SARS ( ) 2002 11 Severe Acute Respiratory Syndrome SARS 2003 5 14 SARS 32 7548 573 ( 1) [1] SARS SARS 1 SARS May 14, 2003. available at http://www.who.int/csr/sars/map2003_05_14.gif 1 SARS 2002 11 2003 2
SARS 32 25 5 14 5013 252 2 WHO 2003 4 16 SARS SARS Virus [2] 2 SARS (http://cmbi.bjmu.edu.cn) SARS SARS SARS SARS 1. SARS [3] 3 3 SARS from Kenneth W.Tsang,2003 [3]
2. SARS 30 39 40 49 20 29 29.2 19 9 Christopher M. Boot 144 SARS [4] 77% 1 57.6 38 8.1 0.9 SARS 70 79 28 Christopher M. Booth SARS ( 4) 8 6 2 SARS (from Booth C M. 2003) [4]
4 SARS (From Booth C M. 2003) [4] 3. Christl A Donnelly [5] 1425 SARS SARS 6.4 3 5 23.5 5 60 13.2 60 43.3 5 SARS from Donnelly C A. 2003 [5] 4. WHO SARS 1 2 ph 4
24 4 80 21 56 15 10000 75 5 5 SARS-CoV 5. WHO 10 60 2 1. SARS [6][19] ARDS. [7] 6 SARS ( 7) SARS 6. SARS A HE 100 B HE 200 C D HE 400 (from Lee N.2003) [7]
7.SARS SARS CoV A,B A from Thomas G.Ksiazek,2003 8 SARS [8]
9. SARS [8] [9] 10. SARS from Peiris J S M,2003 [9]
[10] 11. RT-PCR SRAS-CoV (from Peiris J S M,2003) [9]
12. SRAS-CoV from Christin Drosten,2003 [10] [4]
13 SARS (from Booth C M. 2003) [4]
14. SARS (from Booth C M. 2003) [4] 15. SARS (from Booth C M. 2003) [4] [11] 16 SARS from Hon K L E.2003 [11] 3 SARS WHO http://cmbi.bjme.edu.cn
1. SARS Lee N [7] 138 108 108 59 54.6% 49 45.4% 7 10 17 18 Changi General Hospital 24 1 5 7 19 CT 2 3 5 17. SARS A: B: ; C: (from Lee N.2003) [7] 18 Changi General Hospital Day1, Day5, Day7 [18]
19 CT Day2, Day3, Day5 [18] 2. SARS SARS-CoV WHO 3.2.1 PCR PCR PCR PCR SARS SARS RNA DNA PCR SARS CoV 60 80 PCR 3.2.2 ELISA 21 10 4 21 SARS 3.2.3 Vero E6 SARS-CoV SARS Cov Fouchier R A. SARS [20] WHO SARS SARS-CoV
. 3.2.4 SARS SARS W H Seto [12] SARS 13 SARS 241 SARS 69 13 SARS ICU SARS SARS [13] Bag-valve-mask SARS WHO CDC http://cmbi.bjmu. edu.cn SARS 4 SARS ARDS [8], SARS 3.7 WHO 10 30 [14] 17 13 4 SARS
RNA 1) 95 2) 400 8 12 1.2 10 14 3) 21 1 8 5 1 12 5 0.5 5 3 3 500 2 SARS SARS Kaletra [4] 144 126 2 6 1 4 500 8 3 49 2 / 76 40 14 4 18 ARDS ARDS ARDS
ARDS J J Cordingley [15] ARDS 60 90 CO2 2 3 ph 7.2 6ml/kg, 30-35 cmh20 PEEP 15 cmh20 I:E 1:1 2:1 PEEPi 40 SARS 20 3 SARS ( ) [16], SARS-CoV SARS-CoV RNA 5 SARS SARS 5 10 [17] SARS (Viral replicative phase) immune hyperactive phase (pulmonary destruction phase) (fully recovery) 6 SARS SARS 1. SARS 2. 3.
4. 5. SARS SARS SARS SARS SARS ( ) 1. Cumulative Number of Reported Probable Cases of Severe Acute Respiratory Syndrome (SARS). May 14, 2003, available at http://www.who.int/csr/sars/country/2003_05_13/en/. 2. Coronavirus never before seen in humans is the cause of SARS. Apri1 16, 2003, available at http://www.who.int/csr/sarsarchive/2003_04_16/en/ 3. Donnelly C A, Ghani A C, Leung G M, et al. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. THE LANCET. Published online. 2003, May 7 4. Booth C M, Matukas L M, Tomlinson G A, et al.clinical Features and Short-term Outcomes of 144 Patients With SARS in the Greater Toronto Area. JAMA. 2003; 289:1-9 5. Donnelly C A, Ghani A C, Leung G M, et al. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. THE LANCET. Published online. 2003, May 7 6. Yeung M C, Yu W C.Outbreak of severe acute respiratory syndrome in Hong Kong special adeministrative region: case report.bmj 2003 ;326:850 7. Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in HongKong. The New England Journal of Medicine.2003;April 7: SUNG1-9 8. SARS April 29, 2003 9. Peiris J S M, Chu C M, Cheng V C C, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. The Lancet. Published online. 2003, May 9 10. Drosten C, Gunther S, Preiser W, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. The New England Journal of Medicine. Published online.2003;april 10 11. Hon K L E, Leung C W, Cheng W T F, et al. Clinical presentations and outcome of severe acute respiratory syndrome in children.the Lancet. Published online. 2003; April 29 12. Seto W H, Tsang D, Yung R W H. et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndreome(sars). THE LANCET. 2003; 361:1519-1520 13. Lapinsky S E, Hawryluck L. ICU mamagement of severe acute respiratory syndrome. Intensice Care Medicine. Published online.2003,may 9 14. So L K Y, Lau A C W, Yam L Y C, et al. Development of a standard treatment protocol for severe acute respiratory syndrome.lancet. 2003;361:1615-1618 15. Cordingley J J, Keogh B F. The pulmonary physician in critical care 8: ventilatory
management of ALI/ARDS. Thorax 2002;57:729-734 16. Ruan Y J, Wei C L, Ee L A, et al. Comparative full-lenth genome sequence analysis of 14 SARS coronavirus isolates and common mutations associated with putative origins of infection. The Lancet. Published online. 2003, May 9 17. May 10 2003 http://sc.info.gov.hk/gb/www.info.gov.hk/gia/general/200305/10/0510213.htm 18. Radiological Appearances of Recent Cases of Atypical Pneumonia in Hong Kong. May 15, 2003. available at http://www.droid.cuhk.edu.hk/web/atypical_pneumonia/atypical_pneumonia.htm 19. Nicholls J M, Poon L M, Lee K C, et al. Lung pathology of fatal severe acute respiratory syndrome. The Lancet Published online. 2003, May 16 20. Fouchier RA, Kuiken T, Schutten M, et al. Koch's postulates fulfilled for SARS virus. Nature 2003;423:240