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Severe Acute Respiratory Syndrome (SARS) and Alpha-1 Sandy Sandhaus, MD, PhD April 16, 2003 There has been general concern within Asia, Europe, and North America regarding a lung infection known as Severe Acute Respiratory Syndrome or SARS. While the cause of this infection is not known with certainty, it is currently believed to be caused by a unique Coronavirus, a member of the virus family that is a cause of the common cold. Approximately 3,200 cases have been identified worldwide at time of this writing and there have been about 100 deaths. SARS appears to have originated in China and the vast majority of cases reported to date have occurred in China, Singapore, and Vietnam. In addition, there is a close-knit evangelical community within Toronto, Canada that has a high incidence of SARS infections. Transmission of this illness requires close contact with an infected individual. Individuals with SARS have fever, cough, and shortness of breath. Initial symptoms center around fever. After several days fevers can be quite high and a non-productive cough develops. This is followed by increasing shortness of breath and decreases in blood oxygen. In 10% - 20% of individuals with these respiratory symptoms, it becomes necessary to intubate and provide mechanical ventilation. Worldwide, about 3% to 4% of individuals who contract SARS die. In the US, as of April 9, 2003, there have been 166 suspected cases of which 93% were in persons who had traveled to Asia within the previous 10 days, 5% had household contact with one of these individuals, and 2% were in their healthcare providers (= 100%). Of these 36% required brief hospitalization and there have been no deaths in the US. Individuals with lung disease, such as lung-affected Alpha-1 patients, would be expected to have more severe symptoms than healthy individuals if they were to develop SARS. There is no reason to expect, however, that individuals with Alpha-1 would be more susceptible to this infection. In other words, it should be just as difficult to become infected whether one has Alpha-1 or not. Currently, most health authorities recommend against traveling to China, Singapore, or Vietnam or having close contact with individuals from these areas who have a fever. In practical terms at the present time, Alphas should not make sweeping changes in their lives based on fears of
SARS. While trips to Asia may well need to be postponed, the risks of air travel to other areas do not appear to be significantly increased. Air travel is always of concern to lung-affected Alphas. Being in such close quarters with people who may have a variety of respiratory infections is a high-risk environment. Therefore, air travel should only be undertaken when necessary (such as attending a national educational conference). Any additional risk of becoming infected with SARS at the present time is vanishingly small for the general population and the Alpha-1 community. The outbreak of SARS is still in its early stages. It may have reached its peak or it may become more widespread in the future. Therefore, please understand that the information provided here may become outdated quickly as more information is obtained. We promise to keep the Alpha-1 community informed as additional information becomes available. Source:
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