Severe Acute Respiratory Syndrome (SARS) in Children

What is SARS in children?

Severe acute respiratory syndrome (SARS) is a viral illness. SARS is caused by a type of coronavirus called SARS-associated coronavirus (SARS-CoV). SARS-CoV is related to but is not the same virus (SARS-CoV-2) that causes COVID-19. SARS-CoV is very contagious and can spread quickly. It can cause mild illness, severe illness, or death. It's now known as a virus that can pose a severe threat to public health. No new cases of SARS have been diagnosed anywhere in the world since 2004. Any new cases need to be quickly diagnosed and treated. A child with SARS needs to be kept away from others until the illness is treated and cured.

What causes SARS in a child?

SARS is caused by a type of coronavirus. The virus is called SARS-associated coronavirus (SARS-CoV). It's not caused by SARS-CoV-2, which causes COVID-19. But the viruses are similar. Coronaviruses most often cause mild to moderate upper-respiratory illness. They can cause respiratory, digestive, liver, and nervous system diseases in animals. Researchers think that SARS is a virus that spread from animals to people.

SARS-CoV spreads through close contact with someone who is infected with SARS. When a person with SARS coughs or sneezes, small drops of fluid from the nose and mouth can spray up to 3 feet. They may land on a child’s mouth, nose, or eyes. The virus also can spread when a child touches an object with droplets on it and then touches their mouth, nose, or eyes.

A child who has been exposed to SARS may not yet be ill. A child should have their temperature and health watched for 10 days. The child should also stay home from school or daycare, wash hands often, and cover their mouth and nose when coughing or sneezing.

Which children are at risk for SARS?

A child is more at risk for SARS if they are in an area where SARS is active or if they've had contact with a person who has SARS. This means living with someone with SARS or kissing, hugging, or sharing cups or eating utensils.

What are the symptoms of SARS in a child?

In children, symptoms of SARS occur about 2 to 10 days after contact with the virus. But not everyone exposed to the virus becomes ill.

Symptoms start with:

• Fever

• Headache

• Body aches

• Chills

• Diarrhea, in some cases

After 2 to 7 days, your child may have:

• Dry cough

• Trouble breathing

SARS then often leads to lung infection (pneumonia). Your child may also not have enough oxygen in the blood (hypoxia). These problems can make it very hard for your child to breathe.

A child with SARS is contagious when having symptoms, such as fever or cough. A child is most contagious during week 2 of the illness. A child with SARS needs to be kept away from others, either at home or in the hospital. A child should stay home from school for 10 days after their symptoms have gone away. This is to make sure there is no risk to others.

The symptoms of SARS can seem like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How is SARS diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They may also ask about recent travel to an area where SARS has been active. They will give your child a physical exam. Your child may also have tests. These are done to check for other types of illness.

Tests may be available to check for the SARS-CoV virus. Your child’s healthcare provider may need blood, poop, or nasal fluid samples. These are tested to look for antibodies that mean a person’s immune system is fighting SARS. Or the virus may be grown from a sample and checked with a microscope. Your child’s healthcare provider will tell you more.

How is SARS treated in a child?

There are some antiviral medicines that may help in treating the SARS virus. But SARS most often is treated with supportive therapy, which may include:

• IV (intravenous) fluids

• Antibiotics to help prevent or treat additional infections. Antibiotics don't kill the SARS virus.

• Extra (supplemental) oxygen or use of a breathing machine (ventilator)

Follow all instructions from public health workers if your child has SARS. 

How can I help prevent SARS in my child?

There is no vaccine yet available to prevent SARS. The best way to prevent the virus is to not travel to an area if there is a SARS outbreak and to not have contact with a person who has SARS. In an area or home with SARS, make sure your child:

• Washes their hands regularly with warm water and soap

• Doesn't touch their eyes, nose, or mouth

You should also keep surfaces clean. This includes:

• Tabletops

• Doorknobs

• Handles on faucets, cabinets, toilets

• Cups and eating utensils

• Books and toys

Follow all instructions from public health workers if your child is in an area with SARS. 

When should I call my child’s healthcare provider?

Call your child’s healthcare provider:

• Before traveling with your child to an area where SARS is active

• If your child has traveled to an area where SARS is active and is ill

• If your child has had contact with anyone who has SARS and is ill

Key points about SARS in children

• Severe acute respiratory syndrome (SARS) is a viral illness. It's very contagious and can spread quickly. It can cause mild illness, severe illness, or death.

• No new cases have been seen anywhere in the world since 2004.

• A child is more at risk for SARS if they are in an area where SARS is active or if they've had contact with a person who has SARS.

• Symptoms start with high fever, headache, body aches, and sometimes diarrhea. Symptoms then lead to a dry cough and trouble breathing.

• A child with SARS is contagious when having symptoms, such as fever or cough. A child with SARS must be kept away from others.

• SARS is treated with supportive therapy and sometimes with antiviral medicines. Your child may be given IV fluids and oxygen or other breathing help.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is advised and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.