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 distribution0-14 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 groups0-14 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 dec

laration

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 Terminal

s and Hung Hom Station are required to undergo temperature checks

So far, 2 passengers had been confirmed to have SARS

Other Measures

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

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

Treatment methods

Inpatient treatment– ribarivirin

– steroids

– combination

Vaccine– no effective vaccine

available

– need time for development

– 1 to 5 years

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