Oh Vernon M S, Lim T K
National University of Singapore, Singapore.
Clin Med (Lond). 2003 Sep-Oct;3(5):448-51. doi: 10.7861/clinmedicine.3-5-448.
The coronavirus that causes severe acute respiratory syndrome (SARS) is transmitted mainly via respiratory droplets. Typical presenting symptoms are akin to those of ordinary pneumonia. Young patients start with fever, chills, malaise, headache, or myalgia; cough and dyspnoea follow. Older persons and those taking corticosteroids may have neither fever nor respiratory symptoms. Exceptional suspicion is needed to identify SARS early in the illness. During an outbreak, even patients with low suspicion of SARS should be promptly isolated, and all contacts quarantined. Health workers need training in the use of appropriate barriers against droplets and other body fluids. Any fever cluster in patients or carers requires immediate action: discharges, visits, and transfers between wards and hospitals should be stopped. Halting hospital admissions and ten-day quarantine of suspected cases create wide buffer zones. To counter a possible resurgence of SARS, a system of prepared isolation and quarantine facilities is important.
导致严重急性呼吸综合征(SARS)的冠状病毒主要通过呼吸道飞沫传播。典型的临床表现与普通肺炎相似。年轻患者起病时表现为发热、寒战、乏力、头痛或肌痛,随后出现咳嗽和呼吸困难。老年人及正在服用皮质类固醇的患者可能既无发热也无呼吸道症状。在疾病早期识别SARS需要高度怀疑。在疫情暴发期间,即使对SARS怀疑程度较低的患者也应立即隔离,所有接触者均需检疫。医护人员需要接受使用适当的飞沫和其他体液防护屏障的培训。患者或护理人员中出现任何发热聚集情况都需要立即采取行动:应停止出院、探视以及病房和医院之间的转院。停止医院收治并对疑似病例进行为期十天的隔离可建立广泛的缓冲区。为应对SARS可能的卷土重来,建立一套完备的隔离和检疫设施系统至关重要。