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It is in the breaking news sidebar! |
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Posted on 04/11/2003 4:48:40 AM PDT by per loin
HONG KONG, April 11 (Reuters) - Hong Kong's government said on Friday that a deadly respiratory virus had infected 61 more people in the territory, bringing the total number of cases to 1,059.
Two more patients had died, taking the local death toll from the disease to 32, a government spokesman said.
Worldwide, more than 3,000 people have now been infected and 114 have died.
The flu-like disease, which originated in southern China, hit Hong Kong in March and has been spread around the world by air travellers.
| Time | Cases | Increase | Disposition of Cases | Dead as % of prior time | ||||||||||||||||||
| Day | Date | New | Week | Total | One Day | Week | Got Well | % | Dead | % | Total Gone | % | Still In Hosp | % | Elapsed Hosp-Days | Week | 2 Week | 3 Week | ||||
| Wed | 03/19 | 150 | ||||||||||||||||||||
| Thu | 03/20 | 23 | 173 | 15.3% | ||||||||||||||||||
| Fri | 03/21 | 30 | 203 | 17.3% | ||||||||||||||||||
| Sat | 03/22 | 19 | 222 | 9.4% | ||||||||||||||||||
| Sun | 03/23 | 25 | 247 | 11.3% | ||||||||||||||||||
| Mon | 03/24 | 13 | 260 | 5.3% | ||||||||||||||||||
| Tue | 03/25 | 26 | 286 | 10.0% | ||||||||||||||||||
| Wed | 03/26 | 30 | 166 | 316 | 10.5% | 110.7% | Start | |||||||||||||||
| Thu | 03/27 | 51 | 194 | 367 | 16.1% | 112.1% | figure | |||||||||||||||
| Fri | 03/28 | 58 | 222 | 425 | 15.8% | 109.4% | of 4000 | |||||||||||||||
| Sat | 03/29 | 45 | 248 | 470 | 10.6% | 111.7% | 10 | 2.1% | is a low | 4.5% | ||||||||||||
| Sun | 03/30 | 60 | 283 | 530 | 12.8% | 114.6% | 13 | 2.5% | Estimate: | 5.3% | ||||||||||||
| Mon | 03/31 | 80 | 350 | 610 | 15.1% | 134.6% | 15 | 2.5% | 5.8% | |||||||||||||
| Tue | 04/1 | 75 | 399 | 685 | 12.3% | 139.5% | 16 | 2.3% | 4,000 | 5.6% | ||||||||||||
| Wed | 04/2 | 23 | 392 | 708 | 3.4% | 124.1% | 89 | 12.6% | 16 | 2.3% | 105 | 14.8% | 603 | 85.2% | 4,603 | 5.1% | 10.7% | |||||
| Thu | 04/3 | 26 | 367 | 734 | 3.7% | 100.0% | 98 | 13.4% | 17 | 2.3% | 115 | 15.7% | 619 | 84.3% | 5,222 | 4.6% | 9.8% | |||||
| Fri | 04/4 | 27 | 336 | 761 | 3.7% | 79.1% | 99 | 13.0% | 17 | 2.2% | 116 | 15.2% | 645 | 84.8% | 5,867 | 4.0% | 8.4% | |||||
| Sat | 04/5 | 39 | 330 | 800 | 5.1% | 70.2% | 107 | 13.4% | 20 | 2.5% | 127 | 15.9% | 673 | 84.1% | 6,540 | 4.3% | 9.0% | |||||
| Sun | 04/6 | 42 | 312 | 842 | 5.3% | 58.9% | 116 | 13.8% | 22 | 2.6% | 138 | 16.4% | 704 | 83.6% | 7,244 | 4.2% | 8.9% | |||||
| Mon | 04/7 | 41 | 273 | 883 | 4.9% | 44.8% | 127 | 14.4% | 23 | 2.6% | 150 | 17.0% | 733 | 83.0% | 7,977 | 3.8% | 8.8% | |||||
| Tue | 04/8 | 45 | 243 | 928 | 5.1% | 35.5% | 138 | 14.9% | 25 | 2.7% | 163 | 17.6% | 765 | 82.4% | 8,742 | 3.6% | 8.7% | |||||
| Wed | 04/9 | 42 | 262 | 970 | 4.5% | 37.0% | 142 | 14.6% | 27 | 2.8% | 169 | 17.4% | 801 | 82.6% | 9,543 | 3.8% | 8.5% | 18.0% | ||||
| Thu | 04/10 | 28 | 264 | 998 | 2.9% | 36.0% | 154 | 15.4% | 30 | 3.0% | 184 | 18.4% | 814 | 81.6% | 10,357 | 4.1% | 8.2% | 17.3% | ||||
| Fri | 04/11 | 61 | 298 | 1059 | 6.1% | 39.2% | 169 | 16.0% | 32 | 3.0% | 201 | 19.0% | 858 | 81.0% | 11,215 | 4.2% | 7.5% | 15.8% | ||||
