Patients are an important source of infection, mainly in the acute phase. At this time, the virus content in the respiratory secretions and blood of patients is very high, and obvious symptoms, such as sneezing, are easy to spread the virus. SARS coronavirus is a new type of virus, which is mainly transmitted through close droplets, contact with patients' secretions and close contact. People have no immunity and are generally susceptible.
The mortality of this disease is close to 1 1%, which mainly occurs in winter and spring. Its pathogenesis is related to the damage of immune system. After the virus invades the body, it can cause abnormal immune response. Because the immune system of the body is destroyed, the patient's immune deficiency is caused. At the same time, SARS virus can directly damage the immune system, especially lymphocytes.
Atypical pneumonia refers to pneumonia caused by mycoplasma, chlamydia, Legionella, rickettsia, adenovirus and other unknown microorganisms. Typical pneumonia refers to lobar pneumonia or bronchopneumonia caused by common bacteria such as Streptococcus pneumoniae.
In fact, in the medical field, the name of this infectious disease was controversial in 2003, because it has been found that this disease is actually not the "atypical pneumonia" often mentioned in medicine, but the "infectious coronavirus pneumonia".
For this kind of infectious diseases, people's understanding has gradually deepened and their concepts have gradually become correct. At first, people thought chlamydia virus was the cause of the disease, and it was not until March 2003 that the pathogen was identified as "coronavirus". Doctors in Guangdong, China first used "atypical pneumonia" on June 22nd, 65438. According to its clinical symptoms, such as fever, cough and shadow in the lungs. However, compared with pneumonia caused by Streptococcus pneumoniae and other bacteria, the symptoms are atypical, the pathogen is not completely clear, and it is highly contagious, so the use of antibacterial drugs is ineffective. The World Health Organization also confirmed its drug. At the end of February, Dr. carlo urbani, an Italian infectious disease expert of the World Health Organization, named it Severe Acute Respiratory Syndrome (SARS) according to the data at that time. On March 15, the World Health Organization officially replaced ATP with it.
In fact, the name of severe acute respiratory syndrome does not fully reflect the essential characteristics of the disease. It has long been suggested to name it "infectious coronavirus pneumonia" (if so, it can be called "coronary lung" for short). Although this suggestion has not been accepted by the society and medical circles, it is enough to prove that SARS, like SARS, reflects people's understanding of the distinctive characteristics of things at a certain stage.
A cure has been found so far. Scientists from China and the European Union have jointly found 15 compounds which can effectively kill SARS virus, providing a new method for synthesizing SARS therapeutic drugs. On June 9, 2005, Chinese and European scientists announced this achievement at the annual meeting of the project "SARS diagnosis and virus research in China and Europe".
Recent research by the University of Hong Kong shows that bats may be the wild hosts of SARS virus.
Zhou Gang, an expert in computer Chinese character input, proposed in 2003 that "atypical pneumonia" can be called "tuberculosis".
However, it is still suggested to call it SARS in the medical field according to the naming principle of the World Health Organization (WHO). Like WHO, the Hong Kong medical community changed its name to SARS and Chinese mainland at the first time. Because people have always referred to it as "SARS", it is not recommended to change the entry itself.
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In traditional medicine, atypical pneumonia is relative to typical pneumonia, which is usually caused by common bacteria such as pneumococcus. Typical symptoms, such as fever, chest pain, cough and expectoration. Laboratory tests show that white blood cells increase and antibiotic treatment is effective. Atypical pneumonia itself is not a newly discovered disease, it is mostly caused by viruses, mycoplasma, chlamydia, rickettsia and other pathogens. Symptoms, lung signs and blood test results are not as obvious as SARS infection, and some viral pneumonia antibiotics are ineffective.
SARS refers to a group of diseases caused by the above atypical pathogens, not a definite diagnosis. Its clinical characteristics are that the onset is hidden, mostly dry cough, occasional hemoptysis, and less positive signs of auscultation in the lungs; X-ray chest film mainly shows interstitial infiltration; Its pathogenesis is usually mild, and patients rarely die because of it.
The name of atypical pneumonia originated at the end of 1930, which corresponds to typical pneumonia, mainly lobar pneumonia or bronchopneumonia caused by bacteria. In 1960s, Mycoplasma pneumoniae was considered as the main pathogen of atypical pneumonia, but other pathogens were later discovered, especially Chlamydia pneumoniae. At present, it is believed that the main pathogens of atypical pneumonia are mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Legionella and Rickettsia (causing Q fever pneumonia), especially the first two, which account for almost 1/3 of hospitalized adults with community-acquired pneumonia every year. Most of these pathogens are intracellular parasites without cell walls, so broad-spectrum antibiotics (mainly macrolides and tetracyclines) that can penetrate into cells are effective for their treatment, while β -lactams are ineffective. Antibiotics are ineffective for SARS caused by virus.
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Huang Xingchu, the first SARS patient reported in China (commonly known as "SARS patient" in Chinese mainland), is also the first case in the world.
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Ye Xin, the head nurse of a hospital in Guangzhou, made great contributions in the fight against SARS.
[Edit this paragraph] Clinical diagnosis of symptoms and signs of ]SARS
Beijing subway during SARS
1. Epidemiological history
1. 1 had close contact with similar patients two weeks before onset or had clear evidence of infecting others.
1.2 lived in epidemic area or SARS epidemic area 2 weeks before onset.
2. Symptoms and signs
Fever (> 38℃), cough, rapid breathing, shortness of breath, or respiratory distress syndrome, lung rales or more than one sign of lung consolidation.
3. Laboratory inspection
Early white blood cell count does not increase or decrease.
