Medical Intervention in Treatment of Severe Acute Respiratory Syndrome - Essay Example

? SARS Disease introduction Severe Acute Respiratory Syndrome (SARS) is a viral respiratory disease that originated from China in November 2002 caused by the SARS coronavirus (Schmidt, Wolff & Weber, 2005). After the first incidence in China, the disease has spread to more than 17 countries with causes of the spread not yet accurately determined. According to WHO statistics, the number of cases for the disease that have been reported by the various ministries of health as at April 2003 stood at 2781 cases with 111 fatalities; the global fatality rates for the disease is 4 per cent (World Health Organisation, 11 April 2003). Epidemiology of recent SARS pandemics Most of the cases of SARS that have been reported occur among young adults the age of health care workers, their families, social contacts and global tourists (Peiris & Guan, 2005). With the information that is available, young children are less likely to contract the disease compared to adults (Kleinman & Watson, 2006). The spread of the disease has been traced to close contact with an infected person through infectious droplets or through contact with body fluids of an infected person (Hsu et al, 2003; Donnelly et al, 2003). China, which is the origin of the disease has continued to see new numbers of infectious although the rates have reduced from a peak experienced in February 2013; 1290 cases with 55 deaths have been reported in china since the disease was discovered in 2002 (World Health Organisation, 11 April 2003). Hong Kong has experienced the second largest outbreak of the disease with 998 people having contacted the disease and 30 others passing on from SARS (Leung & Ooi, 2003). A major outbreak occurred between 27th March and 1st April 2013 at the Amoy gardens, however, this outbreak was controlled by strict public health measures put in place by the ministry of health. Since then, no major cases of the infection have been reported although new cases continue to appear among health care workers (Powers & Gong, 2008). Hong Kong authorities are putting in place measures to strengthen their infections control and enacting society-based public health policies (Serradell, 2005). Canada has also experienced an outbreak of SARS disease with 97 cases confirmed and 10 people dead from the disease (Loy, N.D). However, these cases have been confined to Toronto area of the country (Knobler & Institute of Medicine (US), 2004). All these incidents have been confirmed to be epidemiologically attached to infections within a health care institution and among close contact with individuals known to have the infection. The high fatality ratio in Canada was likely as a result of the old age of the patients since most them have other underlying chronic illnesses. In Hanoi Vietnam, the outbreak of the disease which began on 26th February 2013 have been effectively controlled with very low levels of infections reported after 24th march and only 4 deaths reported so far (World Health Organisation, 16th march 2003). Singapore has continued to report new cases with most of them concentrated among health care workers, inpatients and visitors to the hospitals most affected by new infections (Seto et al, 2003). Despite the new infections, the daily increase in numbers has reduced from a peak in March 2013 with 126 cases and 9 deaths reported from the infection by 10th April; at present, Singapore is investigating a case in Singapore General Hospital that affected 52 people with 19 confirmed cases and 33 as suspects. The first case had been admitted in the hospital on 24th march for treatment of unrelated chronic illness but it did not show any signs of SARS therefore it was not put in isolation or managed according to the doctrine of stringent infection control. In the united states of America, cases of SARS continue to increase with 154 people currently under investigation, which includes confirmed and probable cases (World Health Organization, 2006). There are no deaths that have been reported in the country as a result of the infections and in addition, there is minimal transmission from patients to health care workers (Brookes, Khan & American Public Health Association, 2005). Epidemiological data that is available in WHO database shows that all other cases in other countries have been affected by either being present in areas known to be affected by SARS or coming into contact with individuals known to have the infection. How globalisation and human mobility have influenced the SARS pandemic The outbreak of SARS occurred in the most economically active regions in China and the world in general (Powers & Xiao, 2008). This region is the most densely populated regions in the world with Hong Kong and Canton province having more than 100 million people who are highly mobile (Loh & Civic Exchange, 2004). These regions, which are some of the most economically advanced regions in China under dual economic background are some of the most dangerous in case of an epidemic due to the connections that they have with the developed nations and the large number of migrant workers who come looking for jobs in these regions (Ramen, 2005). For instance, the total number of seasonal and floating workers in Canton province was estimated to be over 20million people in 2003, therefore if there is a contagious disease, it is easy to spread it everywhere very fast (Abraham, 2005). These large-scale movements through international flights and big hotels contributed to the spread of the disease in other countries (Fidler, 2004). The Chinese government aggravated this since it was not willing to reveal information on the outbreak of the disease to the public and medical institutions. The reprieve came when some official media and pressure from international bodies such as WHO broke the information to the public and the Chinese government was forced to admit of the SARS crisis (Wong & Zheng, 2004). Effect of air travel on SARS The risk of SARS infection while on board an aircraft is very low, up to date, only four flights have been found to have symptomatic cases of the disease. These cases can be attributed to onboard transmission, two of these cases were before the WHO travel advisory on March 15th 2003, and after the introduction of screening measures to people flying from the SARS prone