20 replies to this topic

[Limitless]

Here's another supposed "Threat to life."


Mar. 18, 2003. 05:17 AM


AP Photo
Travellers wear masks in an attempt to ward off pneumonia at Baiyun International Airport in Guangzhou, capital of China's Guangdong province, March 17, 2003.

SARS FACTS

Some facts about Severe Acute Respiratory Syndrome, a potentially fatal pneumonia-induced illness:

Cause: To date, microbiologists have been unable to isolate the pathogen behind SARS. They believe it is viral, but aren't 100 per cent sure. They admit it could be a brand new disease.

What's ruled out: Experts say this doesn't look like a bioterrorism agent. Increasingly they are ruling out the possibility that this is a new and deadly strain of influenza as well.

Symptoms: Sudden onset of high fever (over 38.5 C) accompanied by muscle aches and one or more of these respiratory symptoms - cough, sore throat, shortness of breath, difficulty breathing.

Treatment: Heavy doses of antibiotics and anti-viral agents.

Canadian cases: Eleven probable and suspected cases, as of Monday. Two deaths in Toronto suburb of Scarborough.

Hot spots: From late November through mid-February, 305 sickened and five dead in southern China's Guangdong province. The current outbreak emanates from Hong Kong, where there have been 83 confirmed cases. More than 30 cases in Hanoi.

At risk: Those who have spent time with anyone affected by the disease, or who spent time in an affected region.

Advice for travellers: In areas where the illness is found, practise good personal hygiene, especially hand-washing. Until further information is available, as a precautionary measure, Canadian travellers may want to avoid crowded, enclosed areas in Hanoi, Vietnam; and in Hong Kong and Guangdong province, China. If you fall ill with listed symptoms, seek medical help.

- Canadian Press





RELATED LINKS

> Disease may have spread in hospital (Mar. 18)

> Deadly pneumonia spreads (Mar. 18)

> New case concerns Pearson workers (Mar. 18)

> Deadly illness in York: Officials (Mar. 17)

> Mysterious illness kills two in GTA (Mar. 15)

> World Health Organization warning

> Health Canada: Public Health

> CDC: SARS warnings



Mystery disease may have spread in hospital
Officials fear bug passed from patient


TANYA TALAGA AND KAREN PALMER
STAFF REPORTERS

Public health officials are investigating one new case of atypical pneumonia in a Scarborough hospital patient, who may have contracted the disease from a sickly patient in the next bed.

Meanwhile, scientists around the world are scrambling to identify the mysterious pathogen that has infected at least 11 Canadians.

The newest Toronto case has been isolated at Scarborough Grace hospital. The patient, who was not identified, is thought to have contracted the respiratory disease on March 7 while receiving care at the hospital's emergency department.

A 27-year-old woman in Edmonton is the latest suspected victim of the pathogen. She returned to Alberta Saturday from Hong Kong.

Fifteen full-time staff members at the Toronto public health unit have contacted at least 200 people who may have come in contact with "Severe Acute Respiratory Syndrome" patients. That includes people who attended the funeral for two who died and patients of a doctor who treated some of the first Canadian cases of the disease, said Dr. Barbara Yaffe, associate medical officer of health for Toronto.

Once they have been contacted, the unit informs them they may have been exposed, explains the signs and symptoms, and helps them get a referral to hospital if needed. If no one has had any symptoms in 10 days, then they don't have to worry, Yaffe said.

Health authorities have yet to contact passengers who may have been exposed to the respiratory disease on flights returning from Hong Kong on Feb. 23 and March 12. Health Canada didn't ask for the passenger manifests until March 13 and has had problems compiling lists of hometowns of all the passengers.

"(The passenger lists) are in a very dense code," said Dr. Howard Njoo, director-general of the Centre for Infectious Disease Prevention and Control in Ottawa. "They have to be translated. To actually go through (the manifests) and tease out the information so that we can package them into appropriate piles to then pass on to the individual provinces and territories, that's going to take a bit of time."

While passenger lists are often deciphered and released within hours of plane crashes, in this case the airlines are simply co-operating with Health Canada, an industry insider said.

"In terms of who takes the lead, it's Health Canada," Air Canada spokesperson Laura Cooke said last night. "We are required to co-operate with the investigation, but any details in terms of contacting people (on board that flight), it's up to Health Canada."

The epidemic, which is spreading around the world, was confirmed in Toronto on March 5, when Sui-chu Kwan died at her Scarborough home after returning from a 10-day trip to Hong Kong.

Her 44-year-old son, Chi Kwai Tse, died at Scarborough Grace hospital last week of the disease, which starts with fever, coughing and trouble breathing.

Her daughter, who travelled to Atlanta on March 3 and fell sick in the American city, was admitted to Mount Sinai Hospital on March 12 with symptoms. Sui-chu Kwan's daughter-in-law was also admitted to Mount Sinai March 12. Kwan's other son was placed in intensive care at Sunnybrook hospital the next day. Kwan's husband is also sick.

Kwan's family doctor, who saw two of the family members for 45 minutes on March 6, developed symptoms on March 9, such as a high fever of 40 degrees Celsius. She is in stable condition at Mount Sinai.

They all seem to be responding well to treatment, said Njoo. At least one of Kwan's children still needs help to breathe.

"At this point, they were all treated with standard supportive medical care, so based on their own immune capacities and the care they're receiving, they're doing quite well," he said.

A 67-year-old man from York Region, who returned from Hong Kong on March 12, is still breathing through an oxygen mask at Sunnybrook hospital.

Information on the ill family, the doctor and the case of the York Region traveller has been sent to the Centers for Disease Control in Atlanta, said Dr. Don Low, chief of microbiology at Mount Sinai Hospital.

