A Note on SARS
(Severe Acute Respiratory Syndrome) with the Possibility of Homeopathy.

Causative agent.
Clinical Features
Laboratory Diagnosis
Homoeopathic Treatment

Homoeopathic Prophylaxis

Please note

SARS in India

Other sites about SARS
Latest info...

Causative agent.

SARS is supposed to be caused by a ‘Corona Virus’ found out very recently and named “SARS Virus” by WHO. This virus is of animal origin and usually is not found in humans. Postulations are there that the virus is a genetic mutation of animal corona virus due to causes not yet known. It is also propagated that the virus is a man made one created for biological weapon purpose and accidentally leaked out.

The incubation period is 2--7 (up to 10) days.
The period of infectivity is not yet ascertained but supposed to be about 10 days too from the onset of symptoms.
Mode of infection is by droplets and direct contact as it is an air born disease. Contaminated formites may also spread it.

Although a few close contacts of patients with SARS have developed a similar illness, the majority have remained well. Some close contacts have reported a mild, febrile illness without respiratory signs or symptoms, suggesting the illness might not always progress to the respiratory phase.

Clinical Features
A Suspect case of SARS is one with respiratory illness of unknown etiology with onset since February 1, 2003, and the following criteria.
1. Measured temperature greater than 100.4°F (greater than 38°C) AND
2. One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty breathing, or hypoxia) AND
3. Travel or transit within 10 days of onset of symptoms to the following areas. People's Republic of China (i.e., mainland China and Hong Kong Special Administrative Region); Hanoi, Vietnam; Singapore; and Toronto; Canada OR
4. Close contact (means having cared for, having lived with, or having direct contact with respiratory secretions and/or body fluids of a patient known to be a suspect SARS case) within 10 days of onset of symptoms with a person known to be a suspect SARS case.

A Probable case is a suspect case with one of the following:
1. Radiographic evidence of pneumonia or respiratory distress syndrome
2. Autopsy findings consistent with respiratory distress syndrome without an identifiable cause

The severity of illness might be highly variable, ranging from mild illness to death. It affects those between 25--70 years. A few suspected cases of SARS have been reported among children of 15 or below. 
It begins generally with a prodrome of fever (>100.4°F [>38.0°C]) often high, sometimes associated with chills and rigors, and also with headache, dizziness, malaise, and myalgia. There may sore throat, and running nose. At the onset of illness, some persons have mild respiratory symptoms with cough. Note that rash and neurologic or gastrointestinal findings are typically, absent but diarrhoea is reported in some during the febrile prodrome.

After 3--7 days, a lower respiratory phase begins with the onset of a dry, nonproductive cough or dyspnoea, which might be accompanied by or progress to hypoxemia. In 10%--20% of cases, the respiratory illness is severe enough to require intubation and mechanical ventilation. The case-fatality rate among persons with illness meeting the current WHO case definition is of approximately 5%.


Laboratory Diagnosis
Initial diagnostic testing for suspected SARS patients should include chest X’ ray, blood routine and cultures, pulse oximetry, sputum Gram's stain and culture, and testing for viral respiratory pathogens, notably influenza A and B and respiratory syncytial virus. Legionella and pneumococcal urinary antigen testing are advanced procedures.

Chest X’ ray in majority shows in the respiratory phase characteristic early focal interstitial infiltrates progressing to more generalized, patchy, interstitial infiltrates. In the late stages some show areas of consolidation also.

The absolute lymphocyte count is often decreased. Overall WBC counts are also generally normal or decreased. Leucopoenia and thrombocytopenia or low-normal platelet counts (50,000--150,000/µL) are seen in 50% of patients at the peak of the respiratory illness. Early in the respiratory phase, elevated creatine phosphokinase levels (as high as 3,000 IU/L) and hepatic transaminases (two to six times the upper limits of normal) have been noted. Renal function remain normal in the majority.

Serum antibody tests, including both enzyme immunoassay (EIA, or ELISA) and indirect immunofluorescence antibody (IFA) formats. Reverse transcription-polymerase chain reaction (RT-PCR) testing is also available. This test can detect coronavirus RNA in clinical specimens, including serum, stool, and nasal secretions and are costly. Viral isolation for the new coronavirus also has been done but is still more costly.  

A new test devised latest (April 18th 2003) can detect the presence of the corona virus in nasal swabs or throat cultures before an antibody response is detectable. Prior to the development of this new rapid test, diagnostic tests for SARS could detect the corona virus antibodies that are produced after infection, which in some cases is within 14 days of illness onset, or as long as 21 days after onset of fever. By contrast, the new test is often positive early in the disease, and the procedure can be completed within a few hours
(For more details visit http://www.clinchem.org/cgi/content/full/49/4/DC1)

This consists of the general management measures for febrile/respiratory diseases with special emphasis on isolation and prevention of spread. Institutional treatment is needed, as there are chances for hypoxaemia and respiratory arrest. 


