Franco-Paredes Carlos, Kuri-Morales Pablo, Alvarez-Lucas Carlos, Palacios-Zavala Ethel, Nava-Frías Margarita, Betancourt-Cravioto Miguel, Santos-Preciado José Ignacio, Tapia-Conyer Roberto
Centro Nacional para la Salud de la Infancia y Adolescencia, México, DF, México.
Salud Publica Mex. 2003 May-Jun;45(3):211-20.
In early February 2003, the World Health Organization (WHO) began receiving reports of patients with a syndrome characterized by an atypical pneumonia with rapid progression to respiratory failure without an identified cause despite extensive diagnostic workups. Most of these reports pointed out that the outbreak started in Southern China, specifically in the Guandong Province. The initial outbreak in South East Asia has already spread to other Regions in Asia, Europe, North and South America, and South Africa. Many of these cases can be linked through chains of transmission to an index case from the Guandong Province who visited Hong Kong. Although the exact mode of transmission has not been clearly established, the etiology of this syndrome has already been identified. A novel Coronavirus has been identified by electron microscopy and molecular assays in multiple laboratories from respiratory specimens throughout the world. The syndrome has been defined as SARS (Severe Acute Respiratory Syndrome) by WHO, and is characterized by an incubation period between 1 and 10 days (average 5 days) and by a febrile phase that usually lasts approximately 3 days. During the respiratory phase that begins around day 3, patients start developing a dry cough, shortness of breath and hypoxemia. Mechanical ventilatory support is required in about 10 to 40% of cases and the case-fatality rate ranges between 3 and 16%. The laboratory findings in SARS cases include leukopenia, thrombocytopenia, and a rise in transaminases and lactic dehydrogenase levels. Treatment of SARS includes supportive measures and the empiric use of ribavirin. Respiratory isolation, use of respiratory masks, and compulsory hand hygiene constitute the principal preventive measures. The confirmation of a case can be performed at reference laboratories by serologic and molecular assays. From the onset of this epidemic Mexico established a surveillance system as well as clinical guidelines and recommendations for the identification, prevention of secondary spread, and medical management of suspicious and probable cases by health care personnel.
2003年2月初，世界卫生组织（WHO）开始收到有关一种综合征患者的报告，该综合征的特征为非典型肺炎，尽管进行了广泛的诊断检查，但仍迅速发展为呼吸衰竭且病因不明。这些报告大多指出，疫情始于中国南方，特别是广东省。东南亚的最初疫情已蔓延至亚洲其他地区、欧洲、南北美洲和南非。其中许多病例可通过传播链追溯至一名来自广东省并前往香港的首例病例。尽管确切的传播方式尚未明确确定，但该综合征的病因已被查明。多个实验室通过电子显微镜和分子检测，在来自世界各地的呼吸道标本中发现了一种新型冠状病毒。WHO已将该综合征定义为严重急性呼吸综合征（SARS），其潜伏期为1至10天（平均5天），发热期通常持续约3天。在大约第3天开始的呼吸期，患者开始出现干咳、呼吸急促和低氧血症。约10%至40%的病例需要机械通气支持，病死率在3%至16%之间。SARS病例的实验室检查结果包括白细胞减少、血小板减少以及转氨酶和乳酸脱氢酶水平升高。SARS的治疗包括支持性措施和经验性使用利巴韦林。呼吸道隔离、佩戴呼吸面罩和强制手部卫生是主要的预防措施。可在参考实验室通过血清学和分子检测确诊病例。自此次疫情爆发以来，墨西哥建立了监测系统以及临床指南和建议，供医护人员识别、预防二次传播以及对可疑和可能病例进行医疗管理。
