Carrillo, Gwen Victoria G.

BSMLS 2C
September 29, 2019

Unmasks Age-Old Quarantine Conundrum

Where was the original epicenter of the SARS explosion?

Severe acute respiratory syndrome is a viral respiratory disease of zoonotic origin
caused by infection of the SARS corona virus (SARS-CoV). ... Antibiotics are ineffective,
as SARS is a viral disease. There is no vaccine to date. Isolation and quarantine remain
the most effective means to prevent the spread of SARS.The outbreak of sars (Severe
acute respiratory syndrome) , chilling reminder of the danger of mother nature. Killed
people worlwide, this documentary shows why and how sars is a killer bug. It was also
vastly effected first in Toronto Canada. Track and monitor progress. The scientists
pointed out that the virus came from the rural china and may originated from animals. It
emerged the world without any warnings.
What was the initial impact when SARS first hit?
The first person that acquired SARS will experienced symptoms like dry cough, fever,
sore throat and body pain. The first hit was massive 1500 people where infected and
struck down. 130 were died. The whole city was geared up on wearing masks to avoid it'
s danger. The SARS coronavirus is a positive and single stranded RNA virus belonging
to a family of enveloped corona viruses. Its genome is about 29.7kb, which is one of the
largest among RNA viruses.
What was the type of exposure?
The type of exposure that SARS have is the spread is by close person-to-person contact
or having personal contact to a certain individual. That is possibly the source of infection.
The most common source outbreak is one in which people are exposed intermit- tently
or continuously to a common harmful source
What was the route of spread?
SARS-CoV is transmitted most readily by respiratory droplet it is produced when an
infected person sneezes or even coughs, but also direct contact basically the route of
spread of this disease is the Human contact.

What was the incubation period?

The incubation period for SARS is typically 2 to 7 days, although in some cases it may
be as long as 10 days.

Who was considered as patient zero?

Liu Jianlun
Where did he come from?
Hong Kong's first patient is Liu Jianlun, he checked in to the Metropole Hotel on
February 21, specifically room 911 not knowing that he has the disease. Even though he
 was already feeling somewhat ill he visited with his family and traveled around Hong
Kong which had caused such a massive spread in hong kong.
Where did patient zero likely acquire the virus? How did he acquire it?
The first super-spreader, Zhou Zoufeng would bring the disease to the international
stage. He checked in to the Sun Yat-sen Memorial Hospital in Guangzhou on January
31. This was the same hospital where Liu Jianlun was treating the disease. The virus
was soon spread to nearby hospitals while Liu would later spread the disease to Hong
Kong. Amoy Gardern's Resident Anna Yuen observed how fast the sars could spread
cycling in every floor in their building.
What happened at Amoy Gardens?
Amoy Gardern's Resident Anna Yuen observed how fast the sars could spread cycling in
every floor in their building. What makes it more scary is sars can also be spread
elevator buttons and door handles which the residents uses in a regular basis. Because
of unclear mode of transmission the hong kong government declared an emergency.
The officials evacuated all the residents and isolated them. Through excretion, the virus
spread through drainage. One speculated theory that supported airborne
transmission was that the virus was spread through dried up U-shaped P-traps in the
drainage and was blown by a maritime breeze to the ventilation of the estate's balcony
and stairwells. It was confirmed that the virus can spread via droplets, but this latest
outbreak made the officials question the possibility of spreading through the air.
How did the officials deal with the situation at Amoy Gardens?
Massive Quarantining of Amoy Gardens and isolated them. A super-spreader is a host
an organism infected with a disease—that disproportionally infects more secondary
contacts than other hosts who are also infected with the same disease. A sick human
can be a super-spreader; they would be more likely to infect others than most people
with the disease. Sars virus is described that cells were literally dying, eating through the
patient's lungs and the scientist proves that SARS is not a regular virus
What is the difference between isolation and quarantine? When are they needed?
They use isolation and quarantine in order to control the spread of disease, Isolation is
used for patients with infectious disease. Quarantine happens in order to separate and
restrict the movement of well persons who may have been exposed to a communicable
disease to see if they were affected. This two are needed when the outbreak of disease.
How is a “superspreader” defined? How does the advances of the modern world play a role in
the spread of disease?
A super-spreader is a host an organism infected with a disease that disproportionally
infects more secondary contacts than other hosts who are also infected with the same
disease. A sick human can be a super-spreader; they would be more likely to infect
others than most people with the disease. Super-spreaders are thus of high concern in
epidemiology. Advances of modern world play a big role in the spread of disease
because people can now easily be migrated from one place to another that is why the
spread of disease become faster.
How is the SARS virus described? What instrument was used to identify it?
SARS is a viral respiratory illness caused by a coronavirus, called SARS-associated
coronavirus because of its crown or spikes that being identified it undergone tests using
virus isolation techniques, an electron microscope, and tools inorder to spot and classify
a specific virus. The most helped tool was the Electron microscopy it revealed features
and characteristic of coronaviruses.
What are the signs and symptoms of SARS?
The signs and symptoms are; fever over 100.4°F, dry cough, sore throat, problems
breathing, including shortness of breath, headache, body aches, loss of appetite,
malaise, night sweats and chills, confusion, rash and diarrhea
What is the proposed etiology of SARS?
The proposed etiology of SARS is from a member of the coronavirus family of viruses
(the same family that can cause the common cold). Based on research, 2003 was the
year that epidemic started when the virus spread from small mammals in China.
What can we learn about how the Canadians and Chinese deal with public health concerns?
Canadian and Chinese government were purely different from solving the case, we can
see that the Canadian are more responsible in solving the issues in public health then
the Chinese government who hide the situation from the WHO. Small symptoms or signs
should be treated immediately in order to identify the cause of the symptoms.
What is the SARS situation now in the Philippines?
.Strengthening capacity for simplified early warning surveillance for diseases of epidemic
potential enhances countries' abilities to detect events affecting public health and acute
threats to global health security during emergencies. The Philippines has reported a
cumulative total of 10 probable SARS cases, with two deaths. The country's Health
authorities have determined that all cases were part of a chain of transmission linked to
a single imported case. All cases were placed in isolation in hospital. Even the reported
contacts of the 10 cases have been traced, and authorities are confident that all contacts
have been identified and placed in isolation.Strengthening capacity for simplified early
warning surveillance for diseases of epidemic potential enhances countries' abilities to
detect events affecting public health and acute threats to global health security during
emergencies.

