President of the American Society of Microbiology on SARS - "Everything says it is airborne."

AP Health ^ | 03-20-03 | AP

[Mother Abigail]

Health - AP

Mainland professor who died in Hong Kong spread mysterious form of pneumonia; another death reported

Thu Mar 20, 8:09 AM ET

By HELEN LUK, Associated Press Writer

HONG KONG - An infected medical professor from mainland China apparently carried a mysterious flu-like disease to a Hong Kong hotel where six other people caught the illness, possibly as they waited for elevators or through the air-conditioning system, officials said Thursday.

 Some of those he infected are suspected of then carrying the disease into Vietnam, Singapore and Canada, as well as to a Hong Kong hospital where dozens of staff became sick.

The Chinese professor died March 4 — one of six people killed and hundreds sickened by severe acute respiratory syndrome, or SARS, on three continents in recent weeks.

His case bolsters suspicions that the outbreak is linked to an earlier one in China's southern Guangdong province, where an illness killed five people and sickened more than 300.

It is not certain how the disease was spread in the Metropole Hotel, but some experts think it may have been airborne.

"Perhaps they all stood outside the elevator at the same time and someone sneezed or coughed," said Dr. Margaret Chan, the director of the Hong Kong Health Department.

Other theories were being floated.

"It would suggest that it spread through the air-conditioning system, but you can't rule out person-to-person contact, since you don't know if they were even in the same room together," said Ronald Atlas, president of the American Society of Microbiology. "But everything says it is airborne."

Hong Kong's health chief, Dr. Yeoh Eng-kiong, told reporters Thursday he believes the disease has been spread through droplets, which is why most victims have been medical workers or close relatives of victims. But Yeoh acknowledged people elsewhere in the community have been infected, including six members of one family.

Hong Kong said the number of infected people had risen by 20 to 165 as of Thursday afternoon and the World Health Organization (news - web sites) has counted at least 264 people who got sick. Vietnam is the second hardest hit, followed by Singapore.

The disease was spread to Vietnam by an American businessman from Shanghai who stayed at the Metropole in Hong Kong on Feb. 21-22, the same time the professor from China was a guest, officials said. All of those infected at the hotel were on the ninth floor, which now has been closed for sterilization. Meanwhile, Hong Kong officials announced Thursday that the professor's brother-in-law died on Wednesday, becoming the sixth person killed here by the disease. The brother-in-law did not stay in the hotel but he had dined with the professor.

Two other relatives, the professor's wife and a sister, were treated for fever or pneumonia but have recovered and been discharged, said Dr. Tse Lai-yin, a consultant in charge of the Health Department's Disease Prevention and Control Division.

Another Metropole guest, a 78-year-old woman from Toronto, died after returning to Canada, officials here said.

The World Health Organization has confirmed nine deaths from the disease in Hong Kong, Vietnam and Canada, not including the latest Hong Kong death. Five others who died in the earlier outbreak in mainland China, from November to at least February, may be related.

Others infected by the professor included three Singaporean women who were hotel guests and apparently spread the disease to Singapore, a man from Canada who was a guest and a Hong Kong man who went to the Metropole to visit a friend.

 That Hong Kong man has been identified as the "index patient" who spread the disease to Hong Kong's Prince of Wales Hospital, where dozens of workers have been sickened, said Health Department spokeswoman Sally Kong.

None of the 200 to 300 workers at the Metropole have become ill and although conditions seem safe there now, the ninth floor remains closed, Chan said. The Metropole was still open, hotel spokeswoman Anita Kwan said. But a group of tourists from Shanghai emerged wearing surgical masks early Thursday and told reporters outside they were seeking different accommodation.

"The Health Department has already indicated that the germ doesn't exist here anymore," Kwan said Wednesday night. But she added that the ninth floor won't be reopened until it has been thoroughly checked. Researchers in Germany, Hong Kong and Singapore have said they believe the illness may have come from something resembling the virus that causes measles, mumps and canine distemper. The WHO has said the focus on the paramyxoviridae family is helpful but more evidence is needed before conclusions can be drawn.

In other developments:

_ Singapore reported three new suspected SARS cases, bringing the number of patients there to 34;

_ Two people with SARS-like victims were placed in isolation wards at two hospitals in Auckland, New Zealand;

_ A flight attendant and a passenger on a Vietnam Airlines flight to Hanoi were hospitalized with suspected SARS;

_ Japanese health officials ordered local authorities to isolate anyone with suffering from SARS symptoms;

_ Health officials said 11 suspected SARS cases have ben reported in the United States.

[twntaipan]

Like, directly sneezed upon? Like, in the vapor produced by nebulizers in hospitals? Sure seems that if it were spread easily by airborne means that a much higher number of people would be sick by now, or, they have the incubation period wrong. Something doesn't add up.

[CathyRyan]

Press reports have referred to 2 suspected cases of SARS, one in an airline crew member and a second in a passenger, travelling on separate flights from Hong Kong and Taipei to Viet Nam. Both suspected cases have been investigated and are now ruled out as cases of SARS.

