What is "SARS"

Atypical pneumonia (SARS) refers to pneumonia in which the exact source of disease has not been found and the pathogen has not been clearly defined. At present, it refers to the SARS epidemic in China in 2003.

In 2003, there were some twists and turns in the naming of SARS in China because the medical department could not find a clear cause. At first, the medical staff gave it a temporary name-"unexplained pneumonia" (UP). For diseases with unknown causes, this diagnosis is permissible and common in clinic. Later, due to the further understanding of the epidemiology and pathology of the disease, it was known that it was an infectious pulmonary parenchymal inflammation that first occurred outside the hospital, so the diagnosis of "community acquired pneumonia" (CAV for short) was put forward. Finally, according to the clinical manifestations of patients, bacteria can't be cultured, and common antibiotics are ineffective. The diagnosis of "atypical pneumonia" finally surfaced and became the most authoritative statement in many media. However, some experts tend to think that SARS is the pneumonia caused by mycoplasma and chlamydia in the past. Because this pneumonia in Guangdong has basically ruled out the infection caused by mycoplasma and chlamydia, it can't be called atypical pneumonia, but should be called "atypical pneumonia" or "atypical pneumonia" to show the difference.

[atypical pneumonia]

Atypical pneumonia is relative to atypical pneumonia, and is usually caused by common bacteria such as pneumococcus. Typical symptoms, such as fever, chest pain, cough and expectoration. Laboratory tests show that white blood cells increase and antibiotic treatment is effective. Atypical pneumonia itself is not a newly discovered disease, it is mostly caused by viruses, mycoplasma, chlamydia, rickettsia and other pathogens. Symptoms, lung signs and blood test results are not as obvious as SARS infection, and some viral pneumonia antibiotics are ineffective.

SARS refers to a group of diseases caused by the above atypical pathogens, not a definite diagnosis. Its clinical characteristics are that the onset is hidden, mostly dry cough, occasional hemoptysis, and less positive signs of auscultation in the lungs; X-ray chest film mainly shows interstitial infiltration; Its pathogenesis is usually mild, and patients rarely die because of it.

The name of atypical pneumonia originated at the end of 1930, which corresponds to typical pneumonia, mainly lobar pneumonia or bronchopneumonia caused by bacteria. In 1960s, Mycoplasma pneumoniae was considered as the main pathogen of atypical pneumonia, but other pathogens were later discovered, especially Chlamydia pneumoniae. At present, it is believed that the main pathogens of atypical pneumonia are mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci, Legionella and Rickettsia (causing Q fever pneumonia), especially the first two, which account for almost 1/3 of hospitalized adults with community-acquired pneumonia every year. Most of these pathogens are intracellular parasites without cell walls, so broad-spectrum antibiotics (mainly macrolides and tetracyclines) that can penetrate into cells are effective for their treatment, while β -lactams are ineffective. Antibiotics are ineffective for SARS caused by virus.

[epidemiological history]

June, 2002165438+1October, 65438+June, Foshan First People's Hospital admitted a patient with special pneumonia. Two or three cases were found in Foshan. Since then, similar cases have appeared in Heyuan, Zhongshan, Jiangmen, Guangzhou and Shenzhen.

From June 5438 to February 65438 to May 2002, Huang Kechu and Guo Ducheng of Zijin County were admitted to Heyuan People's Hospital successively. The five medical staff I have seen have the same symptoms as the patients. Panicked people lined up in front of the major pharmacies in Heyuan. At that time, people flocked to pharmacies, but they didn't know what to buy. They just followed the trend and snapped up some antiviral drugs. Someone bought 10 boxes at once. Soon, the pharmacies in the whole city were out of stock, and people who couldn't buy medicine were even more afraid. Until 9 pm, many pharmacies closed and people were waiting in line. Some parents are rushing to school to take their children home to avoid "disaster".

On June 2, 2003, Zhongshan City admitted a similar patient. Due to the lack of understanding of this disease, medical staff did not take timely protection, and seven or eight staff members in a hospital in Zhongshan City were infected. Since 65438+ 10/6, rumors of "pneumonia epidemic" have spread in Zhongshan, and citizens have gone to pharmacies to buy medicines just in case. Some people buy dozens of boxes at a time. The reporter learned that a box of ordinary roxithromycin costs more than 10 yuan, and a better box of roxithromycin costs several hundred yuan for most citizens. The person in charge of Relay Pharmacy, the largest pharmaceutical chain in Zhongshan City, said that the number of people who came to the pharmacy to buy roxithromycin began to increase on 16, and reached a peak on 17, and half of its eight chain stores were out of stock.

On February 6, 2003, the incidence of atypical pneumonia reached its peak in Guangdong Province, with 2 18 cases found in the whole province, with a sudden increase of 45 cases, which greatly exceeded the previous one-day increase. These cases are mainly concentrated in Guangzhou, and a considerable number of them are medical personnel. "First, the staff inside the hospital sent reminders to relatives and friends, and then these relatives and friends passed them on to more social groups. From the eighth day of the first month to the tenth day of the first month, it spread widely. In Guangdong, quite a few citizens own two mobile phones. " According to the statistics of short message traffic of Guangdong Mobile, its users have sent1260,000 short messages in three days, which is fast catching up with the short message traffic from New Year's Eve to New Year's Day. The extreme flood of information has brought about disastrous social panic. From February 10 to February 1 1, the streets of Guangzhou showed a gloomy scene, with hotels, restaurants and various entertainment places deserted. On June 5438+02, even pharmacies in Beijing adopted the regulation of restricting the purchase of Radix Isatidis (two boxes of Tong Ren Tang and five boxes of other brands).