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The Sars Outbreak

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The SARS Outbreak of 2003
Western Governors University

January 15, 2013

The SARS Outbreak of 2003 Severe acute respiratory syndrome (SARS) is a viral respiratory caused by a coronavirus. Coronavirus is in the same virus family as the common cold. Most commonly spread through person to person contact and droplets when a person coughs or sneezes. It can also be spread when a person touches a surface or object contaminated with the virus then touch their nose, mouth or eyes. Characterized by high fevers, headaches, feeling of discomfort, some may have diarrhea and body aches most will present with a mild respiratory infections, which may lead to pneumonia (CDC, 2012). People that are exposed to the virus may not show symptoms until 2 to 7 days after exposure, this is the viruses average incubation period.
SARS first appeared in southern China in 2002 in the Guangdong Province. The Chinese government did not make the outbreak known at this time. It wasn’t until March 2003 that SARS started gaining attention. The patients were presenting with an atypical pneumonia. It was believed that a businessman carrying the virus stayed in a Metropole Hotel in Hong Kong, at the same time a doctor from the Guangdong Providence was staying. The doctor had treated infected patients in Guangdong before going to visit Hong Kong. Shortly after the visit at the hotel, other quests and staff members started becoming ill. “ Of those were a tourist from Toronto, a flight attendant from Singapore, the businessman who subsequently traveled to Vietnam, and a local Hong Kong resident, who was visiting an acquaintance at the hotel” (Mendoza Monica, 2003). Guests of the hotel did not realize they were carrying the virus due to the long incubation period and traveled into Canada, Vietnam, and Singapore. These people presented with flu-like symptoms and therefore were not diagnosed right away exposing their families and healthcare workers. Once the diagnoses of SARS were obtained the World Health Organization (WHO) issued a global alert. By July of 2003 no new cases had been identified and the WHO stated that the SARS crisis was over ("Areas with recent," 03). According to the World Health Organization, 8,098 people became infected with the SARS virus worldwide, of those 774 people died. Only 8 confirmed cases were reported in the United States and none were fatal and did not spread worldwide. Since 2004 there have not been any confirmed cases of the SARS virus anywhere in the world (CDC, 2012). The incidence rate is figured by the number of diagnosed cases by the number of people at risk of being infected. The incidence and mortality rates of SARS were 18.57 per 100,000 and 1.41 per 100,000 with the fatality of 7.6% The highest incidence rate of SARS was in the group of 20 - 29 years (30.85 per 100,000), and the lowest was in the group of 0 - 14 years (2.54 per 100,000). People aged 20 - 49 accounted for 72.3% of all SARS cases (Dugdale III, 2011). SARS can be spread through respiratory droplets after the infected individual coughs or sneezes. Droplets then enter through the mucous membranes of the uninfected individual by mouth, nose, or eyes. SARS can also be transmitted through person to person contact. Any close contact with the infected individuals can spread the disease. The virus can also live on surfaces that the infected individual may have come into contact with (Environmental and Occupational Health, 2003). As previously discussed, SARS is a highly contagious virus. In a matter of only a few days the virus can spread quickly throughout a community. A single infected individual can infect multiple people through the easy transmission process and those newly infected people carry the virus unknowingly to others.

Affect on My Community If SARS were to reach my community it would be devastating. Springfield, Missouri is highly populated with approximately 275,000 residents and is the third largest city in the state. It is home of the Springfield-Branson airport and has many close outlying cities. SARS would spread very quickly throughout the community. With the airport nearby it would be easily spread throughout the rest of the world.
Protocol for Reporting SARS Outbreak:
SARS is highly contagious and poses a threat to any community. In Missouri, if a patient is diagnosed or suspected of having SARS, a prompt phone call would be required to alert all the public health officials. According to Missouri State Statutes, because of how highly contagious this disease is, SARS must be reported immediately via telephone, facsimile, or other rapid communication technique (“Rules,” “n.d.”). If a patient had a confirmed case of SARS a prompt phone call would be required to alert public health officials. The Missouri State Department of Health would then report to other agencies as needed and issue a global warning if they felt they need to.
Poor Air Quality Index:
The air quality index tells you how clean or polluted the air that we breathe is. When the air quality index is low, it poses a threat to our health. This particularly affects children and people with chronic lung conditions such as asthma and COPD. When the air quality index is low, it is important that we adjust our plan of care to those that are more susceptible to problems. “Ground level ozone also can reduce lung function and inflame the lining of the lungs. Repeated exposure may permanently scar lung tissue” (United States Environmental Protection Agency [EPA], 2012). It is important to educate the patients we treat. Educate them to watch the news, search the internet for current and changing index levels, and even have the index count emailed to them. The air quality index can change from hour to hour, just like the weather (United States Environmental Protection Agency [EPA], 2009). The patients should also be made aware of what effect the air quality has on their health. Educate them to carry their medication with them if they must go out such as an inhaler. Keep all medications and prescriptions filled in the event that the air quality remains poor and they might need refills and to take the medications as prescribed as the air quality may increase the work of breathing. Educate them to stay indoors with windows and doors closed as much as possible, use an air purifier if available. This might pose a problem to patients that lack air conditioning. The community nurse may need to suggest to the patient to stay at cooling shelter or to stay with family that has air conditioning. If they must leave the house, educate them to take necessary inhalers with them. When the air quality is low it makes it difficult to breath especially to those that already struggle with breathing, avoiding any heavy exertion. It might be necessary for the nurse to communicate with the physician regarding home oxygen when breathing becomes too much of a struggle. The nurse should include a case manager and social worker as needed for resources in the community. When the air quality is poor it has a negative effect on the population as a whole, but affects those that already have underlying heart and lung conditions. By adjusting the necessary care and educating these patients hopefully it will make their breathing struggles easier.

Areas with recent local transmission of sars. (03, 20 20). Retrieved 27 January 2013 from
Center for Disease Control. (2012). Center for disease control. Retrieved 15 January, 2013 from
Dugdale III, D. (2011, February 19). U.s.national library of medicine. Retrieved from
Environmental and Occupational Health. (2003). Severe acute respiratory syndrome. Retrieved from
Mendoza Monica, M. (2003, march) Retrieved 27 January 2013 from
Rules of Department of Health and Senior Services, Chapter20. (“n.d.”). Retrieved 27 January 2013 from
United States Environmental Protection Agency. (2009). A Guide to Air Quality and Your Health Retrieved 23 January 2013 from

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