SARS stands for severe acute respiratory syndrome . caused by a corona virus . major outbreak in south china in 2002 with fatality of about 10% and 800 deaths in a single outbreak.

2. MORPHOLOGY OF CORONA VIRUS
• CORONA VIRUS : positive
strand enveloped RNA virus
that are important
pathogens of mammals
and birds.
• Cause enteric or
respiratory tract infections in a variety of
animals inc humans ,livestock and pets.

3. • Its genome is about 29.7 kb , which is one of
the largest among RNA viruses.
• SARS is similar to other corona virus in that its
genome expression starts with translation of 2
large orf 1a and 1b which are 2 poly proteins.

4. SIGNS AND SYMPTOMS

5. PATHOGENESIS
• Infectious agent = severe acute respiratory
virus.
• Newly discovered corona virus
• Corona v= group of viruses that have
halo/crown like appearance.
• mild to moderate respiratory illness in humans
or respiratory,GI,liverand neurologic diseases
in animals
• Sometimes rarely causes pneumonia
especially in weak immune system.
• Can usually survive in environment for a
couple of days.

7. • Mode of transmission- through cough and
sneezes.
- close person to person contact.

8. Clinical findings
• Chest X ray findings

9. COMPLICATIONS
• As with any viral pneumonia, pulmonary
decompensation is the most feared problem.
• Patients often require intubation which may
results in sequelae such as; intensive care ..
Infection from nosocomial pathogens,
tension pneumothorax from ventillation at
high peak pressures & non cardiogenic
pulmonary oedema

10. INVESTIGATIONS
• Selected investigations are intended to
determine the cause of the respiratory
illness.
Test for viral, bacterial and other usual
respiratory pathogens
Identify common pathogens circulating in
the community which may be
responsible for the illness

11. • CBC, DLC, AST, ALT, bilirubin, alkaline
phosphatase, LDH, CPK, urea, creatinine,
electrolytes
• other diagnostic tests as indicated by patients
condition

12. • Respiratory samples:
NP swab #1: rapid antigen detection for
respiratory viruses, viral cultures, viral PCR
ETT aspirate or Auger suction: SARS
investigation
throat swab #1: Group A strep
throat swab #2: Mycoplasma PCR
• Blood for serology:
1. One clotted tube[5 cc] labelled “SARS
serology”
• Stool:
• For viral electron microscopy

13. DIAGNOSIS
. Virus Detection
• Virus isolation: inoculate
suitable cell culture with
patient specimens

14. Antibody Detection
When infected by SARS-CoV 
antibodies (e.g. IgM and IgG) are
produced / change in level
• Enzyme-linked immunosorbent assay
(ELISA)

15. Immunofluorescence assay (IFA):
Sample: patient serum
Method:Fix SARS-CoV-infected cells on
microscope’s slide (patient
antibodiesalready bound to viral antigens)
Immunofluorescent-labeled 2º antibodies
bind to human IgG/IgM
Significance:
positive result after
10 days of onset
of illness

16. CDC guidelines for Confirmatory
testing
• Positive RT-PCR test results should be
confirmed in a reference laboratory.
Confirmatory testing is particularly important
in areas with a low prevalence of SARS-CoV
disease, where the positive predictive value of
the assay is likely to be quite low. CDC will
conduct confirmatory testing during the early
phases of an outbreak.
Dr.T.V.Rao MD16

18. MANAGEMENT OF SARS
• Antibiotics are ineffective as SARS is a viral
disease. Treatment of SARS so far has been
largely supportive with antipyretics,
supplemental oxygen and ventilatory support
as needed.
• Suspected cases of SARS must be isolated,
preferably in negative pressure rooms, with
complete barrier nursing precautions taken for
any necessary contact with these patients.
• There was initially anecdotal support for
steroids and the antiviral drug ribavirin, but no
published evidence has supported this
therapy

19. • Loading dose of 33 mg/kg X 1 [max 2
grams/dose];
• followed 6 hours later by 16 mg/kg/dose q6h
for 4
• days [max 1 gram/dose]
• followed 8 h later by 8mg/kg/dose q8h
• [max 500 mg/dose] for 3 to 6 days depending
on
• clinical course

20. PREVENTION AND CONTROL
• Protect Healthcare Personnel During Aerosol-
Generating Procedures
• Limit personnel to those essential for
performing procedure
• Wear appropriate personal protective
equipment
–Gowns and gloves
–Sealed eye protection (i.e., goggles)
–Respiratory protection device

21. Isolation and Quarantine the best
options
SARS needs to be regarded as
a particularly serious threat
for several reasons. The
disease has no vaccine and
no treatment, forcing health
authorities to resort to
control tools dating back to
the earliest days of empirical
microbiology: isolation and
quarantine

22. • No vaccine is available.

23. REFERENCES
• Textbook of microbiology-ananthanarayan and
panikar
• Textbook of microbiology-baveja
• Wikipedia
• Lange microbiology

24. THANK YOU