The SARS Epidemic Essay

Severe Acute Respiratory Syndrome (SARS), a form of viral pneumonia, emerge as a problem in the first half of 2003 when an unknown virus appeared in Guangdong Province in China, and spread to various parts of the world is causing many deaths and panic. The SARS Epidemic Essay. It jolted these countries economic growth, disrupted the social life of their citizens, and created much stress and strain on their political system and governance”( Tsang, T. 2008). This infectious disease caused by the coronavirus led to the global outbreak.
As of July 2003, there were 8098 probable cases reported in a death toll of 774. The majority of the patients improve treatment but 20 to 36% required intensive care admission and 13 to 26% progressed to acute respiratory distress syndrome [ARDS] requiring mechanical ventilation (Sung, J. J. 2004). The incubation period for the SARS virus is 2 to 10 days. ” It seems to spread by close person-to-person contact. The coronavirus that causes SARS is thought to be transmitted by respiratory droplets produced when an infected person coughs or sneezes.
Droplet spread on cars when droplets from the cough or sneeze of an infected person are propelled a short distance [typicality up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of a person is nearby. The virus can also spread when a person touches the surface or object contaminated with infectious droplets and then touches his mouth, nose, or eyes” ( Centers for Disease Control and Prevention). The SARS virion attaches to a receptor on the host cell membrane and releases enzymes that weaken then membrane and enables the SARS virus to penetrate the cell.
The SARS virus removes the protein coating that protects its genetic materials, multiplies and the infection spreads to the help the cells of the host.The SARS Epidemic Essay.  The symptoms of a SARS infection usually starts with elevated temperature [temperature greater than 100. 4° F),. The infected person develops respiratory symptoms 4 to 7 days after the onset of fever. These respiratory symptoms can be mild to severe and include dry cough, shortness of breath hypoxemia, and pneumonia.
SARS can be diagnosed through a person’s history [if they had traveled an area with documented SARS cases or had close contact with in the past 10 days without person suspected of having SARS], chest x-ray. The WHO developed three types of diagnostic tests for SARS. These include reverse transcription polymerase chain reaction test to detect ribonucleic acid of the SARS virus, serum test to detect anti-bodies by IgM and IgG, and cell culture test. .( www. cdc. gov) There is no specific treatment for SARS other than general supportive care. Vaccinations are being developed.
It is speculated that the SARS virus probably emerged in southern China during the late 2002, where by chance the wild animals that were taken by farmers from their natural habitat and being slaughtered for their meat and sold in the markets may have been carriers of the coronavirus resembling SCoV. It is possible that the virus spreads to the humans due to the crowded and unsanitary conditions of the marketplaces From the mainland China SARS spread to Hong Kong and Hanoi, Vietnam. A so-called super spreader was a doctor in Guangzhou Province. He had unknowingly become infected with SARS while treating patients at a local hospital. The SARS Epidemic Essay.
The doctor travelled to a hotel in Hong Kong [Hotel M]. He stayed there for one night and started experiencing SARS symptoms and passed the infection to 12 other hotel guests and a nearby apartment block. The infected guests traveled to other countries and spread the outbreaks in Hong Kong, Vietnam, Singapore, and Canada. International travel was clearly one of the contributing factors in the spread of SARS. With international air travel time needed for an infectious disease to spread from one country to another is only as long as a trip on an airplane”(Sung, J. J. 2004).
During the five months that SARS was spreading activity in different countries, 27 people were estimated to have been infected during the course of an airline flight, and 22 of them were on the flight from Hong Kong to Beijing. This spread of SARS to Canada and Singapore was facilitated by the volume of flights out of Hong Kong, with onboard transmission, on at least five flights generating 37 cases of SARS. Estimates of losses to Asian economies range from $18-$30 billion.
Disruption to travel was considerable, with the volume of air traffic shrinking considerably. The SARS outbreak came at a time when many countries were experiencing economic , social , political distress. At that time there was worldwide economic recession. One social impact of SARS is the general paranoia that it triggered. ” Public schools in Hong Kong and Singapore was suspended for about two weeks affecting children’s academic work, tests and examinations”( Tsang, T. 2008). The last case of SARS was confirmed on June 11, 2003. The figure below retrieved from a book by Tsang, T. (2008) Public Health Response: A View from Hong Kong, in Severe Acute Respiratory Syndrome, shows how SARS spread from Hong Kong to other parts of the world.
A SARS outbreak in my community would cause many patients to be hospitalized, may result in deaths, disrupt the lives of the community and damage the economy. It would create fear amongst the public all over the community. The SARS Epidemic Essay. This fear would result in closing down of businesses, schools shut down, overcrowding in hospitals, paranoia and widespread use of masks to avoid infection. SARS would adversely affect the psychological health of the community and above all in cause devastation to many families.
The community public health will have to intervene by including disease surveillance, health screening, contact tracing , quarantine, public education and risk communication, infection control suspension of schools, and community mobilization. Disease intelligence gathering in the community would be critical. If there was an outbreak of SARS in the community, surveillance for severe community-acquired pneumonia [SCAP] would have to be initiated. Contacts of every SC AP patient would have to traced and put on medical surveillance. Infection control guidelines on SCAP should be provided in public hospitals.
