SARS

(Severe Acute Respiratory Syndrome)

Novel Coronavirus SARS-CoV-2 This transmission

electron microscope image shows SARS-CoV-2—
also known as 2019-nCoV, the virus that causes
COVID-19. isolated from a patient in the U.S.,
emerging from the surface of cells cultured in the lab.
 • Severe acute respiratory syndrome-related
coronavirus is a species of coronavirus that
infects humans, bats and certain other
mammals.
• It is an enveloped positive-sense single-
stranded RNA virus that enters its host cell by
binding to the angiotensin-converting enzyme
2 receptor.
Angiotensin-converting enzyme 2 (ACE2)
is an enzyme attached to the outer surface (cell membranes) of
cells in the lungs, arteries, heart, kidney, and intestines. ACE2
lowers blood pressure by catalyzing the hydrolysis of angiotensin
II (a vasoconstrictor peptide) into angiotensin (1–7) (a vasodilator).
 Severe acute respiratory syndrome (SARS) is a viral respiratory
disease of zoonotic origin that surfaced in the early 2000s caused
by severe acute respiratory syndrome coronavirus (SARS-CoV or
SARS-CoV-1).
 The syndrome caused 2002–2004 SARS outbreak.
 In late 2017, Chinese scientists traced the virus through the
intermediary of civets to cave-dwelling horseshoe
bats in Yunnan province.
 No cases of the first SARS-CoV have been reported worldwide
since 2004.
 In 2019, a related virus strain, severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), was discovered. This new strain
causes COVID-19, a disease which brought about the
ongoing 2019–22 coronavirus pandemic.
 Geographical distribution

 The distribution is based on the 2002–2003 epidemic.

The disease appeared in November 2002 in the
southern China. This area is considered as a potential
zone of re-emergence of SARS-CoV.
 Other countries/areas in which chains of human-to-
human transmission occurred after early importation
of cases were Toronto in Canada, Hong Kong Special
Administrative Region of China, Chinese Taipei,
Singapore, and Hanoi in Viet Nam.
 Cause
SARS coronavirus (SARS-CoV) – virus identified in 2003.
SARS-CoV is thought to be an animal virus from an as-yet-
uncertain animal reservoir, perhaps bats, that spread to
other animals (civet cats) and first infected humans in
southern China in 2002.
 Symptoms
 SARS usually begins with flu-like signs and
symptoms:
 fever,
 chills,
 muscle aches,
 headache & occasionally diarrhea.
 After about a week, signs and symptoms include:
 Fever of 100.5 F (38 C) or higher
 Dry cough
 Shortness of breath
Pathogenesis
Transmission
 An epidemic of SARS affected 26 countries and resulted in more
than 8000 cases in 2003.
 Since then, a small number of cases have occurred as a result of
laboratory accidents or, possibly, through animal-to-human
transmission (China).
 Transmission of SARS-CoV is primarily from person to person.
 It appears to have occurred mainly during the second week of
illness, which corresponds to the peak of virus excretion in
respiratory secretions and stool.
 Most cases of human-to-human transmission occurred in the
health care setting, in the absence of adequate infection control
precautions.
Risk factors
In general, people at greatest risk of SARS are
those who have had direct, close contact
with someone who's infected, such as family
members and health care workers.
Complications
Many people with SARS develop pneumonia, and
breathing problems can become so severe that a
mechanical respirator is needed.
SARS is fatal in some cases, often due to
respiratory failure. Other possible complications
include heart and liver failure.
People older than 60 — especially those with
underlying conditions such as diabetes or hepatitis
— are at the highest risk of serious complications.
Prevention
Researchers are working on several types of vaccines for SARS, but
none has been tested in humans. If SARS infections reappear,
follow these safety guidelines if you're caring for someone who
may have a SARS infection:
 Wash your hands. Clean your hands frequently with soap and
hot water or use an alcohol-based hand rub containing at least
60% alcohol.
 Wear disposable gloves. If you have contact with the person's
body fluids or feces, wear disposable gloves. Throw the gloves
away immediately after use and wash your hands thoroughly.
 Wear a surgical mask. When you're in the same room as a
person with SARS, cover your mouth and nose with a surgical
mask. Wearing eyeglasses also may offer some protection.
 Wash personal items. Use soap and hot water to wash
the utensils, towels, bedding and clothing of someone
with SARS.
 Disinfect surfaces. Use a household disinfectant to
clean any surfaces that may have been contaminated
with sweat, saliva, mucus, vomit, stool or urine. Wear
disposable gloves while you clean and throw the gloves
away when you're done.
 Follow all precautions for at least 10 days after the
person's signs and symptoms have disappeared.
 Keep children home from school if they develop a fever
or respiratory symptoms within 10 days of being
exposed to someone with SARS.
Prophylaxis
None. Experimental vaccines are under
development.

Precautions
Follow any travel recommendations and
health advice issued by WHO.
Is there a vaccine for COVID-19?
The first mass vaccination programme started in early December 2020.
At least 13 different vaccines (across 4 platforms) have been
administered.
 The Pfizer/BioNtech Comirnaty vaccine was listed for WHO
Emergency Use Listing (EUL) on 31 December 2020.
 The SII/Covishield and AstraZeneca/AZD1222 vaccines (developed by
AstraZeneca/Oxford and manufactured by the State Institute of India
and SK Bio respectively) were given EUL on 16 February.
 The Janssen/Ad26.COV 2.S developed by Johnson & Johnson, was
listed for EUL on 12 March 2021.
 The Moderna COVID-19 vaccine (mRNA 1273) was listed for EUL on
30 April 2021.
 the Sinopharm COVID-19 vaccine was listed for EUL on 7 May 2021.
The Sinopharm vaccine is produced by Beijing Bio-Institute of
Biological Products Co Ltd, subsidiary of China National Biotec Group
(CNBG).
 The Sinovac-CoronaVac was listed for EUL on 1 June 2021.
Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines
mRNA vaccines use mRNA created in a laboratory to teach
our cells how to make a protein—or even just a piece of a
protein—that triggers an immune response inside our
bodies. The mRNA from the vaccines is broken down within a
few days after vaccination and discarded from the body.
Novavax protein subunit COVID-19 vaccine
Protein subunit vaccines contain pieces (proteins) of the
virus that causes COVID-19. The virus pieces are the spike
protein. The Novavax COVID-19 vaccine contains another
ingredient called an adjuvant. It helps the immune system
respond to that spike protein. After learning how to respond
to the spike protein, the immune system will be able to
respond quickly to the actual virus spike protein and protect
you against COVID-19.
Johnson & Johnson’s Janssen (J&J/Janssen) viral
vector COVID-19 vaccine Viral vector vaccines use
a harmless, modified version of a different virus (a
vector virus), and not the virus that causes COVID-
19. The vector virus delivers important instructions
to our cells on how to recognize and fight the virus
that causes COVID-19.
Will COVID-19 vaccines provide long-term protection?
Because COVID vaccines have only been developed in
the past months, it’s too early to know the duration of
protection of COVID-19 vaccines.
Research is ongoing to answer this question. However,
it’s encouraging that available data suggest that most
people who recover from COVID-19 develop an immune
response that provides at least some period of
protection against reinfection – although we’re still
learning how strong this protection is, and how long it
lasts.