[Mother Abigail]

Thats good news

[JoeSchem]

Moslems think we Westerners are barbaric because we keep our dogs in our homes.

And we think they're barbaric because they kill innocent people. We all have our prejudices, I guess.

[Mother Abigail]

Like, directly sneezed upon?

Something like that

[CathyRyan]

WHO is underscoring the need for continued vigilance. Experience with other
emerging diseases makes it clear that, should the causative agent turn out
to be a virus, the new disease could establish endemicity, especially in
light of abundantly documented human-to-human transmission. The world must
protect itself against the widespread establishment of another new
infectious disease.

WHO's concern is now increasingly focused on preparation to assist
vulnerable countries in the likely event that cases continue to spread. Up
to now, all imported cases have occurred in countries well equipped and
well prepared to institute WHO-recommended precautions, including isolation
and barrier nursing practices, for preventing spread to others, whether
health care workers or family members. In view of the rapid spread of this
disease to new countries via exposed air travellers, any country with an
international airport is potentially at risk.

This focus on preparedness underscores the need for a concerted effort to
defend global public health security. In an era of close interconnectedness
and rapid air travel, an outbreak anywhere in the world is a potential
threat to health everywhere.

International collaboration -­ on the part of the medical and research
communities, multinational teams in the field, and health authorities
around the world ­- in the reporting, investigation, and management of this
outbreak has been outstanding.

http://www.promedmail.org/pls/askus/f?p=2400:1001:162694929991895498::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,21028

[Domestic Church]

Does the case in Tenn. have a Hong Kong/Asia link?

[CathyRyan]

I spent a good deal of time today looking and I can not even find out where in Tennessee it is. It may just be that my search skills suck.

[Domestic Church]

"as I just got over acute bronchitis and pleurisy not that long ago. It's enough to make one want to wear a hospital mask"

You've got good reason to wear one if it makes you feel better.

[Domestic Church]

Uncanny how the 11 cases are spread out.

[Mother Abigail]

Early random distribution,


Look now for the cases to begin to accumulate on the West Coast

See post #39

[Domestic Church]

Exactly! It's so perfect it's uncanny.

[frontdeboeuf]

Between 1339 and 1351 AD, a pandemic of plague traveled from China to Europe, known in Western history as The Black Death. Carried by rats and fleas along the Silk Road Caravan routes and Spice trading sea routes, the Black Death reached the Mediterranean Basin in 1347, and was rapidly carried throughout Europe from what was then the center of European trade. Eventually, even areas of European settlement as isolated as Viking settlements in Greenland would be ravaged by the plague. By the time these plagues had run their course in 1351, between 25 and 50% of the population of Europe was dead. An equally high toll was exacted from the populations of Arabia, North Africa, South Asia, and East Asia.


Septicaemic plague is, like the bubonic plague, carried by insects. Its distinguishing feature is its rapidity - death occurs within a day of infection, even before buboes have had time to form. This form of the plague is the rarest rare, but is almost always fatal (4).


Pneumonic plague differs from the other two forms in that it can be spread from person to person. After a two to three day incubation period, victims suffer a sharp drop in body temperature, which is followed by sever coughing and discharge of a bloody sputum. This sputum contains the plague bacteria, making for an airborne transmission. As in bubonic plague, neurological and psychological disorders follow. Pneumonic plague is rarer than bubonic, but is fatal in over 95% of its victims (5).

[Mother Abigail]

Asian Medics Stay Home, Imperiling Respiratory Patients

By LAWRENCE K. ALTMAN

The care of many patients with a mysterious respiratory illness is being seriously jeopardized because nurses and other health care workers are staying away from their jobs out of fear of getting sick themselves, officials at the World Health Organization said yesterday.

Some hospitals in Vietnam and Hong Kong are working with half the usual staff, raising fears that inadequate care will contribute to further spread of the disease, the officials said.

There is pandemonium at some hospitals where workers are staying home, said a doctor familiar with the situation who did not want to be identified.

[k omalley]

An ordinary hospital mask is probably useless against such a virus. An N95 mask will probably offer more protection.

[Domestic Church]

I recall someone recently came upon this pneumonic plague in some outback shed of Siberia.

[Domestic Church]

Okay, what company makes the best?(Not that I have any moola to invest these days.)

[theFIRMbss]

>Look now for the cases to begin to accumulate on the West Coast

Gee. This weekend, all
show biz will be in one room
showing off themselves...

They'll be shaking hands,
kissing each other, maybe
more after the show...

Would the country weep
if all the show biz big-wigs
became ground zero?!

[Justa]

Make a hand-held air sanitizer. Moisten a washcloth with 80-20 water/chlorine mix. Keep it in a ziploc bag and in your purse/pocket when you travel. If you get stuck in an elevator or other confined space with someone coughing cover your mouth with it and breath through it.

[k omalley]

The masks my hospital uses are made by 3M. They are the same masks that are used when caring for TB patients.