Posted on 03/30/2003 6:24:20 PM PST by CathyRyan
TORONTO (CP) - Emerging data out of China - the apparent birthplace of SARS - suggests the incubation period for the disease is longer than has been believed, a spokesman for the World Health Organization said Sunday.
Health authorities in much of the world, including those at the U.S. Centres for Disease Control, have pegged the average incubation period for severe acute respiratory syndrome at two to seven days, with some patients taking as long as 10 to fall sick following exposure. Most infection control measures - including those employed against SARS in Canada - are based on the premise that someone who shows no sign of illness after 10 days is unlikely to come down with the disease.
But previously withheld case information from China has led the WHO to rethink how long SARS can incubate before manifesting itself.
"The longest possible incubation period that we've seen is 14 days," spokesman Dick Thompson said Sunday in an interview from Geneva.
And 10 days? "That's what I would have told you before we had access to the Guangdong data."
China's Guangdong province is believed to have been the spawning ground for SARS. A doctor from Guangdong who attended a wedding in Hong Kong is known to have triggered the infections that spread the disease there and then to Canada, Singapore, Vietnam and several other countries.
Despite the new information, Canadian public health officials insist there is no need at this time to lengthen the period of isolation imposed on thousands of people who may have been exposed to the virus by contact with a SARS patient or by working at, being treated in or by visiting two Toronto-area hospitals.
"I think if there were good reason to do it, absolutely," said Dr. Andrew Simor, head microbiologist at Sunnybrook and Women's College Health Sciences Centre.
"But . . . it's a huge burden on people to say: 'We're still not sure, but let's increase it to 14 days.' I think there are huge implications."
Dr. Donald Low, another key member of the SARS containment team, said the evidence from the mounting number of cases in Canada suggests most people develop symptoms within four to five days of infection, so the 10-day period is probably safe.
"We are seeing occasional patients - and that's occasional - at 10 days. And . . . we feel confident of those numbers," said Low, microbiologist-in-chief at Mount Sinai Hospital.
Ontario's commissioner for public safety said authorities need to balance the risks against the practicalities - or impracticalities - of asking mass numbers of people to withdraw from society for two weeks.
"We have to weigh our experience with what happens in regards to obvious public safety but also people's needs to get on with their lives and all of the other problems that are associated with isolating large numbers of people," said Dr. Jim Young.
"We're not saying that wouldn't change. If our experience began to show everyone developing symptoms in Day 9 and 10, we would likely expand the isolation period. But that's not been our experience to date."
The Chinese say they are cooperating, but still won't let outsiders (even the WHO health teams) into the infected areas. We should not be concerned, especially since they are claiming, "No new cases since March 11."
(They made the same claim in February, just before doubling the number of reported cases. But this time they really mean it.)
Just in case someone might have questions, they imposed a news blackout on this topic for the whole nation.
So... Just how bad is it in China?
And 10 days? "That's what I would have told you before we had access to the Guangdong data."
The problem is that by the time we know how to contain it, it will be too late. In fact, it probably already is.
Flights are leaving hourly from the hotbed of this illness, and the virus has probably already spread worldwide.
The only real chance we have to defend against it is if a person doesn't transmit the disease before severe symptoms manifest themselves.
The whole point is, WE DON'T KNOW.
HONG KONG (AP) - Health officials said Monday that 88 more people from one apartment complex have fallen ill with a mystery flu-like disease, bringing the total number of cases there to 213 and stirring fears that it will keep spreading.
Hong Kong's health secretary, Dr. Yeoh Eng-kiong, announced the big rise in severe acute respiratory syndrome, or SARS, cases in a news conference just hours after authorities imposed a tight quarantine on one block of the Amoy Gardens complex.
Yeoh said 107 of the sick people were from Block E of the Amoy Gardens, and most of those cases were from the same two apartment units on several floors of the building, raising the possibility that the disease was spreading vertically.
Asked whether SARS was being spread through the air, Yeoh said that couldn't be ruled out.
Officials had said previously the illness, which has killed 13 people in Hong Kong and 59 worldwide, seemed to spread through close contact and Yeoh said experts still believe the sickness is being transmitted mostly through droplets, when victims sneeze or cough and nearby people are infected.
"No one can rule out this possibility of airborne transmission, because the virus can change so quickly these days,'' Yeoh said.
Hong Kong's health director, Dr. Margaret Chan, said early Monday that no one can leave or enter Block E of the Amoy Gardens without official permission until midnight on April 9.
Anybody violating the order could be fined or jailed.
The outbreak at Amoy Gardens has heightened fears in Hong Kong, where thousands of people are wearing surgical masks and much activity has ground to a halt.
Yeoh said officials believe the virus was brought to Amoy Gardens by a man infected at the Prince of Wales Hospital, where many of Hong Kong's victims became ill.
The infected person paid four recent visits to his brother, who was staying in Block E, Yeoh said.
The disease was spread to Prince of Wales Hospital by a victim who caught it while visiting the ninth floor of Hong Kong's Metropole Hotel last month.
An infected mainland Chinese medical professor was staying in the hotel and passed the disease to other people who then spread it in Hong Kong and carried it to Vietnam, Singapore and Canada.
Hong Kong has now reported more than 600 cases of SARS, although officials also noted that 60 patients here have recovered and been discharged.
Worldwide, SARS has infected more than 1,600 people.
Yeoh appeared emotional, with reddened eyes and nose, and initially had trouble speaking as he made a statement on the isolation of Block E.
"It's a very exceptional circumstance,'' Yeoh said. "We haven't done it before and we hope we won't do it again.''
A government statement said Hong Kong had "no choice but resort to this exceptional measure and we sincerely ask for residents' forbearance, understanding and support in joining the community's fight against this disease.''
Janet Wong, acting director of Home Affairs, said officials had gotten word of the quarantine to 241 residents from 108 apartment units in Block E.
They had not been able to immediately reach residents from 156 units, but many people have fled Amoy Gardens in fear, stirring worries that if any are infected they could spread the disease further in the community.
Hong Kong is the second-hardest hit place after mainland China, which has reported some 800 cases and 34 deaths.
The World Health Organization has expressed concern over the increasing spread of the disease in Hong Kong, where new SARS cases have picked up pace in the past few days. - AP
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