Severe Acute Respiratory Distress Syndrome

CDC has recognized that this condition as a new previously unrecognized disease.

Tests in Hong Kong, Germany, and the US have identified a new strain of virus in the family of Corona Viruses which are the 2nd leading agent causing the common cold in humans as the most probable causative agent.

Disease Presentation:

• Consistent across all geographic areas
• Sudden onset
• High fever
• Myalgia, chills, rigors, headache, diarrhea
• Non-productive cough
• Chest X-ray: characteristic changes
  At 3-4 days after onset of symptoms interstitial
• WBC and Lymphocyte count of ten decreased with low or low-normal platelet counts

Disease Progression:

• Severity highly variable- range from mild illness to death
• X-ray findings worsen
• Majority 80-90%- at day 6-7 begin to improve
• Remainder 10-20%- begin to worsen
  • Severe Acute Respiratory distress symptoms progressing to hypoxemia
  • Require mechanical ventilation
  • Mortality appears linked to patients other medical illnesses

Prognostic Indicators:

• Increased risk of progression to more severe form of disease
  • Over 40 years of age
  • Other medical conditions/ illness pre-existing
  • Case fatality rate currently around 4%
  • Could increase precipitously depending on outcome for many cases now on respirators

Therapy:

• General Supportive Treatment
  • Hydration, control of fever, nutrition
  • Treatment of secondary infections
  • Control of pre-existing other medical conditions
• Antibiotic Therapy
  • Numerous have been tried with little clear effect
  • Ribavirin with and without steroids being used more, but effectiveness yet proven

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