Cingles Info

Will the New Respiratory Syndrome Fizzle Out or Develop into a Lethal Pandemic?
By Ronald Baker, PhD
Scientists are holding their breath concerning recent reports on the severe
acute respiratory syndrome (SARS), a life-threatening illness that has affected
more than 500 people worldwide and killed 9, mostly in Asia.
The latest news from China has made health authorities guardedly optimistic.
China has reported 305 cases, including 5 deaths, in an outbreak that began in
November and which Chinese government officials say may have ended in late
February. The hope is that the illness will burn itself out elsewhere as well.
The respiratory infection is a pneumonia-like illness that causes a high fever,
breathing problems and a dry cough, among other symptoms (See "SARS Symptoms"
below). Laboratory tests have so far failed to identify any cause for the
illness, and neither antibiotics nor antiviral drugs have proved effective in
combating it. Scientists believe that it is a known organism that is difficult
to grow or a novel one.
The US Centers for Disease Control and Prevention (CDC) continues to advise
travelers to postpone elective and nonessential travel to affected areas. No
cases have been reported in the United States. Doctors have reported 14
suspicious US cases, but 10 have been judged not to be SARS, and it is unlikely
that the four others will turn out to be, Dr. Gerberding said.
The number of cases more than doubled yesterday in Hong Kong, to 95 from 49 on
Sunday; officials said 12 of the 95 were not confirmed. German health officials
said Germany had three cases. The World Health Organization (WHO) reports that
there were 169 cases, including 4 deaths, reported since Feb. 1. They are from
Canada, Germany, Hong Kong, Switzerland, Thailand and Vietnam. The agency
dropped the Philippines from its list yesterday because cases there did not meet
the criteria for SARS. Indonesia was dropped yesterday and Switzerland may be
dropped today for the same reason.
Initial story on SARS outbreak
SARS Symptoms
Health officials are advising all travelers to be aware of the symptoms of SARS.
These include the following
- sudden onset of a high fever (
- One or more signs or symptoms of respiratory illness including dry cough,
shortness of breath, difficulty in breathing, hypoxia, radiographic findings of
pneumonia, or respiratory distress; AND
One or more of the following:
- History of travel to Hong Kong or Guangdong Province in the People's
Republic of China or Hanoi, Vietnam, within 7 days of symptom onset
- Close contact with persons with respiratory illness having the above travel
history. Close contact includes having cared for, lived with, or had direct
contact with respiratory secretions and body fluids of a person with the severe
acute respiratory syndrome (also being called SARS)
Standard lab tests often show low numbers of white blood cells and platelets.
Any traveler who develops these symptoms is advised not to undertake further
travel until they have recovered.
In another unusual action, the CDC has activated its emergency operations center
in Atlanta. The agency has only done this twice in its history, once for the
West Nile fever epidemic in 2002 and then the anthrax attacks in 2001. WHO
officials said they could not recall the last time an emergency global travel
advisory was issued.
CDC Recommendations
In addition to the symptoms outlined above, the CDC has issued the following
information about signs of SARS:
Probable Case
- A suspect case with chest x-ray findings of pneumonia or Respiratory
Distress Syndrome OR
- A person with an unexplained respiratory illness resulting in death, with an
autopsy examination demonstrating the pathology of Respiratory Distress Syndrome
without an identifiable cause
- In addition to fever and respiratory symptoms, SARS may be associated with
other symptoms, including headache, muscular stiffness, loss of appetite,
malaise, confusion, rash, and diarrhea.
CDC has been working with WHO to investigate and confirm the outbreaks of this
severe form of pneumonia. The outbreaks appear to primarily involve health-care
workers and close family contacts to suspect cases. WHO recommends the use of
isolation and barrier nursing techniques for patients who have atypical
pneumonia and any possible links to the outbreaks and that suspect cases be
reported to national health authorities.
As an added measure for hospitalized patients, CDC recommends standard and
respiratory precautions with use of a personal respirator during any close
contact with cases and suspect cases. Standard precautions routinely include
careful attention to hand hygiene. When caring for patients with SARS,
health-care workers should wear eye protection for all patient contact.
To minimize the potential of transmission outside the hospital, case patients as
described above should limit interactions outside the home until the
epidemiology of illness transmission is better understood. Placing a surgical
mask on case patients in ambulatory health-care settings, during transport, and
during contact with others at home is prudent.
CDC advises that persons planning elective or nonessential travel to areas
affected by the outbreak may wish to postpone their trips until further notice.
Updates will be posted about the outbreaks as information becomes available.
03/19/03
Sources
US Centers for Disease Control and Prevention (CDC)
Msnbc.com
http://www.hivandhepatitis.com/health/031903a.html
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