4. Lung imaging examination
Patchy and patchy infiltrative shadows or reticular changes in the lung to varying degrees.
5. The effect of antibacterial drugs is not obvious.
Clinical diagnosis of SARS
According to the comprehensive judgment of epidemiological data, symptoms and signs, laboratory examination and pulmonary imaging examination, the clinical diagnosis was made. Once the pathogen is identified and the detection method is specific, a diagnosis is established. Once the pathogen is identified and the detection method is specific, the definition of a confirmed case is established.
Suspected cases: 1. 1+2+3 or 1.2+2+3+4.
Clinically diagnosed cases: 1. 1+2+3+4 or 1.2+2+3+4+5.
Diagnostic criteria for severe acute respiratory syndrome cases
SARS cases meet the following criteria, among which 1 can be diagnosed as severe SARS cases:
1. Multi-leaf lesion or X-ray chest film progress within 48 hours >: 50%
2. dyspnea, respiratory frequency >; 30 times/minute;
3. In hypoxemia, when the oxygen uptake is 3-5 liters/minute, Sao 2
4. Shock, ARDS or MODS (multiple organ dysfunction syndrome) occurs.
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Obviously, because SARS is caused by virus, any antibiotic drugs that are effective for bacteria have no obvious effect on this disease.
Traditional "atypical pneumonia" may be caused by pathogens such as mycoplasma, chlamydia, rickettsia, or rare bacteria, so it may be sensitive to macrolide antibiotics, that is, macrolide antibiotics (erythromycin) can be used as specific drugs.
But if "atypical pneumonia" in the traditional sense is also caused by viruses, antibiotics are also ineffective. At this point, if you use antibiotics, it is actually abusing antibiotics.
Little information about SARS
1. "SARS" refers to a lung infection caused by coronavirus in some areas of China since 2003. It is a respiratory infectious disease spread mainly through close air droplets and close contact. The main clinical manifestation is pneumonia, which has obvious aggregation phenomenon in families and hospitals. Typical pneumonia refers to lobar pneumonia or bronchopneumonia caused by common bacteria such as Streptococcus pneumoniae.
Second, the clinical manifestations of atypical pneumonia are different from the past. First, the patient has a high fever and a dry cough, and there are no symptoms such as runny nose and sore throat of the general flu, and there is no white or yellow sputum common to the common cold. Occasionally, patients have bloodshot sputum, causing shortness of breath, and some patients have respiratory distress syndrome. Under normal circumstances, white blood cells will increase when patients have a fever, but the white blood cells of patients with atypical pneumonia are normal or decreased. After SARS reaches a certain level, symptoms will be better distinguished from colds, but in the initial stage, it is sometimes very easy to be confused. Even some SARS patients have symptoms similar to a cold from the beginning, or completely the same as a cold, or a bit like the flu, with symptoms of upper respiratory tract infection. Because as the pathogen of SARS, it does not reach the lungs at once, but through the upper respiratory tract, trachea and bronchus. The patients we observe often have persistent fever for three to five days or even a long time, but there is a sudden improvement during the observation. The usual symptoms of patients are dry cough, less sputum, blood in some sputum, and severe breathing difficulties. Symptoms of the common cold include fever, cough and headache, which can be improved after a few days, and there is generally no sign of pneumonia.
3. The incubation period is about two to twelve days, and most people usually have obvious symptoms within four to five days. At present, the recognized route of transmission is through the respiratory tract, mainly through droplets, especially through close contact, coughing, sneezing, patient secretions and body fluids; There are some other situations now. After direct contact with the patient, rubbing your nose and eyes with your hands is also a way of transmission.
Fourth, it is suggested that you should see a doctor as soon as possible if you find symptoms such as fever and cough, because the disease will suddenly get worse during the observation. If early detection and timely treatment can be given, most patients can recover and be discharged after several weeks. In addition, in addition to early diagnosis and treatment, isolation measures can be taken in time to avoid infecting family members and other people in society. Also, some people think that if there are symptoms of runny nose, it is definitely not SARS, which is wrong. No matter what the pathogen of SARS is, it invades through the upper respiratory tract, oropharynx, nose and throat, so symptoms similar to the common cold may appear in the early stage. If you suspect that you are infected with atypical pneumonia, you should go to the hospital as soon as possible. X-ray examination is helpful for diagnosis.
Five, there is no specific drugs and treatment methods, but after timely support and symptomatic treatment, the vast majority of patients can recover. At present, the Department of Disease Control and Prevention of the Ministry of Health has organized multidisciplinary experts to formulate the National Technical Plan for the Prevention and Control of SARS on the basis of summarizing the prevention and control work in the previous stage. At present, there is no vaccine to prevent atypical pneumonia, and there is no specific medicine and treatment. Therefore, the most fundamental way to prevent SARS is to keep fit and enhance your immunity.
Six, mainly can take the following preventive measures:
① Cultivate and maintain good personal hygiene habits, and wash your hands after sneezing, coughing and clearing your nose; After washing your hands, dry them with clean towels and paper towels. Don't use a towel.
Pay attention to a balanced diet, change clothes according to climate change, exercise regularly and get enough rest. Reduce stress, avoid smoking, often go outdoors to breathe fresh air, and enhance the body's resistance.
(3) Indoor ventilation, promote air circulation, pay attention to the cleanliness of the room environment, and frequently dry clothes and quilts. (If air conditioning is installed indoors, it is necessary to maintain the good performance of air conditioning equipment, and often clean the dust screen to ensure the safety of air supply. )
④ Avoid going to public places with poor ventilation and dense population or staying in closed spaces for a long time.
⑤ Seek medical attention in time if you have symptoms.