"It's sort of the first clinical description they've gotten of the cases, possible transmission and how these cases present," he said.

British Columbia is also reporting a suspected case of the disease in a patient who recently travelled to Hong Kong.

So far, none of the Canadian cases have been confirmed in the usual medical sense, said Low.

"We can't confirm anybody until we know what we are dealing with," he said.

All but two of the Toronto area cases are being considered "probable," which means they have a fever over 38 C, a cough, shortness of breath or difficulty breathing, a travel history to Asia or close contact with someone who has recently returned from Asia, and severe progressive respiratory illness.

At least 1,200 people have called a Toronto public health hotline set up to answer questions about the syndrome.

Hospitals have cranked up protective measures for staff who might care for atypical pneumonia patients, Low said. Three patients are isolated in negative air pressure rooms, which helps stop the spread of the disease through the air.

Although public health officials are downplaying the risk of person-to-person transmission, the latest twist in the disease's spread, between patients, has forced hospitals to take extra precautions.

Isolation beds have been added to the list at "Criticall," the real-time computer system that reports hospital bed availability to ambulance dispatchers.

Hospital staff are wearing gowns and special masks that prevent microscopic pathogens from passing through the material.

"Nobody comes in contact with (the patients) unless they are wearing the proper masks, gowns and gloves," Low said.

Since mid-afternoon on Saturday, technologists at the federal microbiology laboratory in Winnipeg have donned protective gear to work in Bio-Safety Level 3 and 4 labs with blood samples and nasal swabs taken from people thought to be sickened by the ailment.

So far they've run more than 300 tests but haven't yet identified the bug that's making people sick.

"We think it's a virus because if it were a bacteria, we probably would have identified it by now. But all possibilities remain open," said lab director Frank Plummer. It's important to separate whether it's a virus or a bacterium, since antibiotics work only on bacteria and anti-virals fight only viruses.

The work at the Winnipeg lab is part of a global effort to put a name to the deadly respiratory illness.

So far, the illness has stumped scientists in 11 laboratories spread across 10 countries, including China, Canada and the U.S

They've ruled out a few illnesses that cause similar symptoms, including the flu.

"We've done extensive testing for influenza A, B and C in Hong Kong, Canada and in the U.S. All the tests are negative, so we're pretty sure it's not flu," Plummer said.

Technologists have tried without success to grow a copy of the unknown infectious agent, using colonies of the bacteria or virus harvested from submitted samples. "It hasn't kept me up at night worrying, but it's keeping me up working on it," Plummer said.

He stressed there seems to be no reason to panic.

"The fact that this seems to require close personal contact suggests it will be quite easy to control," he said.

At this point there is no evidence of transmission in the general public and no reason to think there would be transmission in the general public, Ottawa's Njoo said. "We're taking this seriously and we're instituting all measures to isolate and contain the illness," he said.

The U.S. Centers for Disease Control is currently investigating a potential case that surfaced on a cruise ship. Although the World Health Organization has issued a travel warning, Health Canada is urging Canadians to check with their doctors before heading to Asia, which is thought to be the epi-centre of the outbreak.

"The only risk factors we're aware of right now is travel to Asia and close contact to another case, either a member of your family or caring for a person with this illness," Plummer said.

"The kind of things we can tell people is to take care with hygiene and wash your hands, those kinds of things," Njoo added. "Based on the fact that our population is very mobile, it's very important the world works together to deal with this global threat," he said.


--------------------------------------------------------------------------------
With files from Diana Zlomislic



Toronto Star Website

Edited by XxDoubleHelixX, 29 May 2003 - 11:33 PM.

[kevin]

Latest new on SARS...

What SARS is not.. and more info..

[Lazarus Long]

Doctors in Hong Kong Identify Deadly Pneumonia Virus
http://story.news.ya...th_pneumonia_dc
17 minutes ago
By Tan Ee Lyn

HONG KONG (Reuters) - Doctors in Hong Kong have scored a major breakthrough in identifying a deadly pneumonia virus that has killed at least 11 people and left hundreds ill as it races around the world.

Medical experts said the discovery would make the disease easier to diagnose and opened the way for a vaccine to be developed. But they stressed more lab work had to be done to pin down the exact make-up of the virus and scientists had not ruled out that it might be a new strain.

"From the shape of the virus, it belongs to the paramyxoviridae family," said virologist John Tam at the Chinese University in Hong Kong.

Though the symptoms appear similar, influenza was not a member of the that family, said Lo Wing-lok, an infectious disease expert.

World health authorities have long been preparing for some new strain of flu they fear could repeat the devastation of the 1918 pandemic that killed an estimated 20 million people.

Scientists have been working around the clock to identify the agent causing the contagious disease, which has spread quickly around the world with travelers from parts of Asia.

Most cases have been in China, Hong Kong and Vietnam, but suspected cases have been reported in Australia, Britain, Brunei, Canada, Spain and the United States.

Most of the infections are concentrated in Hong Kong and Vietnam, stretching public health resources.

Health officials in Hong Kong said on Tuesday new cases of the disease had been discovered in two more hospitals, sparking fear that it was slowly spreading into the community of nearly seven million people.

Most of the cases have been medical staff at hospitals or relatives of people who have fallen ill.

MORE DEATHS

A 66-year-old French doctor at the Vietnam-France Hospital in Hanoi died early on Wednesday, the second person to die from the disease in Vietnam. A nurse died at the weekend.

Nearly 60 people are fighting the disease in the capital Hanoi and health officials said two people with suspected symptoms, a Japanese and an American, were in hospital in Ho Chi Minh City.

Two people have died of the disease in Canada.

In Hong Kong, two people have died of the disease while a third, an elderly man, is believed to have died of it on Tuesday night but authorities have not confirmed the cause of death.