areas, there has not been any other on flight case related to SARS. One of the key measures that were put in place to reduce transmission in flights was to educate the cabin crew on the sign and symptoms of SARS, which include severe fever of more than 380C, loss of breath and coughs. These cases of SARS that were diagnosed in passengers aboard flights led to massive cancellation of booked flights especially in the countries that the cases were reported. Some employees of the airlines were also affected with some of them refusing to attend to their duties for fear of contracting the disease. In view of this, the world health organisation recommended several measures that were aimed at curbing the spread of the disease among passengers in flights. Some of those measures include the following; one of the recommendations is that individuals who have developed signs and symptoms of the disease before their flight should cancel their flights until such a time when they are fully healed. In addition, the organisation further recommended that ministries of health in the affected areas should introduce exit-screening measures, which would include temperature measurements for all passengers and staff. In addition, the organisation recommended that individuals who had come into close contacts with individuals suspected to suffer from the disease should not travel either locally or internationally for at least ten days after the infection. To avoid infections during flights, WHO recommended that both the passengers and cabin staff should observer proper hygiene that includes washing of hands before handling any foodstuffs. In addition, if passengers feel the urge to sneeze or cough they should cover their mouths and nose and then wash their hands immediately. Since the studies that have been conducted so far shows that a person cannot spread the disease unless he has the symptoms, there is no need to put on facemasks during flights. However, if the cabin staff suspects one of the passengers is displaying signs and symptoms of SARS disease and he has come from an area with local transmission, he should wear a facemask and be isolated as far as possible from other passengers. In addition, he should also be assigned his own toilet, which should not be used by any other person to reduce the risks of infections. Other measures that WHO put in place and which helped reduce the chances of spreading the disease during the flight include aircraft ventilation. It was recommended that according to international aviation regulations, fresh air should be supplied to the passengers’ area continuously with the possibility of replacing the whole volume within 3minutes; airlines were also to ensure that their filters were fully operational to remove any airborne contaminants (World Health Organisation, 23rd May 2003). Conclusion WHO and ministry of health officials in affected countries collaborate to offer support and guidance to the victims and health institutions in terms of planning, management and response tools to determine infectious disease risks therefore, reducing the risk of spreading the infections. To date, the infection rates have been going down with the previous zones reported to have the highest prevalence rates reporting very few cases of infections. References Abraham, T. (2005). Twenty-first century plague: The story of SARS. Baltimore, Md: Johns Hopkins University Press. Brookes, T., Khan, O. A., & American Public Health Association. (2005). Behind the mask: How the world survived SARS, the first epidemic of the 21st century. Washington, DC: American Public Health Association. Donnelly, C. A., Ghani, A. C., Leung, G. M., Hedley, A. J., Fraser, C., Riley, S., ... & Anderson, R. M. (2003). Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. The Lancet, 361(9371), 1761-1766. Fidler, D. P. (2004). SARS: Governance and the globalization of disease. New York: Palgrave Macmillan. Hsu, L. Y., Lee, C. C., Green, J. A., Ang, B., Paton, N. I., Lee, L., ... & Leo, Y. S. (2003). Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts. Emerging infectious diseases, 9(6), 713. Kleinman, A., & Watson, J. L. (2006). SARS in China: Prelude to pandemic?. Stanford, Calif: Stanford University Press. Knobler, S.& Institute of Medicine (U.S.). (2004). Learning from SARS: Preparing for the next disease outbreak : workshop summary. Washington, DC: National Academies Press. Leung, P.-C., & Ooi, E. E. (2003). SARS war: Combating the disease. Singapore: World Scientific. Loh, C., & Civic Exchange. (2004). At the epicentre: Hong Kong and the SARS outbreak. Hong Kong: Hong Kong University Press. Loy, V (N.D). Severe Acute Respiratory Syndrome (SARS). Retrieved from http://globalautonomy.ca/global1/glossary_entry.jsp?id=EV.0028 Peiris, M., & Guan, Y. ( 2005). Confronting SARS: A view from Hong Kong. Sars : a Case Study in Emerging Infections. Powers, J. H., & Gong, G. (2008). Hong Kong's multiple constructions of SARS. Social Construction of Sars : Studies of a Health Communication Crisis. Powers, J. H., & Xiao, X. (2008). The social construction of SARS: Studies of a health communication crisis. Amsterdam: John Benjamins Pub. Ramen, F. (2005). SARS: Severe acute respiratory syndrome. New York: Rosen Pub. Group. Schmidt, A., Wolff, M. H., & Weber, O. F. (2005). Coronaviruses with special emphasis on first insights concerning SARS. Basel: Birkha?user Verlag. Serradell, J. (2005). SARS. Philadelphia: Chelsea House Publishers. Seto, W. H., Tsang, D., Yung, R. W. H., Ching, T. Y., Ng, T. K., Ho, M., ... & Peiris, J. S. M. (2003). Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). The Lancet, 361(9368), 1519-1520. Wong, J., & Zheng, Y. (2004). The SARS epidemic: Challenges to China's crisis management. Singapore: World Scientific. World Health Organization. (2006). SARS: How a global epidemic was stopped. Geneva, Switzerland: World Health Organization, Western Pacific Region. World Health Organisation. (11 April 2003) SARS epidemiology to date. Retrieved from http://www.who.int/csr/sars/epi2003_04_11/en/ World Health Organisation. (16th March 2003). Severe Acute Respiratory Syndrome (SARS) - multi-country outbreak – Update. Retrieved from http://www.who.int/csr/don/2003_03_16/en/ World Health Organisation. (23rd May 2003). Summary of SARS and air travel. Retrieved from http://www.who.int/csr/sars/travel/airtravel/en/ Read More