SARS

[tonado]

The outlook to eliminate SARS doesn't look good.

 

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Thursday April 10, 5:51 AM

SARS here to stay, health experts say

By Maggie Fox, Health and Science Correspondent

 

WASHINGTON (Reuters) - An alarming new respiratory disease that spread from southern China to virtually every continent within months is probably here to stay, health experts said on Wednesday.

 

World health officials moved quickly to try to contain the outbreak of Severe Acute Respiratory Syndrome once word got out, but it was carried too quickly by person-to-person contact and is now probably entrenched in the population, they said.

 

The disease concerns doctors because it can cause severe pneumonia that cannot be helped by drugs. About 4 percent of patients die.

 

There are more questions than answers right now about SARS because doctors are not 100 percent certain about the virus that causes the disease and are still collecting data, said Dr. Jim Hughes, head of infectious diseases at the U.S. Centers for Disease Control and Prevention.

 

Once there is a test for the virus that causes the disease, doctors can find out how common it is, how infectious, and whether some people are more likely to spread it than others.

 

"We have more than 150 suspected SARS cases in the United States today. At the end of all this we'll be able to classify many of those into confirmed or not SARS categories," Hughes said in a telephone interview.

 

The World Health Organization reported 2,722 suspected SARS cases worldwide, with 106 deaths in 16 countries. This compares to a minimum of 250,000 deaths a year globally from influenza and its complications, but doctors are not ready to dismiss SARS.

 

"I think we have to assume that the virus is in Asia to stay," Hughes said. "In terms of its introduction into North America, whether it is here to stay I think remains to be seen but I think we should assume that it may well be."

 

A SARS SEASON?

 

CDC director Dr. Julie Gerberding earlier this week suggested SARS may begin to show a seasonal pattern, as do other respiratory diseases such as colds and influenza. Doctors believe a coronavirus similar to strains that cause the common cold may cause SARS.

 

"I think you might expect it will because other respiratory illnesses do," Hughes said.

 

Scientists are already working on a vaccine to fight SARS and are screening banks of drugs to see if one can fight the virus. But they have warned that it takes years to develop a new vaccine for a disease.

 

Vaccines and drugs are unlikely to wipe out any illness. The only human disease that has been eradicated is smallpox, through a global immunization program that ended in 1980.

 

WHO says it is close to eradicating polio, another viral disease that infects only humans, but says pockets remain in places like Afghanistan and parts of Africa.

 

Despite years of work on flu vaccines, influenza manages to adapt and evolve and cause a new epidemic every year. Hughes said it is only a matter of time before another influenza pandemic sweeps the world, killing perhaps millions.

[Calvin]

Dave,

 

I cancelled my trip to China to pick up my wife for the same reason too. My principal allowed me to go, but the nonstop questioning by my colleagues whether I am going or not or if I am aware of the danger of SARS led me to think that they might be afraid that I would contract the disease and spread to the whole school. My friends' and family's worry don't help either. Fortunately, my fiancee is willing to fly here on her own this Friday despite her fear of flying. This nasty bug is going to cause a lot of problems in days to come.

[Mick]

Dave,

 

I cancelled my trip to China to pick up my wife for the same reason too.  My principal allowed me to go, but the nonstop questioning by my colleagues whether I am going or not or if I am aware of the danger of SARS led me to think that they might be afraid that I would contract the disease and spread to the whole school.  My friends' and family's worry don't help either.  Fortunately,  my fiancee is willing to fly here on her own this Friday despite her fear of flying.  This nasty bug is going to cause a lot of problems in days to come.

Really glad to hear your fiancee is coming home soon Calvin. Sorry you couldn't make it to China but, under the circumstances, it is perfectly understandable.

[tonado]

This is getting very serious.

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Hong Kong announcies quarantine households of SARS patients

By Helen Luk, Associated Press, 4/10/2003 06:13

 

HONG KONG (AP) Hong Kong said Thursday it will quarantine for up to 10 days anyone who resides with a confirmed SARS patient, in a tough measure to halt the spread of a disease that has killed 30 and sickened almost 1,000 in this city alone.

 

Hours earlier, Hong Kong had reported three more deaths from severe acute respiratory syndrome, or SARS, and China had raised its death toll by two to 55. Most of the nearly 110 SARS deaths worldwide have been in China and Hong Kong. Fatalities have also been reported in Singapore, Vietnam, Thailand, Malaysia and Canada.