About 123 people are known to be infected in Hong Kong, where authorities temporarily closed the emergency clinic at the Prince of Wales Hospital on Wednesday to give exhausted staff a break.

Of those infected, 111 are suffering severe pneumonia and most are in that hospital.

But the identification of the virus is holding out some hope.

"This virus is causing severe pneumonia in our patients...(the discovery means) the type of treatment we have chosen is right," said Joseph Sung, a scientist at the Department of Medicine at the Chinese University in Hong Kong.

Doctors in Hong Kong have been using a combination of anti-viral drugs and steroids to treat victims, but not all patients have responded positively.

FEAR SPREADING

Fear of the disease is spreading. Airports and airlines around the world are on guard, turning away passengers who have symptoms.

The illness begins with a high fever and a dry cough that can lead to breathing difficulties. In five days the worst affected need respirators to keep alive.

In Singapore, where 23 cases have been reported, newspapers said thousands of face masks have been sold across the city-state in the past three days and some pharmacies had run out of stock.

Doctors in Germany said they were treating three people with the illness, including a 32-year-old doctor from Singapore and his pregnant wife, though more infections are suspected. The doctor had treated some of the first cases in the island state.

World Health Organization (news - web sites) experts are expected to arrive in China soon to determine if the pneumonia is linked to an outbreak of respiratory disease that began in southern China in November and has struck more than 300 people, killing five.

Hong Kong health officials said on Tuesday they suspected the outbreaks were linked but they were still investigating.

Chinese authorities only gave the WHO an initial report on their handling of the outbreak last Sunday, a day after the U.N. body issued a worldwide travel alert as cases appeared outside Asia. Chinese journalists say they have been told not to report on pneumonia cases.

China said on Wednesday the pneumonia outbreak that hit parts of the southern province of Guangdong since November had been brought under effective control and pneumonia patients had recovered.

WHO News

WHO Websites

[Lazarus Long]

The coincidence of the appearence is of this strain is an auspicious sign before the start of events that are about to unfold. The history of war and plague demonstrates that there is no requirement of a "bioweapons program" for these two to form and unholy alliance.

The fastest spread for plague usually begins in the populations of displaced refugees and other victims of war and environmental crisis, but it rapidly passes even to troops that are ostensibly more resistent. It most certainly can pass to AID workers and others sent in to manage a crisis like the possible aftemath of the coming war and like we are seeing developing in parts of Asia and Africa. We can expect this to become a factor in events that are unfolding. Here is another relevant article.

U.S. and World Unprepared for Germ Assault -Report
http://story.news.ya...preparedness_dc
Tue Mar 18, 4:15 PM ET
By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - The United States and the rest of the world need to do a lot more to protect people against microbes like the one causing a mysterious and deadly form of pneumonia, as well as more traditional foes like influenza and tuberculosis, experts said on Tuesday.

"The United States has taken important steps," Dr. Margaret Hamburg, who headed the Institute of Medicine panel that published a report on microbial threats, told a news conference. "But the present reality is that we are unprepared ... We still have not done enough in our defense and in the defense of others."

A pandemic of influenza could kill hundreds of thousands of people and devastate economies, but there is no good system in place for even tracking such an outbreak, let alone controlling it, the panel said.

An example is the outbreak of a mysterious pneumonia believed to have killed nine people, said Dr. James Hughes, head of infectious diseases at the U.S. Centers for Disease Control and Prevention.

"This experience with severe acute respiratory syndrome is just the most recent wake-up call," Hughes told reporters.

Despite around-the-clock efforts, scientists have not identified the microbe causing the illness, which has been reported in China, Hong Kong, Singapore, Vietnam, Australia, Britain, Germany and the United States.

The panel recommended the United States work with other governments and the World Health Organization to set up a better system to detect new outbreaks, especially in developing countries, and quickly deal with them.

This means developing better diagnostic tests, more and better vaccines and new drugs -- as well as more wisely using those that exist.

"These are global problems that require global solutions," Hamburg, of Washington-based Nuclear Threat Initiative, said. "To be blunt, we felt our nation and the world faces a crisis with regard to vaccine development ... and deployment."


FIGHTING DRUG-RESISTANT 'SUPERBUGS'

Poor use of antibiotics means that many bacteria have developed resistance to them. The panel called for an immediate ban on the use of antibiotics in farm animals if they are also used on people.

"This was the easiest recommendation for the group to come to consensus on," Hamburg said. She said studies clearly show that using antibiotics to promote the growth of livestock helps bacteria mutate and evolve defenses against the drugs.

She said the United States had not shown enough leadership so far and needed to work at Cabinet level to ensure there were enough drugs and vaccines to protect the population against outbreaks of disease and attacks. The Health and Human Services Department should coordinate this, she said.

But the panel of experts from industry, universities and nonprofit groups praised government efforts to get the country ready for a biological or chemical attack, saying the money spent to bolster defenses was helping to rebuild a badly neglected public health system.

"We think we have an unprecedented opportunity in this country to continue to rebuild the systems required to deal with infectious diseases. We see this report as a call to action," Hughes said.

But the money, recommended by the president and approved by Congress, is not there. "We have had incremental increases in funding starting in 1994," Hughes said.

He said to fully implement the CDC's current infectious disease strategy would cost $260 million. "Appropriations are up to $167 million in the current year," he said.

Another shortfall, said Dr. Patricia Quinlisk, Iowa state epidemiologist and a member of the panel, is trained staff. "In Iowa we are trying to hire trained epidemiologists to deal with the bioterrorist threat," she said. "Only a handful of the applicants actually have had epidemiological training."

The report, available on the Internet at http://www.national-academies.org/, also calls for an aggressive campaign to produce new pesticides and repellents to fight mosquitoes and other carriers of infectious diseases.

