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SARS Issue Toolkit

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Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained.

The SARS outbreak of 2003

According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died. In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world with SARS. SARS did not spread more widely in the community in the United States.

Symptoms of SARS

In general, SARS begins with a high fever (temperature greater than 100.4°F [>38.0°C]). Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry cough. Most patients develop pneumonia.

How SARS spreads

The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.

(Source: CDC)


Severe Acute Respiratory Syndrome (SARS) General Information from the CDC.
Frequently Asked Questions About SARS Available for download in a PDF document.
Severe Acute Respiratory Syndrome (SARS) General information from the WHO.
Severe Acute Respiratory Syndrome Information from MedlinePlus.
Statement on the Treatment of Patients with Infectious Diseases From the ADA Council on Scientific Affairs
ADA Council on Ethics, Bylaws and Judicial Affairs

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UK agency picks name for new coronavirus isolate As the investigation of two severe illnesses associated with a novel coronavirus continued today, the United Kingdom's Health Protection Agency (HPA) released a preliminary phylogenetic tree for the virus and tentatively named it "London1_novel CoV 2012."
New SARS-like virus detected in Middle East Global health officials are closely monitoring a new respiratory virus related to SARS that is believed to have killed at least one person in Saudi Arabia and left a Qatari citizen in critical condition in London.
New SARS-like virus poses medical mystery Scientists are trying to unravel a medical mystery involving a new type of coronavirus, which come from that same large family of viruses that bring us the common cold but also brought us Severe Acute Respiratory Syndrome - better known as SARS - back in 2002.
Response to SARS-Like Virus an Improvement Over 2003 Outbreak Health officials detected a SARS-like virus that started in the Middle East this month, but the global response is drastically different from what it was in 2003, when the world learned about the original SARS virus only after it had already taken hold of Hong Kong.
New coronavirus linked to two severe illnesses Reports of a novel coronavirus linked to two severe illnesses with Saudi Arabian connections put the public health world on alert yesterday and conjured up memories of SARS (severe acute respiratory syndrome), a coronavirus infection that killed close to 800 people in 2002 and 2003.
Deadly portrait of a real-life epidemic SARS provided a dramatic example of how quickly world travel could spread a disease and how fast a connected health system could respond to a new health threat.
China: Gaps Seen in Government’s Ability to Detect Disease Outbreaks Despite advances made since the emergence of SARS and avian flu, China’s ability to detect new outbreaks remains "underdeveloped,” a leading Chinese health official acknowledged last week.
New Research Aims to Shut Down Viral Assembly Line Under the electron microscope, a coronavirus may resemble a spiny sea urchin or appear crownlike, (the shape from which this family of pathogens takes its name). Previously recognized as the second leading cause of the common cold in humans and for economically important diseases in many domesticated animals, a new disease form abruptly emerged as a major public health concern in 2002, when the SARS coronavirus (CoV) surfaced in Asia.
The challenge of severe acute respiratory syndrome
(SARS) in dentistry

A fully effective control of the cross-infection risk will be obtained only by adopting a correct, integrated use of different infection control procedures.

Severe acute respiratory syndrome and dentistry: a retrospective view Researchers believe thata combination of factors, including the universal infectioncontrol measures that the dental community has implemented and/orthe low degree of viral shedding in the prodromal phase of SARS,may have obviated the spread of the disease in dental settings.The dental community should reflect on this outbreak to reinforcethe currently applied infection control measures.
Contaminated Dental Aerosols Dental hygienists practice in a highly contaminated environment—the human mouth.
Aerosols and splatter in dentistry

A brief review of the literature and infection control implications

Aerosols and droplets are produced during many dentalprocedures. With the advent of the droplet-spread disease severeacute respiratory syndrome, or SARS, a review of the infectioncontrol procedures for aerosols is warranted.
Article: Infection control practice guidelines in dental hygiene--Part 1.(EVIDENCE FOR PRACTICE)
Article from the Canadian Journal of Dental Hygiene.
Knowledge of and attitudes toward severe acute respiratory syndrome among a cohort of dental patients in Hong Kong following a major local outbreak The majority of patients interviewed had confidence in their dentists, their treatment environments, and the infection control measures taken, and were not worried about contracting SARS in the dental setting. This perception is an improvement from that described in an earlier study, in which more than half of the patients were concerned about contracting an infection during dental treatment and perceived that the infection control measures undertaken by the dental profession to prevent infectious diseases were not satisfactory. Patients, however, demanded better infection control measures during the SARS outbreak.
Severe Acute Respiratory Syndrome (SARS) and the GDP. Part I : Epidemiology, virology, pathology and general health issues. Until reliable diagnostic tests, vaccine and medications are available, control of SARS outbreaks depends on close surveillance, early identification of index cases, quick isolation of carriers and effective infection control and public health measures.
Severe acute respiratory syndrome (SARS) and the GDP. Part II: implications for GDPs.

The transmission modes of SARS-coronavirus appear to be through droplet spread, close contact and fomites although air borne transmission has not been ruled out. This clearly places dental personnel at risks as they work in close proximity to their patients employing droplet and aerosol generating procedures.

Ontario SARS report cites health system failings Inadequate worker-safety protocols probably contributed to the severity of the 2003 SARS (severe acute respiratory syndrome) epidemic in Ontario, a provincial commission said in a report unveiled this week.

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