| Averages | 40 | 291 | 9.0% | 85.7% | 14.1% | 2.5% | 16.7% | 83.3% | 4.5% | 8.9% | 17.0% | |||||||||||
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FreeRepublic , LLC PO BOX 9771 FRESNO, CA 93794
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It is in the breaking news sidebar! |
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Fri Apr 11, 4:23 AM ET
By Jason Szep
SINGAPORE (Reuters) - Singapore's largest hospital struggled to contain the SARS virus on Friday after tracing the origin of a mysterious batch of infections -- a man in his 60s whose multiple ailments masked the illness while he unwittingly passed it on to 19 people.
Over the border in Malaysia, officials said 13 crew of a cruise ship which had sailed to Singapore and Thailand had been quarantined after one was identified as a "probable" SARS sufferer.
Singapore General Hospital, where 19 people, including staff, patients and visitors, have caught Severe Acute Respiratory Syndrome (SARS) in a week, fears the virus could have spread to other wards.
Nine people have died of 133 confirmed cases in the tiny city state -- a rate of 6.7 percent, above the global average of about four percent. It has the world's fourth-highest number of cases.
"We are facing an unprecedented situation. We are dealing with a serious, unseen threat," Singapore's minister of manpower, Lee Boon Yang, said on Thursday.
He was speaking as governments around the world tightened their defenses against SARS. Singapore has deployed surveillance cameras and the United States has broadened its definition of who is at risk.
Singapore General Hospital Medical Board chairman Tay Boon Keng listed the elderly Chinese man as a SARS "super spreader," and said he "fell through a crack" after being transferred from a hospital that handles SARS victims exclusively.
"There is concern that the virus could have spread to other wards," said a spokeswoman.
Of the 133 cases so far recorded in tropical Singapore, nine people have died in less than a month and 77 have recovered.
As authorities rang former hospital patients trying to trace anyone exposed to the super spreader, authorities were taking drastic steps.
Security officers fanned out across town to enforce quarantine orders that affect 490 residents, mounting Internet-linked "webcams" in homes and threatening to slap electronic wrist tags on offenders.
The disease has already delivered a heavy economic blow across Asia, hitting hotels, airlines, bars and restaurants, taxi companies, cruise tours and other tourist services.
The 26-year-old cruise ship crew member, an Indian national, was only the fourth person Malaysia has discovered to be suffering from SARS although 27 people are in hospital awaiting test results. She was taken to hospital on Monday and was in "stable condition and recovering," Ismail Merican, Deputy Director-General of Health, told a news conference.
"Thirteen crew members of the ship have been quarantined on the ship at Port Klang," he said.
He did not say how many passengers had been on board or why none had been quarantined.
The ship began its cruise in Singapore, stopped in Port Klang, Malaysia, and visited the Thai island of Phuket. The official withheld the name of the cruise operator or the ship.
