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Posted on 04/13/2003 10:16:15 PM PDT by flashbunny
American-style SARS appears be a weaker cousin of the devastating pneumonia-like illness that has taken root in Canada and Asia, statistics out Thursday suggest.
Severe acute respiratory syndrome, or SARS, is so much milder in the USA than abroad that Florida epidemiologist Steven Wiersma says some experts cautiously joke about renaming the U.S. version ''MARS,'' for mild acute respiratory syndrome.
''The cases we have seen in Florida have been of mild acute respiratory syndrome,'' Wiersma says.
The latest Centers for Disease Control and Prevention (news - web sites) statistics reflect this. Of 166 people with suspected SARS in the USA, most have had normal chest X-rays. Only 33 have developed pneumonia or respiratory distress. Only four of 60 patients who needed hospitalization were still admitted Wednesday. Only one person has needed mechanical assistance breathing, and no one has died, says Julie Gerberding, director of the CDC.
Canada, in contrast, reports 253 suspected cases and 10 deaths. Worldwide, 111 of the 2,781 SARS victims have died. Hundreds have developed pneumonia, and people in need of mechanical ventilation have filled intensive-care units in Hong Kong and Hanoi.
Health authorities are baffled at the apparent difference in the severity of a disease caused by the same virus in different countries. ''We can't explain it,'' says John Jernigan, the CDC expert who is monitoring patient care in the USA. ''We're actively investigating possible reasons for that.''
One possible explanation is that the case definition used in the United States is extremely broad, linking a temperature and flu-like symptoms with foreign travel in affected areas. ''It's quite possible that people can meet the case definition for SARS and not be related to the outbreak at all,'' Jernigan says. Another, he says, is that the broad definition, coupled with efforts to educate travelers who may have been exposed to SARS abroad, may prompt people to get treatment earlier than elsewhere.
In other developments:
* The CDC has developed an educational video about SARS to be shown on international flights, Gerberding says.
* Singapore's government said it would quarantine new workers from SARS-afflicted regions for 10 days. People who are quarantined will be monitored with Web cameras and an electronic wristband that sounds an alarm if they leave home.
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Could it be the health care system is better here
It is, after all, a common cold virus.
I agree with you about misdiagnosis. When we finally get a reliable test, I think we'll be able to shrink the number of cases dramatically.
To meet the U.S. definition of SARS requires only that you have a history of recent travel to an affected area, plus a very common set of symptoms. The result has been an acknowledged over-statement of the number of cases.
To illustrate how extreme this has become, the U.S. was listing 166 cases of "possible" SARS last week, but only 33 actually had pneumonia. Of those 33 with pneumonia, only 5 had actually been confirmed as SARS cases.
The U.S. CDC announced last week that they were looking into possible problems over-diagnosis may be causing, including the public perception that SARS was weaker in the U.S. than in the rest of the world.
The U.S. CDC mentioned at the same time that they were certain the number of U.S. cases would fall substantially once a reliable way to diagnose SARS was found.
The idea that the SARS virus would somehow be weaker in the U.S. has not been advanced by anybody working on SARS, nor is there any medical explanation as to why that would be so.
The idea that SARS patients would have better medical care in the U.S. has been prevalent in the press. However, the medical care received in Singapore, Hong Kong, and Toronto has been comparable to what would be received here.
On balance, the most likely explanation for the better than expected SARS results in the U.S. is simply that we do not really have very many cases of SARS. Let's hope it stays that way.
SARS looks weaker here because a lot of our SARS cases are not really SARS.
A CDC spokesman last week estimated 80% or more of U.S. cases are not really SARS. Here in Washington state, ALL of the suspected cases may be reclassified into something else.
Good news, huh?
Do you think it would be OK if I brought the toilets back into the house now? I'm getting a lot of complaints.
19 posted on 04/14/2003 5:19 PM EDT by Scenic Sounds(Rained out! We must find who is responsible for this!.)
Did you put the toilets out in the rain? I'd be complaining too!
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