 

Hong Kong Health Secretary Dr. Yeoh Eng-kiong said the quarantine measure was going ''one step further to help contain the spread of the disease,'' but that the decision had been difficult because of a divergence of views on restricting people's freedoms.

 

Health Director Dr. Margaret Chan said police will make sure people don't violate the quarantine by making unannounced visits to their homes.

 

''This is not a foolproof system,'' Chan told a news conference. ''The key is based on self-regulation plus checks on compliance.''

 

Anyone who does not comply with the order will be removed to designated places for isolation, and they could be fined or imprisoned, Chan said.

 

The health officials declined to predict how soon they can bring SARS under control or how many people will be affected by the new restrictions.

 

People who don't want to stay at home, or elderly people who cannot, will be able to use alternative housing, including outdoor recreation camps that had previously been set up as makeshift quarantine centers for some 240 people from an apartment building that suffered a severe SARS outbreak.

 

Some of those people started going home on Wednesday after showing no signs of SARS, which has infected 998 people in Hong Kong.

 

Yeoh said the use of the quarantine camps, under a law dating to colonial days to curb the spread of infectious diseases, showed that Hong Kong can support such isolation measures, despite the hardship it poses.

 

The Department of Health will provide checkups for those in quarantine.

 

Yeoh said the policy was being introduced to facilitate early detection and treatment and to reduce to a minimum the risk of the spread of SARS.

 

Those under quarantine will not be allowed to go out except ''under exceptional circumstances.''

 

On Thursday, China raised its death toll by two, but the new figure did not appear to include an American teacher who died after falling ill in the hard-hit southern province of Guangdong.

 

The teacher was pronounced dead Wednesday in Hong Kong after being taken there from Guangdong in what a friend contended was an attempt by Chinese authorities to avoid the embarrassment of another foreigner's death on the mainland. Hong Kong, though a part of China, reports its deaths from the disease known as SARS.

 

Beijing has been accused of trying to conceal information about the outbreak that first surfaced in the southern mainland in November.

 

James Salisbury, a 52-year-old English instructor at a polytechnic institute in China, already appeared dead Wednesday when he was wheeled into an ambulance in the southern Chinese city of Shenzhen, according to the friend, David Westbrook, who was with Salisbury and had been in contact with doctors about his condition.

 

Westbrook said mainland Chinese doctors had moved him so there would not be another death of a foreigner from SARS in the mainland.

 

A Guangdong provincial health official on Thursday disputed that contention.

 

''We wanted to keep him in Shenzhen, but at the request of his family, we moved him to Hong Kong, where he died,'' said Zhong Nanshan, an epidemiologist at the Guangzhou Institute of Respiratory Diseases.

 

Elsewhere in Asia, governments invoked new precautions to contain SARS, which has infected some 2,700 people. Authorities believe it is spreading via air travel, and health workers at airports throughout Asia are checking arriving passengers for the symptoms of fever, aches, dry cough and shortness of breath.

 

Malaysia started denying visas to most Hong Kong people. Taiwan said medical staff would quarantine arriving travelers found to have a fever.

 

In Singapore, Manpower Minister Lee Boon Yang said that over the next month all foreign workers arriving from SARS-stricken areas will be quarantined for 10 days.

[Mick]

You are right Tony. This is getting to be a very serious situation. Now some countries are beginning to deny visas to those from the affected areas. Cases continue to rise in HK and it is difficult to get an acccurate picture of what is actually going on in Guangdong. According to several reliable sources I have back in Guangdong, the disease is continuing to spread but the lack of accurate information is creating many rumors and people are beginning to panic a bit.

[tonado]

Friday April 11, 11:37 AM

Evidence shows children may escape worst of SARS virus

By Doug Young

 

GUANGZHOU, China (Reuters) - A new and often deadly virus which is sweeping the globe has infected thousands, with no apparent regard for race, gender or nationality. But one group has so far come through virtually untouched -- children.

 

Doctors are trying to explain why a virus that moves with relative ease through the adult population, so far infecting 3,000 worldwide with more than 100 dead, has come up against something of an immunological wall when it comes to youngsters.

