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Stephen A.

Ujano BSN- III


evere Ayndrom acute


Friday, May 29, 2009 by: S. L. Baker, features writer ml#ixzz2EwvNY6lw

One reason the emergence of H1N1, also called swine flu, has caused so much concern -- and near hysteria in some cases -- is the memory of the painful and often fatal outbreak of Severe Acute Respiratory Syndrome (SARS) back in 2003. Over several months, this devastating viral respiratory illness, caused by a coronavirus, spread to more than two dozen countries in North America, South America, Europe, and Asia..

Before the disease was contained, according to the World Health Organization (WHO), a total of 8,098 people had become sick from SARS and 774 died. Although public health measures finally controlled that global outbreak, there has been no effective way to prevent or treat the breath-robbing malady should a SARS pandemic erupt -until now. A new study shows a protein from red algae may have the ability to successfully treat SARS infections

The research, just presented at the American Thoracic Society's 105th International Conference in San Diego, demonstrated that mice treated with the protein, dubbed Griffithsin (GRFT), had a 100 percent survival rate after exposure to the SARS coronavirus (SARS-CoV). However, only 30 percent of mice exposed to the disease but not treated with the algae substance survived.

GRFT is believed to exert powerful anti-viral effects because it is able to change the shape of the sugar molecules that line the virus' envelope. This prevents the SARS virus from invading human cells and taking over the cells' reproductive machinery to replicate itself. Bottom line: with the sugar molecules disarmed, the virus is unable to cause disease.

The powerful antiviral medicine in red algae

To conduct the experiment, the scientists gave one group of mice GRFT while another group received a sham treatment. Then the lab rodents were inoculated with the SARS virus. When the research team analyzed the antiviral activity of GRFT, they discovered the mice that had not been treated with GRFT showed 20 times more plaque-forming units of virus than treated mice.

Moreover, the lungs of the untreated infected mice showed extensive tissue-killing bronchitis as well as a large amount of fluid. However, the lab animals treated with GRFT showed evidence of far less severe lung damage. In addition, the mice treated with GRFT did not experience drastic weight loss. But the untreated mice lost an amazing 35 percent of their total body mass.

"While preliminary, these results are very exciting and indicate a possible therapeutic approach to future SARS or other coronaviral outbreaks," Christine Wohlford-Lenane, senior research assistant at the department of pediatrics University of Iowa and the lead author of the study, said in a statement to the media. "This indicates that not only did the GRFT stop the virus from replicating, but also prevented secondary outcomes, such as weight loss, that are associated with infection."

The University of Iowa scientists are planning future studies with GRFT. They want to find out whether mice protected from SARS by GRFT develop protective immunity against future infection. Previous research published in the Journal of Biological Chemistry also suggests GRFT's virus-fighting ability could be important in the fight against the HIV virus, too.

Is a viral respiratory disease in humans which is caused by the SARS coronavirus (SARS-CoV).

Is an unknown virus which emerged in 2003. The disease killed 800 people around the world, 44 in Toronto (Abraham, 2005, pp.45-50). The pathogen is virulent and highly contagious. SARS is a coronavirus made up of thirty thousand nucleotides.

SARS coronavirus (SARS-CoV) Coronaviruses are positivestrand, enveloped RNA viruses that are important pathogens of mammals and birds. This group of viruses cause enteric or respiratory tract infections in a variety of animals, including humans, livestock and pets.


1. Travel (including transit in an airport) within ten days of the onset of symptoms to an area with current or previously documented or suspected community transmission of SARS.

2. Close contact within ten days of the onset of symptoms with a person known or suspected to have SARS.

1. The primary mode of transmission appears to be direct. Mucus membranes (especially those of the eye, nose and mouth) are always involved.

2. Contact with infectious respiratory droplets and/or through exposure to fomites

3. Transmission through casual and social contact occasionally occurs as a result of intense exposure to a case of SARS (in workplaces, in vehicles) or in high-risk transmission settings, such as healthcare and household settings.

4. Contamination of inanimate materials or objects by infectious respiratory secretions or body fluids (saliva, tears, urine, and stools) which have been found to contain the virus.

Clinical Manifestations

1. Sudden onset of high grade fever, usually greater than 38 degrees Celsius
2. 2. Headache and overall feeling of discomfort and body aches

3. Mild respiratory symptoms at the onset; after 2 days, dry cough and respiratory difficulty 4. Pneumonia, later on

Diagnostic Procedures

a. Polymerase chain reaction can detect genetic material of the SARS-CoV in various specimens (blood, stool, respiratory secretions or body tissues Sampling for Severe Acute Respiratory Syndrome (SARS) diagnostic tests).

Positive PCR results, with the necessary quality control procedures in place. Recommendations for laboratories testing for SARS-coronavirus, are very specific and mean that there is genetic material (RNA) of the SARS-CoV in the sample.

This does not mean that there is live virus present, or that it is present in a quantity large enough to infect another person.

the SARS coronavirus; the illness is due to another infectious agent (virus, bacterium, fungus) or a noninfectious cause.

Negative PCR results do not exclude SARS. SARS-CoV PCR can be negative for the following reasons: - The patient is not infected with

- The test results are incorrect (falsenegative). Current tests need to be further developed to improve sensitivity.

- Specimens were not collected at a time when the virus or its genetic material was present. The virus and its genetic material may be present for a brief period only, depending on the type of specimen tested.

a. ELISA (Enzyme Linked ImmunoSorbant Assay)- a test detecting a mixture of IgM and IgG antibodies in the serum of SARS patients yields positive results reliably at around day 21 after the onset of illness.

b. IFA (Immunofluorescence Assay)- a test detecting IgM antibodies in serum of SARS patients yields positive results after about day 10 of illness. This test format is also used to test for IgG. This is a reliable test requiring the use of fixed SARS virus on an immunofluorescence microscope.

Positive antibody test results indicate a previous infection with SARS-CoV. Seroconversion from negative to positive or a four-fold rise in antibody titre from acute to convalescent serum indicates recent infection. Negative antibody test results: No detection of antibody after 21 days from onset of illnessseems to indicate that no infection with SARS-CoV took place.

C. Neutralization test (NT)- This test assesses and quantifies, by means of titration, the ability of patient sera to neutralize the infectivity of SARS-CoV on cell culture. NT is therefore likely to be the best correlate of immunity. However, due to the use of the infectious virus it is limited to institutions with BSL-3 facilities.

a. Virus Isolation- Virus in specimens (such as respiratory secretions, blood or stool) from SARS patients can also be detected by inoculating cell cultures and growing the virus. Once isolated, the virus must be identified as the SARS virus with further tests. Cell culture is a very demanding test, but currently (with the exception of animal trials) only means to show the existence of a live virus.

Positive cell culture results indicate the presence of live SARS-CoV in the sample tested.

Negative cell culture results do not exclude SARS.


1. Assess for vital signs. 2. Assess for occurrence of any other problems or exacerbation of respiratory illness. 3. Observe infection control method. 4. Wear protective equipment when having contact with patient. 5. Increase oral fluid intake as indicated to loosen secretions and allow expectoration and elimination of antibiotics which are nephrotoxic.

6. Elevate head of bed to promote good ventilation. 7. Encourage intake of immune system enhancing foods as indicated. 8. Regulate IV fluids accordingly. 9. Administer medications as prescribed. 10. Provide psychosocial support during isolation.


Intravenous (IV) fluids Diagnosed patients may be put to strict isolation Medications, including antibiotics, steroids, and/or antivirals Breathing support from a ventilator

Prevention of secondary infections

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