A note about SARS

[Internat Homoeopathic Helpline]

Causative agent.
SARS is supposed to be caused by a ‘Corona Virus’ found out very recently and named “SARS Virus” by WHO. This virus is of animal origin and usually is not found in humans. Postulations are there that the virus is a genetic mutation of animal corona virus due to causes not yet known. It is also propagated that the virus is a man made one created for biological weapon purpose and accidentally leaked out.
The incubation period is 2--7 (up to 10) days.
The period of infectivity is not yet ascertained but supposed to be about 10 days too from the onset of symptoms.
Mode of infection is by droplets and direct contact as it is an air born disease. Contaminated formites may also spread it.

Although a few close contacts of patients with SARS have developed a similar illness, the majority have remained well. Some close contacts have reported a mild, febrile illness without respiratory signs or symptoms, suggesting the illness might not always progress to the respiratory phase.

Clinical Features
A Suspect case of SARS is one with respiratory illness of unknown etiology with onset since February 1, 2003, and the following criteria.
1. Measured temperature greater than 100.4°F (greater than 38°C) AND
2. One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty breathing, or hypoxia) AND
3. Travel or transit within 10 days of onset of symptoms to the following areas. People's Republic of China (i.e., mainland China and Hong Kong Special Administrative Region); Hanoi, Vietnam; Singapore; and Toronto; Canada OR
4. Close contact (means having cared for, having lived with, or having direct contact with respiratory secretions and/or body fluids of a patient known to be suspect SARS case) within 10 days of onset of symptoms with a person known to be a suspect SARS case.

A Probable case is a suspect case with one of the following:
1. Radiographic evidence of pneumonia or respiratory distress syndrome
2. Autopsy findings consistent with respiratory distress syndrome without an identifiable cause

The severity of illness might be highly variable, ranging from mild illness to death. It affects those between 25--70 years. A few suspected cases of SARS have been reported among children of 15 or below.
It begins generally with a prodrome of fever (>100.4°F [>38.0°C]) often high, sometimes associated with chills and rigors, and also with headache, malaise, and myalgia. At the onset of illness, some persons have mild respiratory symptoms. Note that rash and neurologic or gastrointestinal findings are typically, absent but diarrhea is reported in some during the febrile prodrome.

After 3--7 days, a lower respiratory phase begins with the onset of a dry, nonproductive cough or dyspnoea, which might be accompanied by or progress to hypoxemia. In 10%--20% of cases, the respiratory illness is severe enough to require intubation and mechanical ventilation. The case-fatality rate among persons with illness meeting the current WHO case definition of is approximately 3%.

Laboratory Diagnosis
Initial diagnostic testing for suspected SARS patients should include chest X’ ray, blood routine and cultures, pulse oximetry, sputum Gram's stain and culture, and testing for viral respiratory pathogens, notably influenza A and B and respiratory syncytial virus. Legionella and pneumococcal urinary antigen testing are advanced procedures.

Chest X’ ray in majority shows in the respiratory phase characteristic early focal interstitial infiltrates progressing to more generalized, patchy, interstitial infiltrates. In the late stages some show areas of consolidation also.

The absolute lymphocyte count is often decreased. Overall WBC counts are also generally normal or decreased. Leucopoenia and thrombocytopenia or low-normal platelet counts (50,000--150,000/µL) are seen in 50% of patients at the peak of the respiratory illness. Early in the respiratory phase, elevated creatine phosphokinase levels (as high as 3,000 IU/L) and hepatic transaminases (two to six times the upper limits of normal) have been noted. Renal function remain normal in the majority.

Serum antibody tests, including both enzyme immunoassay (EIA, or ELISA) and indirect immunofluorescence antibody (IFA) formats. Reverse transcription-polymerase chain reaction (RT-PCR) testing is also available. This test can detect coronavirus RNA in clinical specimens, including serum, stool, and nasal secretions and are costly. Viral isolation for the new coronavirus also has been done but is still more costly.

Management
This consists of the general management measures for febrile/respiratory diseases with special emphasis on isolation and prevention of spread. Institutional treatment is needed, as there are chances for hypoxaemia and respiratory arrest.

Treatment
Conventional treatment regimens is to use several antibiotics to presumptively treat known bacterial agents of atypical pneumonia. In several locations, antiviral agents such as oseltamivir or ribavirin are also used. Steroids have also been administered orally or intravenously to patients in combination with ribavirin and other antimicrobials. At present, the most efficacious treatment regimen, if any, is unknown.

Homoeopathic Treatment
As presently there is no definite medicines in allopathy for SARS except offering ventilators, oxygen support therapy, antibiotic cover and some nonspecific antiviral medications, it will be the only wise thing that homoeopathic medicines are evaluated and incorporated in the treatment of SARS.

The following are the drugs came out on analysing* the available symptoms and signs.

Arsenicum album, Belladonna, Bryonia, Hepar sulph, Ipecac, Kali carb, Lachesis, Pulsatilla, Phosphorus, and Rhus tox.
Out of theses Belladonna, Bryonia and Ipecac may be particularly use full in the early stages and Lachesis and phosphorus in the late stages.

Please contact us with more disease specific and individual symptoms if you have so that we can work out more effective Homoeopathic drugs.

Prevention
No known preventive measures are identified presently except avoidance of contact.

Please note
This is a notifiable disease and should be reported to the local public health authorities. Clinicians should save any available clinical specimens (respiratory, blood, and serum) for additional testing until a specific diagnosis is made.

(Taken from www.homeoweb.com/sars.htm on the suggestion of Dr Abdul Ghaffar)
*Good health is one of God's most precious gifts. *Homoeopathic medicines have a remarkable ability to restore health. *Many millions of those people benefit from homoeopathic treatment, who might otherwise have continued sufffering from those health problems for which conventional medicine has little or nothing to offer.*We serve humanity, voluntarily and absolutely free. **Tell others about us at "homoeopathic_helpline@yahoo.co.uk".
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[Catherine Creel]

homoeopathic_helpline@yahoo.co.uk posted:

*** The only protocol now being used is ribavirin, high doses of
steroids, and oxygen support (unless ribavirin is unavailable).

When the first cases were identified at Prince of Wales Hospital in Hong
Kong (while mainland China was still not talking) all were treated with
antibiotic therapy. None of the 135 patients improved. Ribavirin and low
dose steroids were tried next. 18% showed improvement with improvement
being defined as reduced fever for four or more days and less cloudiness on
lung x-rays (this group showed 25% less cloudiness). Finally, ribavirin was
administered with high doses of steroids. A majority of people responded
more positively to this protocol. Other antiviral agents are being worked
with in vitro due to concerns about the toxicity of ribavirin and it's lack
of efficacy unless accompanied by high doses of steroids whose toxicity is
also of concern. Currently, physicians are questioning whether this
protocol is killing more people than would have succumbed to SARS.
As of five days ago, the Hong Kong government agreed to allow TCM
practitioners access to patients who are hospitalized. They have come up
with a protocol for treating SARS.

For accurate information on symptoms of SARS I recommend Luise Kunkle's
website:
http://www.bar-do.net/symptoms_compilation.htm

Regards,
Catherine