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Travel to endemic area within 10 days before symptom onset, including mainland China, Hong Kong, Singapore, Taiwan, Vietnam, and Toronto
Persistent fever, dry cough, dyspnea in most cases
Mortality: as high as 14% in clinically diagnosed cases
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SARS is an atypical pneumonia that affects all age groups
Incubation period is 2–7 days; it can be spread to contacts of affected patients for 10 days. Mean time from onset of clinical symptoms to hospital admission is 3–5 days
In all clinical cases, persistent fever is present; chills/rigor, cough, shortness of breath, rales, and rhonchi are the rule
Headache, myalgias, and sore throat are common
Watery diarrhea occurs in subset of patients
Elderly patients may report malaise and delirium, without fever
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Serologic tests are available, but seroconversion may not occur until 3 weeks after the onset of symptoms
Conventional reverse transcriptase polymerase chain reaction (RT-PCR)
Detection rates for the virus are generally low in the first week of illness
Urine, nasopharyngeal aspirate, and stool specimens are positive in 42%, 68%, and 97%, respectively, on day 14 of illness
Leukopenia (particularly lymphopenia) and low-grade disseminated intravascular coagulation are common
Modest elevations of alanine aminotransferase (ALT) and creatine kinase are frequently seen
Arterial oxygen saturation < 95% with associated nonspecific pulmonary infiltrates is evident in 80% of affected individuals
A high-resolution CT scan is abnormal in 67% of patients with initially normal chest radiographs
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No specific treatment
Supportive therapy is mainstay
The following agents were used during the 2003 epidemic, but their efficacy remains inconclusive