In the former British colony of Hong Kong, hospital workers said the epidemic had pushed the health care system to the brink of collapse.
Worldwide, more than 110 people have died and nearly 3,000 have been infected.
A quarter of Hong Kong's 1,000 cases of SARS, marked by fever, cough and severe pneumonia, are health workers, including 12 diagnosed with the illness on Thursday.
"I am afraid that if more hospital staff get infected, the entire health care system would collapse," Peter Wong, a spokesman for three major nurses' unions, said on Thursday.
He said Hong Kong government hospitals were not providing staff with adequate protective gear. FLEEING THEIR HOMES
Hong Kong said three more people had died of SARS, bringing the toll to 30 and officials feared the illness could spread through the city's crowded apartment blocks.
Health workers at one block with confirmed cases sprayed down sidewalks and scrubbed entrances. They also distributed bleach to some residents, including one older woman who had wrapped herself in plastic and put a plastic bucket on her head.
World Health Organization teams were in Beijing and in China's Guangdong province, the source of the infection, but WHO infectious disease chief Dr. David Heymann said they would like permission to look further.
"China is a worrisome area because (we) don't know what is going on outside Beijing," he said in an interview.
The United States widened its definition of people at risk of SARS, saying anyone who passed through an airport in an affected country should watch for symptoms of respiratory illness and contact a doctor immediately if they developed fever or cough.
The U.S. Centers for Disease Control and Prevention believes its strict measures and broad definition of who is a suspected SARS patient has helped keep the disease from spreading in the United States where there are 166 suspected cases in 30 states.
CDC and European researchers both said they had come closer to proving that a new virus from the coronavirus family causes SARS. They found the virus, which may have jumped from animals to humans, in most patients with SARS.
The CDC has developed three tests for the virus and is working to get a licensed version that can be used widely, although this could take at least a week and probably longer.
Back in Asia, hot meals are off the menu for passengers on Taiwanese flights between Hong Kong and Taiwan as airlines step up efforts to stop the spread of SARS.
The commander of the 37,000 U.S. troops based in South Korea banned military and associated civilian staff from traveling to China and Hong Kong because of SARS, the U.S. military said.
In green and clean Singapore meanwhile, ministers are following Prime Minister Goh Chok Tong's lead and abandoning handshakes in public crowds or when holding meetings.
Instead they are adopting a traditional Thai bow with both hands clasped. (Additional reporting by Maggie Fox in Washington, Syed Azman in Kuala Lumpur, Martin Nesirky in Seoul and Tiffany Wu in Taipei))
I remain convinced that the current mortality rates are being suppressed by the tendency of first presenters to receive highest quality care. When the ventilators are all occupied, that mortality rate of 4% or 6% will climb.
I agree, and it seems that Hong Kong will soon be to that point. The length of hospitalization appears to average about three weeks, as the total number of patients 21 days ago (203) exceeds the combined total of the dead and the released (201). If the disease continues to spread at its present rate, the hospitals will be overwhelmed.
It's beyond containment, we'll all eventually be exposed. Make sure your medical insurance is in order, it's gonna be real expensive.
April 11 2003 at 06:57AM
IOL
Beijing - A medical expert from China's Guangdong province, where the deadly severe acute respiratory syndrome epidemic first appeared, said on Friday that the disease was not under control, despite proclamations to that effect by Chinese leaders.
Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases, said it was better to describe the SARS situation in Guangdong, which has handled more than half the world's cases, and the rest of China as "contained".
"From a medical aspect, this disease hasn't been effectively controlled," he told a news conference.
"We should not use the word 'control'. I think we should use a more objective phrase, such as 'effectively contained', because how can you control it if even the origin of the disease is still unclear?" he said.
Zhong's comments came after repeated statements by government officials, including the health minister, that the little understood flu-like disease was "under effective control".
But some officials softened their wording on Thursday to say it was "stable" or "contained".