Health and Human Services News

Health and Human Services websites

[Limitless]

I also posted this today in Bob's more recent thread on SARS.


Mar. 31, 2003. 01:30 PM

Toronto Star Website

Sick Kids hospital treating 5 children for SARS
FROM CANADIAN PRESS

The Hospital for Sick Children confirmed today that it is treating two probable and three suspected cases of SARS.
The suspect cases are under investigation, said hospital spokeswoman Lisa Lipkin.
She would not disclose any information about the ages of the children or how they were faring.
"I'm not at liberty to give any information out," said Lipkin. ``It's patient confidentiality."
On Sunday, Dr. Colin D'Cunha, Ontario's chief medical officer of health revealed that for the first time in Canada a child — a 21 month old — was among the probable SARS patients in Ontario.
Lipkin confirmed that child is being treated at Sick Kids.
She would not say whether the children are believed to have links to the cluster of cases emanating from an east-end hospital where one of the original SARS patients was treated before health-care workers realized they were facing a highly contagious and occasionally deadly new disease that required high level infection containment measures: gowns, gloves, goggles and masks.
"Dr. D'Cunha's going to have to answer all those questions. All I can really do is confirm that we do have some probable and suspect cases. But anything about those cases, he's going to have to answer those questions," Lipkin said.
Waves of cases have radiated from that first patient.
As a result, the hospital, Scarborough Grace and a second hospital, York Central in Richmond Hill, north of Toronto, have been closed to new patients.
A patient who died on the weekend from severe acute respiratory syndrome was infected at Scarborough Grace but was transferred to York Central. It was several days before officials at York Central realized the patient was coming down with SARS; they hadn't been taking adequate precautions and by then two nurses were infected.
Canada has roughly 100 probable and suspect SARS cases, most of whom are in the greater Toronto area. Four people in Canada have died of the disease.

[Limitless]

I have a family member (one of my grandfathers) that has recently been to one of the hospitals on the list in my previous post (Scarborough Grace Hospital) for stroke therapy. Luckily, his direct family has finished their voluntary 10-day quarantine. [B)] My mother was over at their house during the quarantine, but she also has had no symptoms......which is good, because I've been exposed to her in the meantime. [unsure] lol

[Bruce Klein]

wow.. sounds like a close call there Limitless... take care

[Lazarus Long]

http://aolsvc.health...aolspecial_sars

Common Cold Virus Suspected in SARS

CDC Says New Form of Virus May Cause Mystery Pneumonia

By Jennifer Warner
WebMD Medical News Reviewed By Brunilda Nazario, MD
on Monday, March 24, 2003

March 24, 2003 -- A new form of the virus that causes the common cold may be behind the rapidly emerging outbreak of a mysterious pneumonia illness known as SARS (severe acute respiratory syndrome), according to the CDC. The number of people thought to have SARS has now grown to more than 450 worldwide, including 39 cases under investigation in the U.S., and international laboratories are working at "breakneck speed" to confirm the cause of the deadly illness.

At a briefing today, CDC director Julie Gerberding, MD, presented strong evidence that a new strain of a virus most frequently associated with upper respiratory infections and the common cold in humans called the coronavirus might be likely cause of severe acute respiratory syndrome.

"We are reporting that our evidence indicates that the coronavirus is the leading hypothesis on the cause of this infection," says Gerberding.

Gerberding says laboratory tests performed at the CDC on tissue and blood samples from SARS patients suggest that a new, unknown form of the highly contagious coronavirus is, if not the primary cause of the illness, then at least a major contributor.

The CDC is part of a network of 11 leading international laboratories formed by the World Health Organization that is sharing information to determine a cause and develop treatments for severe acute respiratory syndrome. Previous findings from laboratories in Germany and Hong Kong reported last week implicated a new strain of a virus from the Paramyxovirus family as a possible cause of the illness.

Gerberding says it's still too early to assign a definite cause of SARS, but from a scientific standpoint, this new evidence on the common cold coronavirus is very strong. CDC researchers were able not only to grow the virus in the laboratory based on cultures from two SARS patients, but they also found evidence of the previously unknown strain of coronavirus in tissue samples from affected patients.

Further support for their hypothesis came from blood samples from several SARS patients taken at early and later stages of their illness. Tests found that these patients developed had antibodies to the common cold virus in the later stages that were not initially present (a process known as seroconversion), which suggests that the virus was a likely cause of the illness.

"Everyone is keeping open mind," says Gerberding. "The challenge is that it's a nonspecific illness, and we're dealing with families of viruses that are ubiquitous. And finding them is not same as finding a cause of the disease."

Even so, U.S. secretary of Health and Human Services Tommy Thompson says this finding from the CDC is encouraging news.

"These and other excellent scientists all over the world have been working around the clock for days and their hard work is paying off. They continue to look at other possible causes of SARS, but this is a key finding in our efforts to identify the cause of this global outbreak," says Thompson, in a news release.

As with the common cold, Gerberding says there currently no known treatments that are effective against the coronavirus. But the Department of Defense is currently testing all known antiviral drugs against this newly discovered form of the virus in an attempt to find an appropriate treatment for the mysterious pneumonia.

Health officials continue to recommend that persons suspected of having the pneumonia illness associated with SARS should be treated as any other person with an unknown form of pneumonia with antibiotics and supportive nursing care.

Since the outbreak began, health officials have also learned more about the symptoms most commonly found in SARS and updated their description of the condition. The main symptoms of SARS are now described as:

High fever (over 100.4 degreed Fahrenheit)
Dry cough, shortness of breath or breathing difficulties.
Changes in chest X-rays that suggest pneumonia.

