organs.

A new disease

SARS was first reported in November 2002. It initially only appeared in Southeast Asia. Within six months, the disease had spread worldwide. In total, about 8,000 people contracted SARS, 744 of whom died from the disease.

SARS mainly affected adults. Up to this point in time, viruses belonging to the same group as the SARS virus (coronaviruses) were only known to cause mostly harmless colds in adults.

Few cases of SARS have emerged since 2003 that originated in research laboratories working with the virus.

Similar clinical pictures

Another coronavirus was discovered in 2012. In the Arabian Peninsula in particular, people were infected who subsequently suffered from respiratory problems and kidney failure. About half of them died. The virus that was discovered there is known as MERS-CoV (middle East respiratory syndrome coronavirus).

SARS: symptoms

The time between infection and the onset of SARS disease (incubation period) is around two to seven days. In the first days of the illness, SARS is usually announced with

• rapidly rising fever
• headache
• muscle pain
• strong general feeling of illness

After about three to seven days, the actual SARS phase begins, in which the respiratory organs in particular are affected (respiratory phase). The patients then suffer from

• dry cough
• Shortness of breath (dyspnoea)
• Lack of oxygen in the blood (hypoxemia) and organs

Around 70 percent of patients also suffer from thin diarrhea. In some of them, this occurs as early as the first week of illness.

If the lungs are so severely damaged by the SARS virus that they can no longer ensure adequate gas exchange, this is referred to as lung failure. Without intensive medical help, the patients would die. However, numerous SARS cases have also been reported that were mild or asymptomatic.

SARS: causes and risk factors

The cause of SARS is an infection with the SARS virus. Viruses are particles that consist of a shell and a genetic material located in it. The SARS virus is a coronavirus and is correctly referred to as the SARS coronavirus. "Corona" is the name given to the shell of this type of virus, which looks like a wreath under the microscope.

Animals carry the virus

It is assumed that the SARS virus originates from an animal reservoir. This means that animals originally carried the virus and the viruses were able to multiply in them. It is believed that Asiatic bats formed this reservoir. SARS was eventually transmitted to humans through other animals such as cats. That is why one speaks of a zoonosis in connection with SARS. Zoonosis is the term used to describe diseases that can be transmitted from animals to humans and vice versa.

This is how the virus harms the body

Human-to-human transmission of SARS occurs as a droplet infection via the air. Only patients who are acutely ill are contagious. The SARS viruses then attack the cells that line the respiratory tract. They are called ciliated epithelium in the bronchi because they have small structures on their surface that look like eyelashes (cilia). These cilia are normally used to clean the airways, for example by moving mucus that has formed to the outside with a beating movement.

The viruses multiply in the cells of the ciliated epithelium and paralyze the movements of the cilia. This inhibits the defense against pathogens, pollutants and mucus. In addition, the release of carbon dioxide and the absorption of oxygen (gas exchange) can no longer take place properly in the lungs, since the alveoli in which the gas exchange takes place are also damaged by the viruses.

Who is at risk?

In principle, anyone who comes into contact with the virus can be infected with SARS. Observations show that certain groups of people are particularly at risk. During the 2002 and 2003 outbreak, it was found that children were rarely diagnosed with SARS. Men died from it more often than women, especially if they had other chronic diseases.

If pregnant women contracted SARS, the unborn child died more frequently during the first months of pregnancy. In the later pregnancy, however, the mortality of expectant mothers increased.

SARS: examinations and diagnosis

In order to diagnose “SARS”, your doctor will first ask you in detail about your medical history. He will ask you the following questions, among others:

• How long have you been feeling sick?
• Do you have fever?
• Do you have muscle pain?
• Are you breathing well?
• Have you been abroad recently?

Your doctor will then do a physical examination. Your temperature will be measured and your lungs will be monitored. A chest x-ray can also be taken. You can already see changes in this in the first days of SARS disease.

All results from the medical history interview and physical examination can also point to another illness, such as the flu. If SARS is suspected, for example because a large number of cases have come back, a blood test will be carried out. Only in this way can SARS be unequivocally determined. For this, blood will be drawn from you and examined in a special laboratory under high security conditions. A procedure is used that allows the genetic makeup of the virus to be detected directly.

Another way to detect SARS disease is to look for specific antibodies in the patient's blood. These are made by the body during the course of the disease to fight the viruses.

SARS: treatment

There is no causal therapy for SARS. So there are no drugs that can render the SARS virus harmless in the human body. Therefore the treatment is purely symptomatic. So you treat the individual signs of illness, such as fever or pain, without eliminating their cause.

In the case of SARS, respiratory masks with oxygen are used to relieve shortness of breath, fever-lowering drugs such as paracetamol or ibuprofen, and infusions to maintain the body's water balance, especially in the case of severe diarrhea.

It has been found that Interferon Alpha (IFNα) can support the healing process in SARS. Interferons are proteins that are also produced by the body and that support the immune system in fighting viruses.

An important goal of therapy is to prevent the disease from spreading among the population. Therefore, SARS patients are isolated. It is important to ensure that people such as medical staff only approach the patient with a face mask and protective gown. In addition, hands must be carefully disinfected after each contact.

SARS: disease course and prognosis

The time between infection and the onset of SARS disease (incubation period) is around two to seven days. The infection then often runs in two phases. In the first week, flu-like symptoms appear, while in the second week the full picture of SARS appears.

About ten percent of patients die from SARS. Mild forms that remain almost asymptomatic have also been reported. If the patient survives a SARS infection, the disease usually heals without consequences.

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