Severe acute respiratory syndrome and Middle Eastern Respiratory Syndrome

Abstract

Prior to the onset of severe acute respiratory syndrome (SARS) in 2003, there were several known human coronaviruses which caused a spectrum of respiratory symptoms ranging from upper respiratory infections to severe pneumonia in humans. Severe acute respiratory syndrome (SARS) was the first pandemic of the 21st century caused by a novel coronavirus (SARS-CoV), which probably crossed from animals at live markets to humans in mid-November 2002. Patients usually presented with atypical pneumonia, with up to a third of patients requiring intensive care. The majority of critically ill patients developed acute respiratory distress syndrome (ARDS). Treatment was supportive as there was no effective anti-viral therapy. The global case fatality rate was 9.7%. About 21% of the patients were healthcare workers. In 2013, the Middle Eastern Respiratory Syndrome (MERS) was caused by MERS-CoV. This had a high fatality rate of 35% and extensive nosocomial transmission as well. Every country has an essential role in limiting the spread of outbreaks through early, prompt and transparent reporting of SARS-like illness so that immediate and appropriate public health actions can be taken as initially occurred when SARS2 emerged in late 2019, and several countries in Asia rapidly responded within the first month after a WHO alert.