 

In the south China city of Guangzhou, just miles from where the outbreak began, Guangzhou Children's Hospital has yet to see its first patient with Severe Acute Respiratory Syndrome (SARS), officials said this week.

 

"We haven't had any cases of SARS," said Yu Minghua, chief of paediatrics at south China's largest hospital for children. "No one has died and no one has been on a respirator...This hospital has about 300 doctors, and none of them has got SARS either."

 

China, especially southern Guangdong province where the disease emerged in November, has been criticised by the World Health Organisation for not fully reporting the real number of SARS cases early enough.

 

But the resistance of children to SARS is a phenomenon that is seen in other places where the disease has struck hardest.

 

In Singapore, just three of the 126 cases to date, or 2.4 percent, are children under the age of 18, according to government data published on Thursday.

 

Out of about 1,000 sufferers in Hong Kong, "the number of children infected with SARS is low... and they had close contacts with SARS patients before infection," Hong Kong's Department of Health told Reuters in a statement. It said more specific data was not available.

 

A Chinese official could not say how many of the 1,206 people who have come down with the disease in Guangdong were children.

 

But Yu said that no children with SARS had come through her hospital, as one might suspect, before being transfered to Guangzhou's No 8 People's Hospital where many of the city's SARS sufferers have been quarantined.

 

SCHOOL'S OUT

 

Just two weeks ago, when first Singapore and then Hong Kong closed schools to prevent the disease's spread, less was known about who gets the disease.

 

The Hong Kong suspension of classes was later extended through the Easter holidays, while Singapore began a graduated reopening of its schools on Wednesday.

 

The latest research, published by two teams in the new England Journal of Medicine on Thursday, identifies the virus as a completely new version of the coronavirus family, the infection that causes the common cold, among other diseases.

 

To date, however, doctors have found no clear evidence that SARS is spread through children-to-children contact either in or outside schools, said C.K. Li, a paediatrician at Prince of Wales Hospital, where most of Hong Kong's first SARS cases came.

 

"Initially when I saw the first one or two cases (of children with SARS) I was in great worry that they would spread that disease within the schools," he said. "But that has never happened within Hong Kong."

 

Hong Kong's school officials must still decide whether to extend the suspension of classes beyond April 22, when they are set to reopen.

 

Deng Li, who heads the respiratory department at Guangzhou Children's Hospital, said it was not uncommon for children to get some respiratory diseases that adults don't get and vice versa, and that that may be the case with SARS.

 

Hong Kong's C.K. Li said that children may, in fact, get SARS at proportionate rates to their share of the population, but that their cases may be less debilitating.

 

"We probably see quite a similar number of children who are affected as adults," he said. "But...it seems that young children are not so severely affected."

[tonado]

Some good news for a change

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Scientists think they have found a SARS key

 

By Stephen Smith, Globe Staff, 4/11/2003

 

Scientists announced yesterday that a novel coronavirus is the likely source of severe acute respiratory syndrome, a discovery that should expedite the search for drugs to treat the ailment or even a vaccine to prevent it.

 

But the director of the US Centers for Disease Control and Prevention cautioned that treatments and vaccines could be months if not years away for a condition suspected of killing 111 people in China, Southeast Asia, and Canada. Researchers have been frustrated so far in their efforts to use existing medicines to treat SARS patients.

 

''It's a ways off, and I don't think we should hang our hat on that as the way we contain the problem,'' said Dr. Julie L. Gerberding, director of the CDC.

 

Still, Gerberding acknowledged, the rapid isolation of a probable source for SARS represents a significant milestone as disease specialists across the globe track the spread of an ailment that first appeared in China in November and has made people sick on four continents, with nearly 2,800 cases under investigation. In addition to guiding drug and vaccine researchers, the findings should speed development of an easy-to-use test for SARS.

 

More than two weeks ago, scientists first revealed that a coronavirus related to the common cold was the probable cause of SARS. But findings from two teams of researchers released yesterday on an urgent basis by The New England Journal of Medicine provide the most detailed profile yet of the virus implicated in the mysterious illness.

 

In one of those reports, scientists describe a review of blood and tissue samples drawn from 19 patients suspected of having SARS. After looking for more conventional causes of illness, including well-known viral and bacterial infections, the researchers time and again returned to an agent they'd never before seen: a coronavirus only distantly related to other members of that viral family.

