Question

Topic 1: Students should review case definitions for SARS as well as the recommendations for laboratory diagnosis. Students should also be able to identify limitations of SARS testing as well as criteria for the clinical focus and public health focus. Question 1: The reliability of clinical and laboratory diagnosis of SARS is uncertain. Should it be used as the basis for public health decision-making

Answer 1

Answer:

No, laboratory information should be complemented with data related to the disease (e.g., symptoms of the viral disease) and patient' history (i.e., risk of exposure or close contact who were diagnosed with the disease)

Explanation:

In the last years, laboratory diagnosis of viral diseases has greatly improved and current methods (e.g., RT-PCR) have often a high sensitivity, thereby patients with this type of disease usually are accurately diagnosed clinically. However, there exist certain diseases where this information may not be conclusive. In these cases, it is imperative to use different sources of information to complement decision-making. For example, when laboratory diagnosis is not conclusive, the information provided by clinical symptoms of the disease in patients with severe acute respiratory syndromes (e.g., congestion and cough with or without fever in the first few days) can be very useful in order to determine if the infection is of viral origin or caused by bacterial types of pneumonia. Moreover, epidemiological data related to the recent life history of the patient (i.e., recent travel or residence in an area with viral transmission) can also be used for effective decision making.