Useful Information

Guidelines to Primary Care Physicians / Family Physicians on the management of cases of suspected Severe Acute Respiratory Syndrome

In accordance with World Health Organization, symptoms and signs of Severe Acute Respiratory Syndrome include -

high fever (>38^o C) AND
one or more respiratory symptoms including cough, shortness of breath, difficulty breathing AND

close contact^* with a person who has been diagnosed with Severe Acute Respiratory Syndrome

*	close contact means having cared for, having lived with, or having had direct contact with respiratory secretions and body fluids of a person with Severe Acute Respiratory Syndrome.

In addition to fever and respiratory symptoms, Severe Acute Respiratory Syndrome may be associated with other symptoms including: headache, muscular stiffness, loss of appetite, malaise, confusion, rash, and diarrhea.

When to refer

Doctors are advised to refer patients with the following conditions to hospital for further management -

(I)	Fever more than 38^o Celsius and new onset of pulmonary infiltrate and either shortness of breath or cough and no symptomatic response to standard therapy including a beta-lactam (penicillin & cephalosporin groups) and coverage for atypical pneumonia (a fluoroquinolone, tetracyclines, or a macrolide) after 2 days of therapy in terms of fever and general well being
OR
(II)	Fever more than 38^o Celsius and new onset of pulmonary infiltrate and either shortness of breath or cough and patient has been exposed to patients with pneumonia in the previous 7 days

(Issued on 17 March 2003)