 

''Certainly, it has not circulated widely in humans, which is further evidence in favor of the association between infection with this novel coronavirus and SARS,'' which made its first appearance last November, the scientists wrote in The New England Journal study.

 

The researchers have proposed a name for the virus: Urbani SARS-associated coronavirus, a posthumous honor for the World Health Organization scientist credited with first sounding an alarm about a lethal respiratory infection felling patients in Asia.

 

Carlo Urbani died after contracting SARS.

 

 

Stephen Smith can be reached at stsmith@globe.com.

 

 

This story ran on page A2 of the Boston Globe on 4/11/2003.

© Copyright 2003 Globe Newspaper Company.

[tonado]

This is a retaliation from China because those countries stopped issuing visas to Chinese.

 

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Friday April 11, 7:40 PM

China bans tours to Singapore, Malaysia, Thailand

 

BEIJING, April 11 (Reuters) - China has ordered travel agencies to halt Chinese tour groups to Singapore, Malaysia and Thailand because of the outbreak of the SARS flu-like virus, the official Xinhua news agency said on Friday.

The China National Tourism Administration ordered the halt after the World Health Organization declared the countries as areas infected with Severe Acute Respiratory Syndrome, Xinhua said.

[tonado]

It is good that Dave decided not to go to China (for his students).

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N.H. man returning home after scare with SARS

By Associated Press, 4/12/2003 11:45

 

EXETER, N.H. (AP) Phillips Exeter Academy has confirmed that a 60-year-old man treated for a possible case of SARS is an employee at the school.

 

The man, whose name has not been released, was treated in Michigan after returning from a trip to mainland China, and was is returning to home to Exeter to resume his duties at the private school.

 

School communications Director Julie Quinn declined to say if the man is a teacher or support staff member to protect his privacy.

 

''He's fine,'' Quinn said, adding that a letter was sent to students, parents and the school community explaining the situation.

 

The respiratory virus known as SARS severe acute respiratory syndrome has killed more than 100 people worldwide and sickened more than 2,700. There are more than 150 suspected cases in the United States, most of them involving people who recently traveled to the Far East.

 

Phillips Exeter Academy took precautions with 25 students at the school who traveled in Asia, including Hong Kong, Singapore and Vietnam during their spring vacation, Quinn said. The students were checked out at the school's infirmary once a day for 10 days upon their return. None exhibited any signs of SARS.

 

The Exeter man was hospitalized in Detroit after he told airline employees on his flight home he was feeling ill.

 

''There was a doctor on board who realized the SARS situation. That plane was diverted and the person was taken to a hospital in Michigan,'' New Hampshire state epidemiologist Dr. Jesse Greenblatt said.

 

Symptoms include a fever higher than 100.5 degrees, cough, shortness of breath, difficulty breathing and respiratory distress.

[lele]

Hi all...

This thing doesn't want to go away....

 

 

MSNBC NEWS SERVICE

 

 

     BEIJING, March 26 —  China on Wednesday dramatically raised the death toll from a mystery flulike illness to 31, with nearly 800 infected, as health officials secretly placed Beijing hospitals on high alert.    

 

 

 

   Officials with WHO and the CDC said Monday that SARS may be caused by a new form of the coronavirus, one of a few viruses that can cause the common cold.

 

        THE GOVERNMENT of Guangdong, which borders Hong Kong, said in a statement that 792 people had contracted atypical pneumonia in the southern province by the end of February.

      In Guangzhou, the provincial capital of 10 million people, 24 had died and 680 had contracted the disease. The other seven deaths were spread among six other Guangdong cities, which had reported no new cases in March, the statement said.

      World Health Organization officials said that although the Guangdong outbreak was “very similar” to the severe acute respiratory syndrome, or SARS, that has killed at least 18 people around the world, it was too early to say if the two were the same disease.

      China had previously disclosed that five people were killed by the pneumonia outbreak in Guangdong province, but critics have charged that the mainland authorities were not providing a complete picture.

      A World Health Organization official in Geneva said WHO experts had sought permission to get into Guangdong but their request was not immediately granted, leading to calls for greater cooperation from Beijing. A WHO team leader in Beijing, Dr. John MacKenzie, later said experts were to meet with Guangdong authorities Wednesday afternoon. He said his agency was unaware of the additional deaths.

