SARS Protocol
Please note that this protocol is subject to change as more is learned about
this condition.
Applies to adult and paediatric cases:
Provisional case definition:
A person presenting with one or more signs of a respiratory illness including
cough, shortness of breath, difficulty breathing, hypoxia, chest X ray finding
suggestive of pneumonia, or acute respiratory distress syndrome.
AND:
Fever > 38 o C.
AND
one or more of the following:
- Close contact (having cared for, having lived with, or having direct contact
with respiratory secretions and / or body fluids of a patient suspected of
having SARS) within 10 days of onset of symptoms with a person under investigation
for SARS.
- Travel within 10 days of onset of symptoms to an area with documented transmission
of SARS.
Areas with transmission of SARS:
- Guandong province in China.
- People's republic of China.
- Hanoi, Vietnam.
- Singapore.
- Toronto, Canada.
- Additional cases have been found in Frankfurt am Main, Germany, and UK.
Infection control:
Standard precautions:
- Hand hygiene
- Eye protection.
Contact precautions:
For contact with patient or the patient's environment - include cleaners.
Respiratory precautions:
- Isolation room preferably with negative pressure.
- Use of N-95 filtering disposable masks for all persons entering the room.
If N-95 masks are not available, surgical masks should be used.
For outpatients or ambulatory patients at home:
- Evaluate in separate area from other patients.
- Place surgical mask on patient.
- Observe contact and standard precautions, and use N-95 masks on personnel.
- If at home and patient unable to wear masks, other household members should
do so.
Diagnostic evaluation:
- Chest X ray.
- pulse oximetry
- Blood and respiratory cultures for bacterial pahtogens.
- Exclude other viral pathogens e.g. influenza and RSV
Specimens required:
Nasopharyngeal aspirate: 1-2 ml collected into sterile vial.
Two nasopharyngeal and two oropharyngeal swabs:
- Place one NP swab and one OP swab into the same vial of viral transport
medium.
- Place second NP and OP swabs into the same vial of STGG medium for bacterial
culture.
One tube of EDTA blood 5 ml.
One tube of clotted blood 5 ml.
If post mortem specimens:
- Fixed tissue from all major organs. Do not freeze.
- Frozen tissue from lungs and upper airway. Each specimen in a separate
sterile container containing small amount of viral transport medium.
Contact details:
- Prof. BD Schoub: 082-082-908-8049
- Dr Terry Marshall: 082-909-1792
- Infection control of your hospital.
- Microbiology registrar on call NHLS. 082-807-4966
Please note:
People should be cautious, keep updated on the current situation and not panic.
Refer to the websites listed below for updated information.
http://www.who.int,
http://health.gov.za,
http://www.cdc.gov.za
Sources of information: http://www.who.int
and http://www.cdc.gov