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SARS (Severe acute respiratory syndrome)

Description:
SARS, or Severe acute respiratory syndrome, is the disease caused by SARS coronavirus. It causes an often severe illness marked initially by systemic symptoms of muscle pain, headache, and fever, followed in 2–10 days by the onset of respiratory symptoms,[3] mainly cough, dyspnea, and pneumonia. Another common finding in SARS patients is a decrease in the number of lymphocytes circulating in the blood.

You may click to see the picture: ....(01 )   (1)…….(2)

Virus classification:-

Group: Group IV ((+)ssRNA)

Order: Nidovirales

Family: Coronaviridae

Genus: Coronavirus

Species: SARS coronavirus

SARS coronavirus is a positive and single stranded RNA virus belonging to a family of enveloped coronaviruses. Its genome is about 29.7kb, which is one of the largest among RNA viruses. The SARS virus has 13 known genes and 14 known proteins. There are 265bp in the 5’UTR and 342bp in the 3’UTR. SARS is similar to other coronaviruses in that its genome expression starts with translation of two large ORFs 1a and 1b, which are two polyproteins.

The functions of several of these proteins are known:  ORFs 1a and 1b encode the replicase and there are four major structural proteins: nucleocapsid, spike, membrane and envelope. It also encodes for eight unique proteins, known as the accessory proteins, with no known homologues. The function of these accessory proteins remains unknown.
In the SARS outbreak of 2003, about 9% of patients with confirmed SARS infection died. The mortality rate was much higher for those over 50 years old, with mortality rates approaching 50% for this subset of patients.

Coronaviruses usually express pp1a (the ORF1a polyprotein) and the PP1ab polyprotein with joins ORF1a and ORF1b. The polyproteins are then processed by enzymes that are encoded by ORF1a. Product proteins from the processing includes various replicative enzymes such as RNA dependent polymerase, RNA helicase, and proteinase. The replication complex in coronavirus is also responsible for the synthesis of various mRNAs downstream of ORF 1b, which are structural and accessory proteins. Two different proteins, 3CLpro and PL2pro, cleave the large polyproteins into 16 smaller subunits.

SARS-Coronavirus follows the replication strategy typical of the Coronavirus genus.

In the SARS outbreak of 2003, about 9% of patients with confirmed SARS infection died. The mortality rate was much higher for those over 50 years old, with mortality rates approaching 50% for this subset of patients.

Causes:
SARS is caused by a strain of coronavirus, the same family of viruses that causes the common cold. Until now, these viruses have never been particularly dangerous in humans, although they can cause severe disease in animals. For that reason, scientists originally thought that the SARS virus might have crossed from animals to humans. It now seems likely that it evolved from one or more animal viruses into a completely new strain.
 
How do SARS spread:
Most respiratory illnesses, including SARS, spread through droplets that enter the air when someone with the disease coughs, sneezes or talks. Most experts think SARS spreads mainly through face-to-face contact, but the virus also may be spread on contaminated objects — such as doorknobs, telephones and elevator buttons.

Symptoms:
Once a person has contracted SARS, the first symptom that they present with is a fever of at least 38°C (100.4°F) or higher. The early symptoms last about 2–7 days and include non-specific flu-like symptoms, including chills/rigor, muscle aches, headaches, diarrhea, sore throat, runny nose, malaise, and myalgia (muscle pain). Next, they develop a dry cough, shortness of breath, and an upper respiratory tract infection.

SARS typically begins with flu-like signs and symptoms — signs and symptoms include:

*Fever of 100.4 F (38 C) or higher
* Dry cough
*Shortness of breath

Complications:
The main complication of SERS  is that most people develop pneumonia. Breathing problems can become so severe that a mechanical respirator is required. SARS is fatal in some cases, often due to respiratory failure. Other possible complications include heart and liver failure.

People older than the age of 60 — especially those with underlying conditions such as diabetes or hepatitis — are at highest risk of serious complications.

Risk Factors:
In general, people at greatest risk of SARS have had direct, close contact with someone who’s infected, such as family members and health care workers.

Diagnosis:
At that time, a chest x-ray is ordered to confirm pneumonia. If the chest appears clear and SARS is still suspected, a HRCT scan will be ordered, because it is visible earlier on this scan. In severe cases, it develops into respiratory failure and acute respiratory distress syndrome (ARDS), and in 70-90% of the cases, they develop lymphopenia (low count of lymphocyte white blood cells).

The incubation period for SARS-CoV is from 2–10 days, sometimes lasting up to 13 days, with a mean of 5 days.  So symptoms usually develop between 2–10 days following infection by the virus. As part of the immune response, IgM antibody to the SARS-CoV is produced. This peaks during the acute or early convalescent phase (week 3) and declines by week 12. IgG antibody is produced later and peaks at week 12.

Tests:
When SARS first surfaced, no specific tests were available to help doctors diagnose the disease. Now several laboratory tests can help detect the virus. But no known transmission of SARS has occurred anywhere in the world since 2004.