Other non-specific symptoms such as headache, muscular stiffness, loss of appetite, malaise, confusion, rash, and diarrhea, have also been reported in SARS patients.

Despite the rapid spread of the mysterious illness, officials say SARS has yet to become a community-spread illness. All of the suspected cases have occurred among people who have recently traveled to one of the affected areas of Southeast Asia within the last 10 days or those family members of health care workers who had close, face-to-face personal contact with someone who has.

Hong Kong remains the area hardest hit by the outbreak of mysterious pneumonia, with 260 cases reported and 10 deaths. Other severely affected areas include Singapore, with 65 cases and no deaths, and Vietnam, with 58 cases and four deaths. In addition, Canada has reported 11 cases and three deaths.

Gerberding says of the 39 suspected SARS cases currently under investigation in the US, 32 are among persons who have traveled to the affected areas of Southeast Asia, and the remaining seven are healthcare workers or close family members of these individuals.

--------------------------------------------------------------------------------

SOURCES: News release, CDC. CDC telebriefing, March 24, 2003. News release, World Health Organization.

© 2003 WebMD Inc. All rights reserved.

Edited by Lazarus Long, 01 April 2003 - 04:29 AM.

[Limitless]

wow.. sounds like a close call there Limitless... take care

Yeah, you could say that.....although anyone (including me) in Toronto could get SARS from some unexpected place. Especially people like me who depend on the subway to get around.....During rush hour people are often pretty close together. [unsure] Toronto also has a huge population of Chinese people, some of which who travel regularly to China. We also have the most diverse population in the world.....so SARS is a little more likely to seriously hit the people here.....we pretty well have connections to every part of the world......and now they say to "Wash your hands." Good thing I'm a manic hand-washer. lol

That being said, the good news is that it appears that only around 1% of people experience serious symptoms, and only 1-4% of these people die......but being young isn't enough to avoid SARS, so I'll stay informed, and hope the current local measures help eradicate this disease, or lessen its impact. (I have never trusted the WHO, especially because of the AIDS situation....so so much for trust in international measures....how about a vaccine [?] .... or did the WHO release this on us? [roll]).....I hate relying on "Faith", -but either that or computers. Reminds me of that Hal-9000 line from 2001: A Space Odyssey:

"Dave, I think you need to sit down, take a stress pill, and think things through." [ggg] [ggg] [ggg]

-Well, I'm not into pills, but I'm thinking all right.


Bye for now.

Edited by Limitless, 01 April 2003 - 06:07 AM.

[Mind]

Who names these diseases anyway?

Here is a definition of acute from Websters:

Medicine.
**Having a rapid onset and following a short but severe course: acute disease.
**Afflicted by a disease exhibiting a rapid onset followed by a short, severe course: acute patients.

Why put severe and acute in the same disease name? Their meanings are very similar. Why not "Rapid Onset Severe Pneumonia" or "Super Coronavirus Disease" or something?
I suggest the name "SARS" was picked for its impact. Naming something a syndrome generates more fear in the population.

Just for recent historical context.
Remember the Ebola virus scare?
Remember the Hanta Virus Scare?
Remember the Hong Kong Bird flu scare?
Remember the West Nile Virus scare?
And yes (I can't help myself) remember AIDS?

All of these "killer" diseases have run the course through the world psych. All have been prophesied at one time or another to spread like wildfire through the general population. The word epidemic has been attached to each "scare" at some point. All have generated requests for more money to keep virologists employed. None of them come close to the suffering and death caused by Cancer and Age related diseases (ie. Alzheimers and organ failure).

Of course it is smart to avoid contact with people who have the "syndrome". Of course, the verdict is still on the exact details of the disease or how far it will spread. My skepticism may be overblown. We will see.

[Limitless]

Apr. 1, 2003. 05:07 PM - Toronto Star Website



Toronto deaths push SARS toll to 6
Also, local infectious diseases expert quarantined
FROM CANADIAN PRESS

Ontario health officials reported two more SARS deaths today, bringing the Canadian death toll from the disease to six.

Dr. James Young, Ontario's commissioner of public safety, expressed his condolences to the two families at a briefing.
One of the deaths occurred Monday night, and the other patient died Tuesday morning. Both were in the Toronto area.

Dr. Colin D'Cunha, Ontario's chief medical officer of health, said both patients were elderly individuals and clearly linked to the Scarborough Grace cluster of cases in Toronto.

Across Canada, the number of suspected and probable cases of SARS is in the vicinity of 130, most of them in the Toronto area, and emananating from Scarborough Grace, where one of the first Canadian SARS patients was treated.

In another disturbing development Tuesday, Dr. Donald Low, an infectious diseases expert who has taken part in daily briefings to media in Toronto, is now in isolation.

Earlier today, the city's Hospital for Sick Children reduced to three from five the number of children listed as possible cases.

"We have two that I've called probable and are being treated as probable and one that is a suspect case," Dr. Stanley Read of Sick Kids told CFRB Radio.

Of the three suspect and probable cases of SARS, Read said two are children of health care workers and the third is reported to have returned recently from southeast Asia.

All three were said to be in good condition and Read said proper containment procedures were in place when the children arrived.

In British Columbia, 40 people near Vancouver were told to go into quarantine earlier this week when it was discovered the province's second probable SARS case had gone to a health clinic in the suburb of Coquitlam while she was ill.

A SARS clinic was being opened today in Vancouver.

Health officials say the walk-in facility with x-ray capability will ease the strain on hospital emergency wards and put people's fears to rest.

Quarantine officers are also being trained to help screen all flights from Asia into Vancouver International Airport.

New Brunswick experienced a run on face masks after that province revealed over the weekend that a school principal who recently returned from China was under observation as a suspect case.