Many in Hong Kong are pushing for much more drastic quarantine procedures, including rounding up all potential contacts and shipping them to camps in the hills. As the economic effects of SARS become more visible, I suspect the government will do that.
UCSF Experts Offer Advice About Severe Acute Respiratory Syndrome (SARS)
As the Centers for Disease Control and Prevention (CDC) continues to investigate the cause of severe acute respiratory syndrome (SARS), UCSF experts emphasize that most people with respiratory symptoms do not have SARS and that appropriate infection control measures can prevent transmission of the disease.
In addition, they recommend a consultation with a health care provider if individuals match the SARS case definition, which includes:
1) Temperature greater than 100.4 ° F (> 38° C)
2) One or more symptoms of respiratory illness (cough, shortness of breath, difficulty breathing) AND
3) Travel within 10 days of symptom onset to an area with suspected community transmission of SARS
4) OR close contact within 10 days of onset of symptoms with either a person with respiratory illness who traveled to a SARS area or a person known to be a suspect SARS case.
Areas of documented or suspected community transmission of SARS include the Peoples' Republic of China (mainland China and Hong Kong special administrative region); Hanoi, Vietnam; and Singapore. Close contact is defined as having cared for, lived with or had direct contact with respiratory secretions and/or body fluids of a patient known to be a suspect SARS case.
While the cause of SARS is not yet known, scientists suspect it is a new and more dangerous form of coronavirus, a family of viruses that causes colds and diarrhea. Two weeks ago, using a technology that he and colleagues developed, Joe DeRisi, PhD, UCSF assistant professor of biochemistry and biophysics, led a team that provided the CDC with important supporting evidence that coronavirus may be the cause of SARS. DeRisi's work is sponsored by an award from the Sandler Program for Asthma Research.
The mechanism by which SARS is transmitted is unknown, but evidence suggests that the SARS infection is spread by close contact between people, said John Conte, MD, director of hospital epidemiology and infection control at UCSF Medical Center. He explained that it is most likely spread when a sick person coughs droplets into the air, which are then breathed in by someone else or come into contact with the lining of the eyes (conjunctivae). It is also possible that SARS can be spread more broadly through the air or from touching objects that have been contaminated.
To prevent transmission of the disease, UCSF Medical Center experts recommend regular hand washing with soap and warm water. In addition, household setting suspected SARS patients are advised to cover the mouth and nose with a facial tissue when coughing or sneezing and, if possible, wear a surgical mask. If the suspected SARS patient is unable to wear a surgical mask, household members should wear surgical masks when in close contact with the patient, said Conte. Masks should be worn securely enough to ensure breathing through -- and not around -- the mask, he said.
Patients who have SARS and are being cared for at home should avoid sharing silverware, towels or bedding with anyone in their home until these items have been washed with soap and hot water. Surfaces such as counters, tabletops, doorknobs and bathroom fixtures that have been contaminated by body fluids (sweat, saliva, mucus, or even vomit or urine) should be cleaned with household disinfectant. Those who clean these surfaces should wear gloves and dispose of them after use. These instructions should be followed for 10 days after the patient's fever and respiratory symptoms have gone away, said Conte.
In addition to fever, SARS symptoms may also include headache, an overall feeling of discomfort, body aches, and/or mild respiratory symptoms. After two to seven days, SARS patients may develop a dry cough and have trouble breathing. After exposure, the incubation period for SARS is typically 2-7 days. However, isolated reports have suggested an incubation period as long as 10 days. The majority of patients identified with the disease have been adults 25-70 years old who were previously healthy. Few cases have been reported among children aged 15 years or less.
Several healthcare workers have been reported to develop SARS after caring for infected patients. Transmission to healthcare workers appears to have occurred after close contact with symptomatic patients before recommended infection control precautions for SARS were implemented. The severity of the illness has proven to be highly variable among patients, according to Conte.