Treatment:
Although global efforts are still on, scientists have not yet found out any effective treatment for SARS. Antibiotic drugs don’t work against viruses and antiviral drugs haven’t shown much benefit.

Prevention:
Researchers are working on several types of vaccines for SARS, but none has been tested in humans.Engineering of SARS virus has been done. In a paper published in 2006, a new transcription circuit was engineered to make recombinant SARS viruses. The recombination allowed for efficient expression of viral transcripts and proteins. The engineering of this transcription circuit reduces the RNA recombinant progeny viruses. The TRS (transcription regulatory sequences) circuit regulates efficient expression of SARS-CoV subgenomic mRNAs. The wild type TRS is ACGAAC.

A double mutation results in TRS-1 (ACGGAT) and a triple mutation results in TRS-2 (CCGGAT). When the remodeled TRS circuit containing viruses are genetically recombined with wild type TRS circuits, the result is a circuit reduced in production of subgenomic mRNA. The goal of modifying the SARS virus with this approach is to produce chimeric progeny that have reduced viability due to the incompatibility of the WT and engineered TRS circuits.

Novel subunit vaccine constructs for an S protein SARS vaccine based on the receptor binding domain (RBD) are being developed by the New York Blood Center. The re-emergence of SARS is possible, and the need remains for commercial vaccine and therapeutic development. However, the cost and length of time for product development, and the uncertain future demand, result in unfavorable economic conditions to accomplish this task. In the development of therapeutics and next-generation vaccines, more work is required to determine the structure/ function relationships of critical enzymes and structural proteins.

If SARS infections resume, follow these safety guidelines if you’re caring for an infected person:

 *Wash your hands. Clean your hands frequently with soap and hot water or use an alcohol-based hand rub containing at least 60 percent alcohol.

* Wear disposable gloves. If you have contact with the person’s body fluids or feces, wear disposable gloves. Throw the gloves away immediately after use and wash your hands thoroughly.

* Wear a surgical mask. When you’re in the same room as a person with SARS, cover your mouth and nose with a surgical mask. Wearing eye glasses also may offer some protection.

* Wash personal items. Use soap and hot water to wash the utensils, towels, bedding and clothing of someone with SARS.

* Disinfect surfaces. Use a household disinfectant to clean any surfaces that may have been contaminated with sweat, saliva, mucus, vomit, stool or urine. Wear disposable gloves while you clean and throw the gloves away when you’re done.

Follow all precautions for at least 10 days after the person’s signs and symptoms have disappeared. Keep children home from school if they develop a fever or respiratory symptoms within 10 days of being exposed to someone with SARS. Children can return to school if signs and symptoms go away after three days.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/SARS_coronavirus
http://www.mayoclinic.com/health/sars/DS00501/DSECTION=prevention

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Tool ‘May Help’ Early Meningitis Diagnosis

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The most dangerous form of  meningitis can kill within hours – but doctors think they have developed the best way to identify it early.

The “predictive model” developed by the Health Protection Agency could clear the way for the right treatment to be given quickly.

It uses a combination of blood tests and symptoms to help identify bacterial meningitis.

A simple way to test the rash is to press a clear glass against the skin

Charities welcomed the model, while calling for further testing.

Meningitis is an inflammation in the membranes surrounding the spinal cord and brain. It is most often caused by either bacterial or viral infection.

Knowing which is which can make a big difference to the best treatment.

Bacterial meningitis needs antibiotic treatment as soon as possible – and it is often prudent to give these drugs to close family members as well.

Rash

There are tests to identify the cause of meningitis, the best known being a lumbar puncture to obtain spinal fluid for analysis.

However, this does not always yield clear-cut results.

The new model has a simple set of three criteria which helps doctors tell the difference without having to wait for conclusive spinal fluid results.

Researchers found them by examining 385 confirmed meningitis cases over a 12-month period.

The first two criteria are blood tests positive for two specific chemicals associated with bacterial meningitis, the third is the presence of the “classic” meningitis rash of spots which do not disappear when pressed with a glass.

The three results are combined to provide a score which then tells the doctor how likely bacterial meningitis is.

Dr Toyin Ejidokun, a consultant in communicable disease at the HPA, said: “The total score allows a treating clinician to simply and quickly assess the likelihood of whether or not the case is bacterial meningitis by checking it against the predictive probabilities we have developed.

“While further testing needs to take place to test the accuracy of the model, it offers the prospect of a rapid predictive tool to help clinical and public health management of suspected bacterial meningitis cases.”

‘Step forward’

Steve Dayman, the chief executive of Meningitis UK, said the protocol was “an excellent step forward”.

He said: “It’s vital that the differentiation between bacterial and viral meningitis is made straight-away because the bacterial form can kill in less then four hours. Quick treatment can mean the difference between life and death.