How does mutation play a role in the spread of disease?

The ultimate source of all genetic variation is mutation. Mutation is important as the first
step of evolution because it creates a new DNA sequence for a particular gene, creating
a new allele. Recombination also can create a new DNA sequence (a new allele) for a
specific gene through intragenic recombination. Although optimists once imagined that
serious infectious disease threats would by now be conquered, newly emerging (e.g.,
severe acute respiratory syndrome [SARS]), reemerging (e.g., West Nile virus), and
even deliberately disseminated infectious diseases (e.g., anthrax bioterrorism) continue
to appear throughout the world.
What is the prospect of emerging infectious diseases in the next few years?
Within the National Institutes of Health, the National Institute of Allergy and Infectious
Diseases (NIAID) is the lead agency for infectious disease research. Emerging infectious
diseases are infections that have recently appeared within a population or those whose
incidence or geographic range is rapidly increasing or threatens to increase in the near
future. Emerging infections can be caused by Previously undetected or unknown
infectious agents. Known agents that have spread to new geographic locations or new
 populations, Previously known agents whose role in specific diseases has previously
gone unrecognized & Re-emergence of agents whose incidence of disease had
significantly declined in the past, but whose incidence of disease has reappeared. This
class of diseases is known as re-emerging infectious diseases.

Establish Diagnosis The diagnosis methods are preventive

education and publicity
Establish case definition Mistakenly Identified Outbreak
Determine if epidemic is occurring A lot of cases have similar signs and
symptoms
Characterized epidemic Type of exposure
Person-to-person
Route of spread
Human contact
Incubation period
2-7 days
Primary cases
The primary source as Zhou Zoufeng he
brought the disease to the international
stage. He checked in to the Sun Yat-sen
Memorial Hospital in Guangzhou
Secondary Cases
The secndary case was the same hospital
where Liu Jianlun was treating the disease
which is the patient zero.
Common Source
Outbreak in Amoy Gardens
Propagated outbreak
Outbreak caused by person-person
contact
Index Case
Zhou Zoufeng
Outer case
Hong Kong and Canada
China, Hong Kong, Singapore,
Vietnam, Canada
Time
February 2003
Develop hypotheses The develop hypotheses experts discovered
that SARS is a special influenza.
Test hypotheses Doing more tests in order to classify kills and
killed thousands of people in the world.
Initiate control measures
Initiate specific follow-up surveillance
The initial control measures for SARS is
isolation and quarantine in order to stop the
propagation and spread.
Initial follow ups should be strengthening
connection with China and the World Health
Organization and progressive development
for a quick diagnostic test for SARS.

References:
https://www.nhs.uk/conditions/sars/
https://www.medicalnewstoday.com/articles/7543.php
https://www.pnas.org/content/104/29/12123
https://lsa.umich.edu/content/dam/english-assets/migrated/honors_files/Rao%20Neil-
%20SARS%20How%20the%20News%20Media%20Causeand%20Cure%20an%20Epidemic%
20of%20Fear.pdf
https://www.who.int/ith/diseases/sars/en/
https://cmr.asm.org/content/20/4/660