Because there is no simple test to diagnose SARS, health care providers at UCSF Medical Center are using targeted screening questions concerning fever, respiratory symptoms, and recent travel to evaluate patients. If a suspect SARS patient is admitted to UCSF Medical Center, infection control measures include: hand hygiene, eye protection, use of gown and gloves for contact with the patient or their environment and the implementation of airborne precautions. Airborne precautions include the use of a negative pressure isolation room with adequate ventilation and use of high filtration N-95 masks for people entering the patient room. N-95 masks effectively remove 95 percent of particulates and are reusable as long as they remain dry and intact, according to Kathy Mathews, RN, nurse epidemiologist at UCSF Medical Center.
Mathews and Conte are part of a campus-wide group developing a set of guidelines regarding SARS for health care workers and employees at UCSF. UCSF clinical guidelines for SARS are largely based on CDC guidelines, which appear on the CDC web site at http://www.cdc.gov.
UCSF experts note that this illness can be severe and, due to global travel, has spread to several countries in a relatively short period of time. On April 2, 2003, the World Health Organization (WHO) revised its advice to international travelers recommending that persons traveling to Hong Kong and Guangdong Province of China consider postponing all but essential travel as a measure for preventing the further international spread of SARS. On April 4, 2003, President Bush issued an executive order allowing the Health and Human Services secretary to decide when forced quarantine of patients with SARS symptoms is necessary. More information on travel precautions can be found at http://www.cdc.gov.
The CDC currently recommends that patients with SARS receive the same treatment that would be used for any patient with community acquired atypical pneumonia of unknown cause. Reported therapeutic regimens have included antibiotics, antiviral agents such as oseltamivir or ribavirin. Steroids also have been administered in combination with ribavirin and other antimicrobials. However, there is insufficient information at this time to determine if they have had a beneficial effect, according to Julie Gerberding, MD, director of the CDC.
The CDC recommends that people with fever or respiratory symptoms that develop during the 10 days following an unprotected exposure to a SARS patient, should limit their activities outside the home (work, school, public areas) for 10 days after resolution of fever and respiratory symptoms.
People do not need to stay home if they have not developed fever or respiratory symptoms. However, those exposed to a SARS patient may be required to report the unprotected exposure to an appropriate workplace official, according to CDC officials.
As of April 8, 2003, the WHO has reported 2, 671 cases in 20 countries. The United States is reporting 148 suspect cases under investigation. There have been 103 deaths internationally and no deaths in the United States so far. Most of the United States patients are doing well and recovering, according to Gerberding.
Thank God, for economic effects, as it may in the end be what saves us.
However, it could be argued, it is also the reason it has gotten this far.
Todays increase looks grim. I was hoping yesterdays numbers, if true, would hold.
Looks that way to me too.
Another factor interfering with statistics and holding down current mortality rates is the inclusion of "suspected" patients who do not actually have SARS. Most of these patients are doing well, just as non-specific pneumonia cases always have. Their favorable outcomes are causing many people (including some Freepers) to think SARS is not really that bad.
This factor is especially pronounced in the United States. The U.S. is using such an extremely broad definition for "suspected" SARS that just about anyone who has been through an infected area and gets a cold could be diagnosed as "suspected" SARS.
I can see why our doctors want to err on the side of caution. But this has led to the perception among the public that SARS is somehow not as severe in the U.S., and/or that the concern is overblown in general.
"The concern we have for all Americans is the quality of medical care" available in host countries, said Ms. Barnes, the family liaison director. "No airline will evacuate anyone with SARS. The idea is to get them out before they get sick."………..
A core group of employees designated as essential remain on the job in each American mission, and officials insist that diplomatic efforts are not overly hindered……...
http://www.nytimes.com/2003/04/11/international/worldspecial/11CND-EVAC.html?ex=1050724800&en=7ed2bd03961cd0b1&ei=5062&partner=GOOGLE
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