“In the absence of a vaccine to protect against all forms of meningitis, this new model could help to save precious lives.”

Experts said people should still be vigilant for the warning signs of meningitis to maximise the chances of recovery.

Although not every patient has every symptom, common signs include a combination of “classic rash”, suddenly appearing high fever, a severe and worsening headache, stiff neck, vomiting, joint and muscle pain, a dislike of bright lights, very cold hands and feet, and severe drowsiness.

A spokesman for the Meningitis Research Foundation said: “Early detection of meningitis and septicaemia is critical when treating these diseases, every second matters.

“We welcome all research and development to identify meningitis early so treatment of antibiotics can be administered as soon as possible to prevent the worst outcome.”

However, she said that doctors should stick with existing protocols for diagnosing and treating meningitis until the new version had been fully tested.

Source : BBC News:

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Warning: Swine Flu Shot Linked to Killer Nerve Disease

A warning that the swine flu vaccine has been linked to a deadly nerve disease has been sent by the UK Government to senior neurologists in a confidential letter.
swine flu jab.swine flu jab.jpg-1
The letter from the Health Protection Agency, the official body that oversees public health, was leaked to The Daily Mail, leading to demands to know why the information has not been given to the public before the vaccination of millions of people, including children, begins.

It tells the neurologists that they must be alert for an increase in a brain disorder called Guillain-Barre Syndrome (GBS), which could be triggered by the vaccine. GBS attacks the lining of the nerves, causing paralysis and inability to breathe, and can be fatal.

The letter refers to the use of a similar swine flu vaccine in the United States in 1976 when:

•More people died from the vaccination than from swine flu
•The vaccine may have increased the risk of contracting GBS by eight times
•The vaccine was withdrawn after just ten weeks when the link with GBS became clear
•The U.S. Government was forced to pay out millions of dollars to those affected
Concerns have already been raised that the new vaccine has not been sufficiently tested and that the effects, especially on children, are unknown.

Source: The Daily Mail August 15, 2009

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Faecal Bacteria Join the Commute

More than one in four commuters has bacteria from faeces on their hands, an investigation suggests.

………
Commuters in the north were dirtier than in the south

Scientists from the London School of Hygiene and Tropical Medicine swabbed 409 people at bus and train stations in five major cities in England and Wales.

The further north they went, the more often they found commuters with faecal bacteria on their hands – men in Newcastle were the worst offenders.

………….

Washing thoroughly with soap is enough to keep hands clean
Experts stressed the importance of hand hygiene for preventing illness.

The bacteria found suggested people were not washing their hands properly after using the toilet, said the researchers.

Toilet hands

In Newcastle and Liverpool, men were more likely than women to show contamination – 53% of men compared with 30% of women in Newcastle and 36% of men compared with 31% of women in Liverpool.

” We were flabbergasted by the finding that so many people had faecal bugs on their hands” Says Dr Val Curtis, director of the Hygiene Centre at the London School of Hygiene and Tropical Medicine

In the other three cities – London, Cardiff and Birmingham – the women’s hands were dirtier.

People who had used the bus had higher rates of hand contamination than those who had used the train.

Manual workers had cleaner hands than other professionals, students, retired people or the unemployed.

Dr Val Curtis, director of the Hygiene Centre at the London School of Hygiene and Tropical Medicine, said: “We were flabbergasted by the finding that so many people had faecal bugs on their hands.”

“The figures were far higher than we had anticipated, and suggest that there is a real problem with people washing their hands in the UK.

DIRTY HANDS

Newcastle – men 53%, women 30%
Liverpool – men 36%, women 31%
Birmingham – men 21%, women 26%
Cardiff – men 15%, women 29%
Euston (London) – men 6%, women 21%

“If any of these people had been suffering from a diarrhoeal disease, the potential for it to be passed around would be greatly increased by their failure to wash their hands after going to the toilet.”

Professor Mike Catchpole, director of the Health Protection Agency‘s Centre for Infections, said: “These results are startling and should be enough to make anyone reach for the soap.

“It is well known that hand washing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting, colds and flu.

“People should always wash their hands after using the toilet, before eating or handling food, and after handling animals. And remember to cover all cuts and scratches with a waterproof dressing.”

Winter vomiting
The HPA’s monitoring of infections over recent weeks suggests that cases of norovirus – the winter vomiting bug – are rising and that the annual norovirus season is likely to have begun.

Norovirus is the most common cause of gastrointestinal disease in the UK with peak activity in terms of numbers of cases and outbreaks during the winter months, from October to March.

It has been estimated that between 600,000 and a million people in the UK are affected each year.

Professor Catchpole said: “Norovirus is highly infectious and easily spread in settings where people are in close contact with one another so good hygiene, including frequent handwashing, is really important.”

The study was part of the world’s first Global Hand-washing Day, dedicated to raising awareness about the importance hand hygiene plays in public health.

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Sources: BBC NEWS:15TH. OCT. ’08

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