Discharge and Follow-up
The duration of shedding of the SARS virus from respiratory secretions of SARS patients appears to be variable. Some animals can shed infectious coronavirus persistently from the enteric tract for weeks or months without signs of disease, transmitting the infectious virus to neonates and other susceptible animals (Holmes). Studies are being done to learn whether the SARS virus is shed persistently from the respiratory and/or enteric tracts of some humans without signs of disease (Holmes). In the meantime, all SARS patients should limit interactions outside the home and should not go to work, school, out- of-home childcare, or other public areas until 10 to 14 days after the fever and respiratory symptoms have resolved. During this time, the infection control precautions for SARS patients should be followed. In a small study of 14 patients, none reported secondary cases in their household following their discharge home (Avendano).
At a follow-up visit one week after discharge, all 14 patients in one series still felt weak and complained of dyspnea on exertion. They all reported significant weight loss during their acute illness (mean 7 kg). Two patients had had a low grade fever (up to 37.5°C) for 2–3 days following discharge. Only 2 patients had persistence of a slight dry cough. The chest radiograph was clear for 7 patients and, although
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- References
- 30 Virology
- Discovery of the SARS Virus
- Initial Research
- Coronaviridae
- SARS Co-V
- Genome Sequence
- Antiviral Agents and Vaccines
- Antiviral Drugs
- Vaccines
- Outlook
- References
- Routes of Transmission
- Patient Factors in Transmission
- Asymptomatic Patients
- Symptomatic Patients
- The Unsuspected Patients
- High-Risk Activities
- Transmission during Quarantine
- Introduction
- Global Spread
- Hong Kong
- Other Countries
- Eradication
- Outlook
- Introduction
- International Coordination
- Management of SARS in the post-outbreak period
- National Measures
- Legislation
- Quarantine after Discharge
- Infection Control in Healthcare Settings
- General Measures
- Protective Measures
- Special Settings
- Intensive Care Units
- Intubating a SARS Patient
- Anesthesia
- Triage
- Internet Sources
- After the Outbreak
- Conclusion
- 108 Case Definition
- WHO Case Definition
- Suspect case
- Reclassification of cases
- CDC Case Definition
- 112 Diagnostic Tests
- Introduction
- Laboratory tests
- Virus isolation
- Antibody detection
- Interpretation
- Limitations
- Biosafety considerations
- Clinical Presentation and Diagnosis
- Clinical Presentation
- Diagnosis
- Clinical Course
- Histopathology
- Lung Biopsy
- Postmortem Findings
- Discharge and Follow-up
- Psychosocial Issues
- References
- 144 SARS Treatment
- Antibiotic therapy
- Antiviral therapy
- Ribavirin
- Alternative medicine
- Immunomodulatory therapy
- Other immunomodulators
- Assisted ventilation
- Invasive mechanical ventilation
- Clinical outcomes
- Appendix 1
- A standardized treatment protocol for adult SARS in Hong Kong
- Appendix 2
- A treatment regimen for SARS in Guangzhou, China
- References
- 168 Pediatric SARS
- Clinical Manifestation