The province's chief medical officer looked alarmed when asked at a news conference whether the province would supply residents with protective masks.

"This is an example of unnecessary fear, undue anxiety and a misinterpretation of the situation in the province," Dr. Wayne MacDonald said.

[Mind]

Dr. Colin D'Cunha, Ontario's chief medical officer of health, said both patients were elderly individuals and clearly linked to the Scarborough Grace cluster of cases in Toronto.

This "new" disease sounds a lot like a bad case of the flu. All of the symptoms are similar to flu. Those most at risk are probably the elderly or people with already compromised health. There are people that need to worry about the flu/SARS, it has proven to be deadly (3.6% of the time), but most people I suspect have good enough immune systems. Mass hysteria can be as deadly as any virus.



I found these 2 statements on the front page of Web MD

****Declared a "worldwide health threat" by the World Health Organization, the mysterious Illness dubbed severe acute respiratory syndrome (SARS) is confounding researchers who are trying to identify its cause, control its spread

****Bush Allows Quarantine of SARS Patients - April 4, 2003

Obviously there is a contradiction. The symptoms are similar to the flu...and the cause is not known. How can we run an effective quarantine? Are we going to quarantine everyone with a fever, a cough, or pneumonia? It seems to me that hysteria is running amuck...much like when a million chickens were slaughtered in Hong Kong because a few people died of the flu....the infamous/mysterious/deadly "Hong Kong Bird Flu".

Edited by Mind, 07 April 2003 - 03:44 PM.

[Mind]

Does anyone know where to find case histories of SARS? There must be some resource out there.

I checked all of the government sites from different countries but couldn't get any details. It would be nice to see the ages and physical conditions of the victims. So far all I know is a 46 year-old virologist/doctor died after travelling in Vietnam (might have been Singapore), and 2 "elderly" people died in Toronto.

Edited by Mind, 07 April 2003 - 03:49 PM.

[Mind]

OK...I know it seems like I am the world's greatest skeptic, but mass hysteria about SARS is not going to help anything. The war may be a blessing in disguise by deflecting news coverage away from SARS.

And yes...I realize a quarantine can slow the spread of a disease, giving time to develop defensive strategies. However, the fact the the world is more connected is a good thing. In the past when people started travelling around the earth, long isolated societies were ravaged by "new" diseases that their immune systems had never encountered. Nowadays, most viruses and bacteria travel around the world. We all have encountered most strains of the flu. When new viruses pop-up our immune systems are ready.

[Limitless]

Apr. 8, 2003. 05:45 AM - Toronto Star Website



Life and death in the time of SARS

TANYA TALAGA, ANN PERRY AND NICOLAAS VAN RIJN
STAFF REPORTERS

One is in tears, unable to understand why kids are throwing rocks and icy snowballs at her house.

Another became so weak she couldn't turn over in bed, and began to wonder whether she was "going to die."

And a third thinks back to the fever and chills she felt as she drove herself, masked and alone, to an isolation room at Mount Sinai Hospital.

All SARS patients. All confident they'll beat Severe Acute Respiratory Syndrome and, in time, get better.

But all are traumatized by the mystery illness that has so far claimed the lives of 10 victims in Ontario, and a possible 11th. By yesterday, public health officials said, the number of probable and suspect SARS cases in the province stood at 188, and totalled 226 nationwide.

Medical officials are warning Ontarians that the numbers — at least in the near term — will keep on climbing.

"I would not be surprised to have a few more deaths," said Dr. Colin D'Cunha, Ontario's chief medical officer, adding some patients remain in critical condition.

The peak, whenever it comes, can't come soon enough for nurse Susan Sorrenti, who spoke with the Star about her illness yesterday from her isolation room in Mount Sinai Hospital.

Sorrenti, who normally works at Mount Sinai as an intensive care unit nurse, has developed a bad cough and her x-rays show something in her lungs.

"At that point I was confirmed," Sorrenti said, talking about a "pneumonia-type cough" that turns her blue and forces her to her knees.

But Sorrenti began crying as she talked about the travails faced by her husband and two young daughters, struggling at home without Mom and facing the ignorance of a world itself struggling to come to grips with SARS.

"I feel very upset that people would be so cruel," Sorrenti said, talking about the rocks and icy snowballs that some kids are throwing at her house. Dr. Allison McGeer, an infectious disease specialist at Mount Sinai, and one of the first doctors to get involved in the health crisis, has been sick with SARS and in isolation since the end of March.

"I'm feeling well, I'm one of the fortunate ones who hasn't had it too severely," she said yesterday. "I don't want to get too cocky about it, but I think I'm over the worst," she said. "It's just a matter of waiting it out now."

Another SARS victim, known only as Miss Tse, doesn't have to look beyond her own family to see the devastating effects of SARS.

Her mother, Sui-Chu Kwan, 78, was Toronto's first SARS victim and died in her Scarborough apartment March 5. Her older brother Chi Kwai Tse, 44, was the second to die here of SARS, passing away of respiratory failure March 13.

"He was on an oxygen mask, but he looked so tired," Miss Tse told CBC Radio's The Current yesterday, recalling the early stages of her brother's disease. "At that time a light bulb went on and I started questioning whether something unusual was happening."

But when he died five days later, and after a younger brother had been rushed to hospital with symptoms of the same deadly respiratory disease, and after a doctor summoned the rest of the family to Mount Sinai, Miss Tse was no longer in doubt.

"That day is really critical and really sad," she said. "I do believe that day I changed from being sad to worried."

In fact, she admitted, there was a time she was afraid that she was "going to die." Placed in isolation, too sick to make arrangements for her brother's funeral, Miss Tse became so weak she couldn't turn over in bed.