      Beijing, hoping to head off panic, has quietly put its hospitals on alert and laid out a plan to prevent the deadly disease from spreading in the city of 14 million people.  

 

World health experts are trying to identify the cause of severe acute respiratory syndrome, or SARS, a new form of deadly pneumonia that is spreading rapidly through Southeast Asia and other parts of the world. For more information about the illness, click on a question above.

Most patients have a fever of about 101 degrees Fahrenheit (38 degrees Celsius), coughing and shortness of breath. Other possible symptoms include headache, muscular stiffness, loss of appetite, confusion, rash and diarrhea.

 

The illness appears to spread through close contact, such as between family members or between patient and doctor. Experts believe it is transmitted through coughing, sneezing and other contact with nasal fluids. Once someone has been exposed to the illness, it takes three to seven days for symptoms to develop.

 

Researchers don’t know whether the illness is caused by a bacteria or a virus. However, test results from the Centers for Disease Control and Prevention are expected within days and will likely provide an answer. Some health officials report that patients have responded well to anti-viral medications, as opposed to antibiotics, which indicates the illness may be caused by a virus.

 

Patients suspected of having the illness are being quarantined in hospitals. Until health officials learn its cause, there is no definite course of treatment.

 

So far there have been nine fatalities among the 150 most recent cases. Other patients remain seriously ill.

 

U.S. health officials said travelers should consider postponing trips to countries at risk. Those who have traveled to Hong Kong; Guangdong province in China; or Hanoi, Vietnam, are being told to monitor their health for seven days. If a fever and shortness of breath develop, they are advised to see a doctor.

 

        A WHO team seeks to determine whether the outbreak was linked to the global spread of SARS, which has sickened nearly 500. Cases have also been reported in the United States, Britain and Australia.

      In the United States, 39 people have the disease, and the U.S. Centers for Disease Control and Prevention said 32 of those had traveled to Asia. The others were health-care workers or family members of infected patients.

      Elsewhere:

Singapore reported its first death from SARS on Wednesday, which would bring the global total to 18, and said it would shut its schools for the first time since a polio outbreak in the 1940s. Five new cases have been reported, raising the total to 74, and 861 citizens were ordered to stay home this week in an unprecedented quarantine in the city-state of 4 million people.

In Hong Kong, where many citizens were going about town in masks, media reported that about 60 schools had been closed as a precaution. Hong Kong reported 26 new cases Tuesday, bringing its total to 286 — more than half the worldwide total of 487. Ten of the world’s 17 SARS deaths since Feb. 1 have been in Hong Kong.

In Canada, where three patients have died, health officials said Tuesday that they had quarantined about two dozen possible carriers of SARS after the number of probable cases in Ontario jumped to 18 from 10.

      The disease is believed to have spread to Singapore, Vietnam and Canada by people who caught it while spending time last month on the ninth floor of the Metropole Hotel in Hong Kong, where an infected mainland Chinese medical professor was a guest.

      The South China Morning Post in Hong Kong reported early Wednesday that the professor had been treating atypical pneumonia patients in the mainland before he came to Hong Kong. The professor died in Hong Kong in early March.

     

SPREAD BY AIR TRAVEL?

      Adding to fears that a deadly flulike illness is being spread by air travelers, Hong Kong officials also said Tuesday that nine tourists apparently came down with the deadly disease after a mainland Chinese man infected them on a March 15 Air China flight to Beijing.  

 

         If SARS can be more easily spread through the air — rather than through close contact with infected people — it could force travel and other restrictions to contain the disease.

      “We would want to be sure that it was people sitting next to that person and not the ventilation system in the airplane which was spreading the disease,” said Dr. David Heymann, head of communicable diseases at WHO. “We have no evidence of the latter right now.”

      For one thing, he said, health investigators have followed thousands of passengers who flew with SARS-infected travelers and did not become sick.

      However, he said that if they find there are cases that did not involve close contact with someone sick or at high risk, “we will then be very concerned that this might have become airborne.”

      The airplane cases seem similar to how the disease got its start — from one hotel guest who spread it to six strangers staying on the same floor. One expert theorized it might have spread through the air-conditioning system.