Steps to quarantine these patients and close contacts would be initiated. A multidisciplinary response team would be needed to inspect and disinfect residences and buildings that are suspected to have SARS cases. A SARS outbreak would affect elderly homes and residences as they are a growing population in my community and are at high risk due to decreased immunity and frequent hospital visits. Important measures to protect these elderly would include close medical observation, education and direction sessions on infection control for healthcare workers, providing homes appropriate protective gear and monitoring achievement.
Since educating the public would not be easy during the initial phase of the SARS outbreak, regular updates and changes would be necessary for the community to know more about the disease. local and international media, politicians and community leaders, professional healthcare groups, academic institutions such as schools, nursing homes, government departments and international health organizations such as WHO would be needed at this time. Channels of public communications including newspapers, TV and radio announcements, the Internet, and hotlines for public inquiry would be set up. The SARS Epidemic Essay.
Protocol For Reporting Possible SARS Outbreak When an outbreak such a SARS are identified and investigations initiated, or potentially affected public health and regulatory agencies should be notified. The Centers for Disease Control and Prevention [CDC] started a reporting system called National Outbreak Reporting System [NORS] in 2009 into which health departments can enter and report a disease outbreak information. The diagram below retrieved from the CDC website shows the flow of outbreak information to NORS.

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1) People are exposed to a pathogen; 2) People get sick and seek treatment; 3) The local Health department should be notified of a possible outbreak. Risk management personnel should also be notified because outbreaks frequently result in lawsuits being filed against healthcare organizations; 4) Health department conducts an outbreak investigation in which a member of the investigative team is appointed to be the primary contact person will answer questions and communicate findings and recommendations.
The team may be composed of personnel from infection prevention and control, infectious disease, quality management, laboratory, pharmacy and nursing. The investigators create a data collection form to collect information on each case; 5) Health department enters outbreak information into NORS the legal basis requiring reporting of an outbreak varies by state. The CDC’s National Notifiable Diseases Surveillance System [NNDSS) enables public health officials ability to monitor development and spread of a disease.
The NNDSS allows sharing of information between State Health departments to improve disease detection and containment; 6) CDC checks data for accuracy and analyzes; 7) Data are summarized and published. When the public needs to be made aware of ongoing outbreaks, the use of health alert networks, press releases, and postings of agency websites can achieve this objective. ” (www. cdc. gov) Poor Air Quality Index and Respiratory Diseases The US Environmental Protection Agency [EPA] develop the Air Quality Index [AQI] as a measure to better advice citizens of pollutants in the atmosphere.
This includes the levels of carbon monoxide, ozone, nitrogen oxide and sulfur dioxide. Poor AQI contributes to respiratory illness such as asthma.  The SARS Epidemic Essay.Environmental triggers in both indoor and outdoor air contributes to exacerbation of respiratory diseases. The primary nursing goal for a patient respiratory disease is to achieve and maintain adequate oxygenation and improved ventilation. Poor AQI can worsen asthma symptoms and trigger attacks. The polluted air causes breathing difficulties coughing , wheezing and shortness of breath.
Patients with respiratory diseases such as asthma should be assessed more currently by the community nurse especially during bad” air days. A parallel assessment for adventitious respiratory sounds such as wheezing, Chronicles, rhonchi and diminish sounds is critical during this assessment. Other assessment should include a skin inspection for cyanosis, diaphoresis, and tachycardia due to overuse of albuterol inhalers. Severe exacerbations need even closer monitoring.
Shortness of breath, wheezing, cough, trouble speaking and increase respiratory rate may indicate changes in airway clearance and impaired gas exchange. Persons with exacerbations can become extremely anxious and coping strategies such as meditation of the visualization could be helpful in their plan of care. Patients should be well knowledgeable of how to use the inhaler, comply with their medication, use self-assessment tools and avoid environmental triggers The EPA recommends limiting outdoor activities as the AQI for ozone rises to unhealthy levels”(www.epa. gov).
The community nurse would have to give patients information that would help protect their health from bad” air days. 1. Patient should know how sensitive they are to air pollution. If the patient’s asthma symptoms are exacerbated when the air is more polluted or when he or she develops asthma symptoms after that been outside in polluted air, then they may be sensitive to air pollution. 2. Patients should be aware of days of poor AQ I which seemed to worsen during hot summer days, afternoons and evenings.
Particle pollution is high near heavy traffic, around factories or where there is smoke from cigarettes, woodstoves or burning vegetation. 3.The SARS Epidemic Essay.  Patient sensitive to polluted air should change the activity level. This reduces the amount of polluted air being inhaled. The benefits of exercise should not be forfeited however outdoor activity should be reduced to minimize exposure to polluted air. A less intense activity like a walk instead of a jog would be beneficial.
Patient should be taught how to pay attention to their body. When there is exacerbation of respiratory illness due to polluted air, patients should stop the activity and engage in a less strenuous one. 4. Patients with respiratory illnesses such as asthma should keep their quick relief medication handy especially when they are outdoors during polluted air days. This is even more necessary to address symptoms such as shortness of breath and wheezing due to outdoor exposure.  The SARS Epidemic Essay.