For Miss Tse, the ordeal had started weeks earlier, when her parents visited Hong Kong for Chinese New Year. After staying with family, they booked into the Metropole Hotel, where experts believe her mother contracted SARS.

Miss Tse and her family finally buried her elder brother last week.

McGeer, the Mount Sinai doctor who was infected through her close contact with SARS patients, is philosophical about her brush with the world's newest health threat.

"One tries very hard to not make this a hazard of the job," she said. "But there is no denying, when you are involved in working on something where you don't know what the rules are, sometimes it doesn't matter how careful you are."

McGeer says she became infected after touring Scarborough Grace on the weekend of March 22. At that time, the hospital was still open and dozens of nurses, doctors and other hospital staff weren't — as they are now — in voluntary isolation.

"That was the weekend of the original investigation at Scarborough Grace, when we began to recognize there were health-care workers who were ill and we needed to understand what had gone wrong and what we needed to do to stop it," McGeer recalled.

A team of infectious disease experts spent much of that weekend interviewing staff, combing through records and figuring out transmission modes.

At the time, all McGeer heard about was reports of three health-care workers who had "some illness. We didn't know it was real. We didn't know it was clearly associated with Hong Kong," she said. "It's now become blindingly obvious. But at the time, the issues looked a lot more limited than they've turned out to be."

They weren't wearing masks to prevent disease because they weren't dealing with any infected patients, she said. But there were unrecognized cases of illness in patients and staff.

Kwan's son Chi Kwai Tse went to the emergency ward at Scarborough Grace on March 7, complaining of fever and breathing problems. He was placed in an observation room along with an elderly man suffering heart problems. Since it wasn't known at the time by physicians that Tse had contracted SARS from his mother, no precautions were taken and he also infected the man sharing the room with him.

That man, in turn, infected some members of his family.

By Monday morning, McGeer was confident there had been "substantial exposure throughout the institution.... Everybody was at risk and that included me," she said.

She put herself under voluntary home quarantine. She took her temperature twice a day. On Monday evening, Scarborough Grace was ordered closed and thousands of people connected to the hospital went on voluntary quarantine for 10 days.

By the next weekend, McGeer had a temperature, felt achy and had the chills. She called Mount Sinai and told them to get an isolation room ready, she was coming in. She put her mask on and drove to the emergency department. "This is a very simple illness. You get fever and the respiratory symptoms start four or five days later," she said.

McGeer has been treated with ribavirin, a hepatitis C drug. She hopes to be let out in a few days. However, since doctors still don't know how long someone is infectious, she'll go home to spend a few more days in quarantine.

Sorrenti knows she was infected because of the direct contact she had with her ICU patient.

"We have direct contact. It's plain and simple," she said.

The patient was transferred to her ward on Sunday, March 23. A transfer from Scarborough Grace, the patient had a respiratory ailment but was thought to be SARS-free, she said.

But doctors were wrong.

Once it was discovered the patient was ill, Sorrenti ended up in voluntary quarantine along with her two daughters, husband and other health-care providers from ICU. As a result, the ICU was shut down.

[Lazarus Long]

I have heard the damaging impact on ICU's, Emergency Rooms and general care facilities, along with the devastating impact the disease is reaping by transmission through the caregivers themselves worldwide may cause more deaths than the actual disease by the time this "event" runs its course. Good luck and I hope things settle down to a normal revovery mode for you and your city.

[Limitless]

I have heard the damaging impact on ICU's, Emergency Rooms and general care facilities, along with the devastating impact the disease is reaping by transmission through the caregivers themselves worldwide may cause more deaths than the actual disease by the time this "event" runs its course.  Good luck and I hope things settle down to a normal revovery mode for you and your city.

Thanks......although this issue is a big concern, I do think the coverage is pretty sensational, and does exaggerate the risk to the average citizen......That is one weakness of the Toronto Star in many cases regarding local coverage, but even more comprehensive newspapers, and TV stations especially, -are playing to the public's fears.....that being said, I can tell you that a failure of procedure in Toronto emergency rooms is supposedly what caused the outbreaks here......and then there's the issue of China not-bothering to tell us about a problem they've known about since November, 2002 [!]

[Limitless]

Apr. 8, 2003. 02:18 PM - Toronto Star Website



Hospitals balk at allowing visitors
Ontario health chief had said healthy guests would be permitted

HELEN BRANSWELL
CANADIAN PRESS

It appears tight restrictions on visitors to at least some Toronto area hospitals aren't going to be lifted just yet.

Ontario's commissioner of public security announced Monday that hospitals could allow one visitor per patient, as long as the visitor was healthy.

But several of the big Toronto hospitals said today they are still barring visitors while they struggle to stop the spread of SARS.

"We are asking the public to be patient and understand that while these measures may cause inconvenience and frustration, they are designed with everyone's safety in mind," said Tom Closson, president and CEO of the University Health Network, which encompasses Toronto General, Toronto Western and Princess Margaret hospitals.

Closson said the three hospitals have been flooded with inquiries since Dr. James Young announced the easing of visitor restrictions at Ontario's SARS briefing Monday.

Some people even showed up at the hospitals, only to find they were not allowed inside, Closson said in a statement.

"Our hearts go out to our hospital patients who may feel isolated and lonely," he said. "We also empathize with the family members and friends who are frustrated that they cannot visit their loved ones in time of need.

"However, we have no indication at this time that we should be letting our guard down and will continue to take all necessary precautions to ensure the safety of our patients and our staff."

A spokesperson for Sunnybrook and Women's College Health Science Centre said that facility was also maintaining its ban on visitors at this time.

As officials in Toronto have struggled to contain the biggest SARS outbreak outside of Southeast Asia, they barred visitors in all Toronto-area hospitals. Only dying patients and young children were allowed visitors.