      The disease has spread most rapidly through Asian hospitals, some of which lacked the surgical masks and goggles needed to prevent catching the disease from patients. WHO has been distributing such equipment.

      The U.S. State Department has warned citizens not to travel to Vietnam, where four people have died, because it lacks medical facilities to deal with the disease.

     

ANOTHER VIRAL CANDIDATE CAUSE

      Officials with WHO and the CDC said Monday that SARS may be caused by a new form of the coronavirus, one of a few viruses that can cause the common cold.

     

    The coronavirus had been found in SARS patient specimens by scientists at Hong Kong University and by the CDC. But more research confirming that is being pursued.

      There is no government-approved treatment for the common cold or SARS, but CDC head Dr. Julie Gerberding said the Defense Department is testing the coronavirus against all known antiviral drugs. There has been progress with antivirals against other respiratory viruses, and some of those drugs have been effective in studies against some coronaviruses, she said.

      However, WHO virologist Dr. Klaus Stohr, who is working with the agency’s network of 11 global labs, said researchers in some labs continue to find signs of another germ family, the paramyxovirus.

     

MORE THAN ONE MICROBE?

      “We are a bit puzzled because we are not only dealing apparently with one pathogen but with two. The reason why we believe that both pathogens should be given equal attention is that there is consistent finding of both pathogens in individual patients or of either of the pathogens in other patients,” he said.

      “What we are seeing actually are three hypotheses.”

      SARS might be caused by one of those two viruses or “these two pathogens have to come together to cause this very severe outbreak.”

      The latter theory is that the coronavirus — which Stohr said lives in immune cells that fight off disease — destroys or weakens the immunity in the patient so the second virus “has practically an open door to go in and to sicken the patient beyond what this virus would be able to do normally.

      “But more research is being done to verify that.”

     

      The Associated Press and Reuters contributed to this report.

 

Dave

An extremely interesting topic to re-read.

 

I am aware that for many individual people, SARS caused them personal loss and pain and suffering, and for those people, I want to extend my true feelings of forgiveness. I am sorry for your loss.

 

For me, this is where my story begins.

 

The first time I entered into China was near the height of the SARS crisis. I have to admit, I was so happy and excited to be going to China then! Everyone warned me about the long lines, and sure enough, as I left Vietnam to go to Thailand, and then onto china a few days later, I found that there were few to no lines everywhere. It was quite a hassle to constantly fill out those white travel forms everywhere I went (until I got to Yunnan, it seems that being sars free there, they were a bit more relaxed about the papers).

 

Being a scientist, I made the following quick computations:

 

What is the chance of dying due to SARS and how would this compare with other risks that I could encounter on my trip? Here is what I concluded:

 

Most Probable (on the top) through least probable (on the bottom)

1.Motor Vehicle Accident

2.Air Pollution

3.Water Pollution

4.General Accident

5.General Panic Created among the people by all of the press associated with SARS

6.Being struck by lightning

7.SARS

8.Terrorism

9.Finding someone whom I would ultimately love and possibly pass away of a heart attack when I realized that we would need to say goodbye

 

And as you can see, the least probable of all of the causes (thankfully neither of us died of a heart attack, and we are both still strong today, although a bit sad at having to wait for so long...through three in person meetings, and daily communication to fill those gaps) would up happening to us. However, as a matter of fact, the chances of dying due to the pollution, or due to a traffic accident, or due to just accidently falling down or off a bridge or out a window, is much higher than getting SARS. However, the chance of SARS (or similar infections killing you) is far higher than Terrorism.

 

These are facts which have been documented throughout the years. I can understand that people are afraid of SARS though, as it and other diseases of its type are far more of a threat than terrorism, and look at all that is being spent currently on this threat, however, I saw it as an opportunity for me to save time in lines, and to get to places which may otherwise have not been accessible due to my short-duration visa (2 months) and my many dreams to explore so much of the nation. In fact, if it were not for the time saved, I would never had had those extra 4 days left on my visa (between days 55 and 59) to have changed my airplane ticket around to have gone with my darling from Beijing to her home town and to have truly realized our future together.

 

Again, I am so sad for all of those who have been effected, and hope that we can use our knowledge of science, of the environment, and of history, to help to prevent any recurrences of this disease.

 

Thanks for taking the time to read my thoughts on this issue!