Conventional treatment regimens is to use several antibiotics to presumptively treat known bacterial agents of atypical pneumonia. In several locations, antiviral agents such as oseltamivir or ribavirin are also used. Steroids have also been administered orally or intravenously to patients in combination with ribavirin and other antimicrobials. At present, the most efficacious treatment regimen, if any, is unknown.

Homoeopathic Treatment
As presently there is no definite medicines in allopathy for SARS except offering ventilators, oxygen support therapy, antibiotic cover and some nonspecific antiviral medications, it will be the only wise thing that homoeopathic medicines are evaluated and incorporated in the treatment of SARS.

The following are the drugs* can be of use for SARS based on symptom similarily.

Aconitum napellus, Ailanthus glandulosa, Arsenicum album, Baptisia, Belladonna, Bryonia, Chelidonium majus, Crotalus horridus, Hepar sulph, Ipecac, Kali carb, Lachesis, Muriatic acid, Natrum sulphuricum, Nux vomica, Pulsatilla, Phosphorus, and Rhus tox.

Out of these Aconitum, Arsenicum, Belladonna, Bryonia and Ipecac may be particularly use full in the early stages and Ailanthus glandulosa, , Kali carb, Lachesis, and phosphorus in the late stages.
Veratrum viride mother tincture is said to be particularly effective in containing the illness.

The available actual symptoms** of SARS on analysing, including detailed repertorisation and reference to the Materia medica gave the following medicines as the leading ones.

Phosphorus, Bryonia, Lachesis, Arsenicum, Rhus tox and Baptisia.


Based on the recent analysing (see above) of actual symptoms
** of SARS and on our experience with massive prophylactic work with marked success against Leptospirosis, Dengue, Japanese Encephalitis and Cholera, we suggest Phosphorus as the best Prophylactic drug against SARS. 
The dosage can be adjusted as
2 pills of no. 40 medicated with Phosphorus 200c taken two times daily for five days.

Twenty two persons from Kerala who attended a conference at Singapore took Phosphorus and reported safe even after ten days of returning. 
Dr. Muraleedharan (drvmurali@sancharnet.in) from Trichur, Kerala.

Pulsatilla is one of the the best medicines for common viral infections both as a preventive and curative, if required an intercurrent of Thuja will enhance its powers. According to Dr. Mansoor Ali.
Dr Jean Doherty, suggests Oscillococcinum 200 as 1st line defence if contact with Sars.
Dr. Manish Bhatia gives Chelidonium majus as a prophylactic drug.

Please contact us with more disease specific and individual symptoms if you have so that we can work out more effective Homoeopathic drugs.

No known preventive measures are identified presently except avoidance of contact. Thailand claimed (on 27-04-2003) 100% control over the disease by stringent surveillance and isolation.


Please note
This is a notifiable disease and should be reported to the local public health authorities. Clinicians should save any available clinical specimens (respiratory, blood, and serum) for additional testing until a specific diagnosis is made.

Clinicians evaluating suspected cases should use standard precautions (e.g., hand hygiene) together with airborne (e.g., N-95 respirator/face mask) and contact (e.g., gowns and gloves) precautions. Until the mode of transmission will be defined more precisely, eye protection is also recommended. These will be updated as more clinical and epidemiologic information becomes available

As of August 15th, 2003, (from November 1st 2002) a total of 8456 SARS cases with 809 deaths have been reported from 25 countries, including 220 probable cases in the United States. Main land China and Hong Kong remains the worst affected area on the globe with 5329 and 1755 reported cases, including 348 and 296 deaths respectively. It is also to be noted that as late as the end of June 2003 WHO declared the mainland China and Hon Kong as areas where SARS is under control and they are also lifted the travel ban to these nations.

SARS in India 
Till the beginning of 2003 only 3 cases of SARS have been reported in India with no deaths. Virologists are of the opinion that this is because of the extreme heat in India. Also it is proved that the virus cannot survive out side human body for more than 3-4 days in this extreme conditions. But however the picture may change according to them once the monsoon begins. There may be a dramatic change in the environment in favour of the virus and there may be a sudden escalation of cases. But we rightly thought there is not enough evidence for a nation wide action or panic in this regard as evident from the fact that SARS never caused casualties here in the monsoon of 2003, 04 or 05!




Latest info...
SARS or suspected to be likely infection has struck again Singapore in early September 2003. Confirmation of the same as well as more news never materialized as most probably there were no such episodes. Any way it didn't escalate to an epidemic to the knowledge of any of us. Any body having actual symptoms from any cases may please contact Dr. Abdul Gafar.

*Compiled by Dr. Abdul Gafar with the help of Dr. Sudinkumar and Dr. Mansoor Ali

With help from Catherine Creel ccreel@adelphia.net And Luise Kunkle's website: http://www.bar-do.net/symptoms_compilation.htm. Repertorial help from Dr. Mansoor Ali