J. Trembley SARS: SEVER ACUTE RESPIRATORY SYNDROME

CORONAVIRUS Common viruses Human coronaviruses usually cause mild to moderate upper-respiratory tract illnesses. Coronaviruses are named for the crown-like spikes on their surface. Common diseases include Common cold CDC and Socio-Ec

LIFE CYCLE Enters the cells through membrane fusion instead of endocytosis Replicates in the Nucleus Nucleocapsids assemble in the Rough ER and mature by budding into the smooth vesicles, which derive from the Golgi apparatus. The smooth vesicles fuse with the cell membrane, and the mature particles are released. Nature and Pubmed

CHOOSE YOUR OWN ADVENTURE Following time line of SARS global outbreak and discovery Occurred in 2003 Began in the small farming villages of China Note: some of this is extrapolation

NOVEMBER 2002 You are a Horseshoe bat in china carrying a SARS like virus. You are hungry and see a human and a cat like mammal walking side by side. Which one do you bite?

EAT?

FEBRUARY 2003 You are Chinese Doctor Liu Jianlun, a 64-year-old Chinese doctor who had spent time treating cases from the original outbreak but you have traveled to Hong Kong to attend a wedding. You begin to have a cough and some slight difficulty breathing but but its probably just a common cold. your friend asks you to go sightseeing, what do you do?

FEBRUARY 2003 You are WHO doctor Carlo Urbani, an infectious diseases specialist. A 47-year-old Chinese-American businessman arrives at your hospital in Vietnam and is sick with what appears to be Avian Influenza. You are assigned to diagnose him but are contemplating whether or not to wear respiratory protection while you care for him, what do you do?

MARCH 2003 You are a passenger sitting next Carlo Urbani on a plane headed for Bangkok. you see him coughing and sneezing. you think nothing of it. Some days later you begin to get sick and you need to sneeze in public. Do you cover your mouth with your hand or with your elbow? wiki

MARCH 2003 March 2003, you are a head of Infectious disease control at WHO. You have already issued a global health alert due to the many alerts raised by nations across the globe. However, at this point, the disease is still unknown. many travel advisories and bans have been implemented worldwide in attempt to quarantine off infected areas but the number of new cases still is not dropping. You have the option to poor all your resources into one laboratory to perform research or create a team of 11 laboratories world wide. Whats the best option for the discovery and prevention of the disease?

The death rate from SARS was 9 to 12% of those diagnosed. In people over age 65, the death rate was higher than 50%. The illness was milder in younger patients. Many more people became sick enough to need breathing assistance. And even more people had to go to hospital intensive care units. Public health policies have been effective at controlling outbreaks. Many nations have stopped the epidemic in their own countries. All countries must continue to be careful to keep this disease under control. Viruses in the coronavirus family are known for their ability to change (mutate) in order to spread among humans. (All information, unless otherwise stated, regarding the 2003 outbreak is from WIKI)

Antibiotics to treat bacteria that cause pneumonia Antiviral medications High doses of steroids to reduce swelling in the lungs Oxygen, breathing support (mechanical ventilation), or chest therapy In some serious cases, the liquid part of blood from people who have already recovered from SARS has been given as a treatment. There is no strong evidence that these treatments work well. Cough Difficulty breathing Fever greater than degrees F (38.0 degrees C) Other breathing symptoms Chills and shaking Cough -- usually starts 2-3 days after other symptoms Fever Headache Muscle aches SYMPTOMS AND TREATMENTS SymptomsTreatments (Board)

PREVENTION Reducing your contact with people who have SARS lowers your risk for the disease. Avoid travel to places where there is an uncontrolled SARS outbreak. When possible, avoid direct contact with persons who have SARS until at least 10 days after their fever and other symptoms are gone. Hand hygiene is the most important part of SARS prevention. Wash your hands or clean them with an alcohol-based instant hand sanitizer. Cover your mouth and nose when you sneeze or cough. Droplets that are released when a person sneezes or coughs are infectious. Do not share food, drink, or utensils. Clean commonly touched surfaces with an EPA-approved disinfectant (Board, A)

TECHNOLOGICAL RESPONSE Solidified global response tactics Developed solutions for viral/disease control in low-resource areas Medical technological responses are limited WHO

WORKS CONSULTED Qinfen, Z., Jinming, C., Xiaojun, H., Huanying, Z., Jicheng, H., Ling, F., et al. (2004, July 1). The life cycle of SARS coronavirus in Vero E6 cells.. National Center for Biotechnology Information. Retrieved June 10, 2014, from Tracking SARS back to its source. (2013, July 1).. Retrieved June 10, 2014, from Timeline of the SARS outbreak. (2014, June 6). Wikipedia. Retrieved June 10, 2014, from Du, L., He, Y., Zhou, Y., Liu, S., Zheng, B., & Jiang, S. (2009, March 1). The spike protein of SARS-CoV — a target for vaccine and therapeutic development. Nature.com. Retrieved June 10, 2014, from

WORKS CONSULTED SARS. (2013, April 16). Centers for Disease Control and Prevention. Retrieved June 10, 2014, from About Coronavirus. (2014, June 5). Centers for Disease Control and Prevention. Retrieved June 10, 2014, from Board, A. (2013, January 28). Severe Acute Respiratory Syndrome (SARS). Severe acute respiratory syndrome (SARS). Retrieved June 10, 2014, from Commercial Labs Patent Novel Coronavirus Delaying Diagnostic Tests!. (2013, June 8). SocioEconomics History Blog. Retrieved June 10, 2014, from coronavirus-delaying-diagnostic-tests/ WHO SARS Scientific Research Advisory Committee concludes its first meeting. (2003, October 22). WHO. Retrieved June 11, 2014, from

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