Severe Acute Respiratory Syndrome (SARS)

Severe Acute Respiratory Syndrome (SARS) Introduction

Hong Kong situation (on 23 May 2003) • No. of cases:1724 • No. of death: 260 • male: female 4.5:5.5

Age distribution 0-14 5% 15-24 10% 25-34 24% 35-44 21% 45-54 15% 55-64 7% 65-74 8% 75 or above 10%

Occupations • Information collected from 90.3% of cases • 61% working population • 39% non-working population

Working Group Health Care Workers 23.9% Food Handlers 1.9% Domestic Helpers 1.9% School Staff 1.5% Disciplinary Force 0.6% Others 31.3% (e.g. drivers, clerical and administrative personnel)

Non-working Group Retired 12.9% Housewives 10.1% Students 8.7% Pre-school Children 0.6% Visitors/Tourists 0.3% Others 6.6% (e.g. unemployed)

Incidence of SARS cases by residential areas • Kwun Tong 11.8 per 10 000 • Tai Po 6.2 • Sha Tin 4.1 • Other 15 districts 0.5-2.4

Clinical Presentation • Fever is the commonest reported symptom • Other symptoms: chills, malaise, cough, headache and muscle ache • % of elderly having fever is lower • Only 61% have respiratory symptoms, 32% have GI symptoms

General Symptoms Fever 93.3% Chills 58% Malaise 55.9% Headache 42.6% Muscle Ache 41.8% Rigors 35.9% Loss of appetite 28%

Respiratory Symptoms Cough 45.8% Sore throat 18.3% Shortness of breath 15.3% Running nose 12.4%

GI Symptoms Diarrhoea 17.5% Vomiting 11.5% Nausea 11.3% Abdominal pain 10.2%

Combination of symptoms Fever and chills 55.8% Fever and malaise 53.1% Fever and cough 42.8%

Symptoms of different age groups 0-14 Fever and cough 15-64 Fever with general symptoms 65 and above only 10 to 36% having fever with one other symptom

Home Confinement • Household contacts • confirmed or suspected cases • maximum of 10 days • for monitoring and referral for treatment

As at 22 May • 1219 persons had been affected • 49 were still under confinement • 33 had been confirmed to have SARS

Border Checks Health Declaration Post • airport, ports and border points • incoming travellers to complete a health declaration

Temperature checks • All passengers arriving, departing and transit passengers • at the HK International Airport • temperature checks

Other control points: • arriving passengers subjected to screening • all departing passengers from Ferry Terminals and Hung Hom Station are required to undergo temperature checks • So far, 2 passengers had been confirmed to have SARS

Setting up of Designated Medical Centres (DMC) monitor contacts other than household contacts daily reports and monitoring Schools recent return to school daily temperature checks Close school for cleaning once suspected case identified Other Measures

General Health Education • Daily press release for dissemination of information • SARS symptoms • Hand hygiene, personal and environmental hygiene • Cleaning campaigns

Thank You

Background Information • Nov 02, reports of cases in Guandong, China • Mar 02, professor visited Hong Kong to attend banquet • Outbreaks of infection in local hospitals and overseas

Case Definition • WHO • Probable cases • Suspected cases • other considerations

Cases worldwide • No. of cases • No. of deaths

The responsible agent • SARS related corona virus • co-infection with other agents • new recent findings

Mode of transmission • Droplets infection • close contacts • Amoy garden reports • superspreaders

Virus behaviour • Survival • incubation period

Treatment methods • Inpatient treatment • ribarivirin • steroids • combination

Inpatient treatment ribarivirin steroids combination Vaccine no effective vaccine available need time for development 1 to 5 years Treatment methods

WHO recommendations • Case detection and treatment • Contact tracing and isolation • Prevention of export of cases by health checks at borders • Education of public • symptoms of SARS • hand hygiene, personal and environmental hygiene

WHO information • Updates in website • affected areas with recent local transmission • travel advice to affected areas

Severe Acute Respiratory Syndrome (SARS)