The no-visitors policy was later extended to all hospitals around the province. Seniors homes and jails were told to restrict visitors to one per resident.

On Monday, Young announced a gradual rollback of some of the heavy restrictions placed on the system. He said hospitals could allow a designated visitor per patient; visitors would be screened for fever and other SARS symptoms and be required to sign in.

"We'll make sure the visitors are well before they come in and we'll know who they are and who they visited," he said.

Young also announced that volunteer programs at hospitals could be resumed.

[Limitless]

We'll see if/when these concerns are realized.......


Apr. 8, 2003. 05:46 AM - Toronto Star Website (thestar.com)


Disease will continue to spread, doctors say
New cases in several countries


ANN PERRY
STAFF REPORTER

Health officials warned yesterday a highly infectious respiratory disease could continue to spread as clusters of new cases appeared in several countries.

Meanwhile, a major U.S. airline suspended some flights to Hong Kong after the World Health Organization (WHO) warned travellers last week to postpone trips to several regions severely affected by Severe Acute Respiratory Syndrome (SARS).

"This has very quickly become an international epidemic," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, told the U.S. Senate Health, Education, Labor and Pensions Committee. "We don't know where this is going to go. We have to be prepared for this to continue to spread."

WHO officials, who earlier had said they were close to containing SARS in many areas, said they suffered serious setbacks yesterday as new clusters appeared in Singapore, which had imposed stringent quarantine measures, and in Vietnam, where health officials thought they had broken the chain.

Dr. David Heymann, executive director in charge of communicable diseases for the WHO, said an unusual cluster of 29 SARS cases in Singapore was "particularly worrisome" because their source is unknown.

There were also signs the virus had spread to a fifth Singapore hospital, after six more nurses contracted the illness at three different hospitals.

Despite efforts to contain SARS, the death toll continued to rise yesterday. More than 100 people have died and more than 2,600 are believed to be infected in 20 countries.

Hong Kong officials said yesterday they had 41 more cases of SARS there, bringing the total number to 883. Two more people died in Singapore, while India reported its first suspected case, a 23-year-old American woman who had been travelling in China, Vietnam, Cambodia and Thailand.

The U.S. has reported 148 cases, but no deaths.

Continental Airlines said yesterday it was stopping flights between Newark, N.J., and Hong Kong until June 2 because of a plunge in traffic that it blamed on SARS. The move comes after the WHO advised travellers last week to postpone trips to Hong Kong and the southern Chinese province of Guangdong.

Meanwhile, Heymann, who also appeared before the U.S. Senate committee yesterday, complained that China's secrecy had cost valuable time.

"China has not been as open with information about the disease as we had hoped, despite our working intensively with them," he said. "Now they are a full partner."

Officials believe SARS originated in Guangdong. Chinese officials kept the disease secret for months, allowing SARS to spread before international health authorities could begin to fight it.

Robert Breiman, head of a WHO team of international researchers investigating the disease's origins in Guangdong, said the number of cases is slowing in the province.

"It does look like the disease rates are dropping — dropping quite a bit," he said in a telephone interview.

"We're still not ruling out the possibility that the virus itself could become burned out and become less and less transmissible," he added.

With files from Star wire services

[Lazarus Long]

then there's the issue of China not-bothering to tell us about a problem they've known about since November, 2002

Not that it helped the problem specifically, I think it indicated they REALLY DO understand the gravity of their error by having apologized upfront in that regard. I also think the importance of cooperation and taking nothing for granted has also been hammered home.

The Chinese want to be in the loop NOT out, and this bodes well for our ability to bring about a rational response in the future when calmer minds prevail.

You are right about the sensationalistic media but they are becoming "pirana in feeding frenzy" with the respect to the current state of global events. And the procedure isn't just the only aspect of the problem, so is the public's panic and overloading of the system along with a lack of preparedness that investigators have in fact been telling them to expect that this incident only demonstrated as much in great detail.

Here in the States we have cases all over the country but the public hasn't taken it to heart and the system is "handling" the patients up front with "kid gloves" having seen the chaos you folks went through. But I think the spread to caregivers and their subsequent quarrantine is a problem that will require additional review as this goes forward.

One thing is clear, this has already been a tremendously important dry run of emergency procedures even where few to no cases have resulted.

Stay healthy [!]

[Limitless]

Not that it helped the problem specifically, I think it indicated they REALLY DO understand the gravity of their error by having apologized upfront in that regard.  I also think the importance of cooperation and taking nothing for granted has also been hammered home.

The Chinese want to be in the loop NOT out, and this bodes well for our ability to bring about a rational response in the future when calmer minds prevail.  

Yeah, China will have to co-operate if they want to be a player in the world economy (than they already are), but they have a long way to go..... (I don't believe foreign journalists are even allowed to photograph the plethora of jobless Chinese, with signs attached to their bodies, -advertising their various skills.)

You are right about the sensationalistic media but they are becoming "pirana in feeding frenzy" with the respect to the current state of global events. And the procedure isn't just the only aspect of the problem, so is the public's panic and overloading of the system along with a lack of preparedness that investigators have in fact been telling them to expect that this incident only demonstrated as much in great detail.

The first night of war coverage, I fell asleep on my couch..... [blush] .

Here in the States we have cases all over the country but the public hasn't taken it to heart and the system is "handling"  the patients up front with "kid gloves" having seen the chaos you folks went through.  But I think the spread to caregivers and their subsequent quarrantine is a problem that will require additional review as this goes forward.

One thing is clear, this has already been a tremendously important dry run of emergency procedures even where few to no cases have resulted.

Perhaps this situation is good (if unwanted) practice for a terrorist attack.

Stay healthy [!]

You too - take care [!]