ONG KONG, April 15 — The toll in Hong Kong from severe acute respiratory syndrome set a new single-day record today with the death of nine patients, five of whom were under 45.Posted on 04/15/2003 1:54:57 PM PDT by Dog Gone
ONG KONG, April 15 — The toll in Hong Kong from severe acute respiratory syndrome set a new single-day record today with the death of nine patients, five of whom were under 45.
The rising death rate among younger patients came as the United States Centers for Disease Control questioned the efficacy of the treatment protocol used by Hong Kong doctors for the disease, known as SARS.
The deaths announced today, which included a pregnant woman and four patients with no underlying illness, brought the territory's death toll since mid-March to 56. The rate of infection remained steady, with 42 new patients, bringing the total to 1,232 victims.
A new cluster of 31 infections in a Canadian religious community and 14 new cases reported by China helped push the number of cases worldwide to more than 3,250 infected and at least 150 dead.
Political fallout from the outbreak also moved to a new level today with the government of Shanghai imposing the first travel restrictions within China by ordering a halt of all group tours to Hong Kong.
With the full extent of the disease still unknown in China, the World Health Organization pressed Beijing today to allow inspection of military hospitals that are widely rumored to contain hundreds of uncounted victims of the disease.
"We are going through a very difficult time," said Dr. Ko Wing-man, the acting chief executive of Hong Kong's Hospital Authority. "The number of patients in the public hospitals is high and of course we have been very saddened by the large number of fatalities."
Dr. Ko stoutly defended the potent drug cocktail developed by Hong Kong health care workers.
"Our experts have come up with the treatment based on the clinical experience of more than 1,000 patients," Dr. Ko said. "While we have successfully treated 80 to 90 percent of patients, we are now realizing the limits of medicine."
Since the outbreak began in mid-March, Hong Kong has developed a treatment that combines Ribavirin, a powerful drug intended to inhibit replication of the virus, with steroids that suppress dangers posed by the body's own immune response.
As yet there is no vaccine, cure or conclusive diagnostic test available for the newly emergent disease, so Hong Kong doctors have adopted a trial and error method for developing the treatment.
The drug cocktail's dangerous side effects and questionable efficacy were raised in a recent report by the United States Centers for Disease Control.
"Clinicians who use it should be aware of all potential adverse events, including severe hemolytic anemia," the Morbidity and Mortality Weekly Report of the Disease Centers said last week. "Preliminary results from in vitro testing indicate that Ribavirin concentrations that inhibit ribavirin-sensitive viruses do not inhibit replication or cell-to-cell spread of the novel coronavirus."
Dr. Ko said Hong Kong's high-dosage Ribavirin treatment came as the result of on-the-ground experience in treating disease victims.
"When doctors get used to treating patients, they can get more bold with dosages," Dr. Ko said. "I am not pretending the treatment we have evolved is the best, but so far it serves us well."
Although Hong Kong has reported one of the fastest growing outbreaks of the disease, many disease experts believe the Beijing government has hidden the full extent of the disease on mainland China.
By late today a team from the W.H.O., on its final day for study of the outbreak in Beijing, had not yet been allowed to visit the military hospitals believed to house the majority of victims in the capital.
"Based on international community's concern over Beijing response to the SARS outbreak, it will be meaningful to see whether we can visit the military hospitals," said James Palmer, a Beijing-based spokesman for the W.H.O.
While Hong Kong faces a persistent outbreak that has shown no sign of slowing from the rate of 40 new infections a day, a survey released today suggested that government health measures have had an impact on hygiene habits of the general public.
Among 500 Hong Kong residents surveyed by the Hong Kong office of the polling company Taylor Nelson Sofres, 89 percent reported washing their hands more often and 86 percent wore a face mask. Other measures undertaken include 81 percent avoiding crowded places or staying at home, and 83 percent maintaining good ventilation.
Beyond the human toll, the ratings agency Standard and Poor's predicted today that the disease could lower growth rates in much of the region. In addition to a drop in tourist arrivals and consumer spending, the agency said business operations and investments would be affected.
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In other words, Ribavirin doesn't work against SARS.
People are less concerned when "treatment" is available. My understanding is that Ribavirin is the least expensive of the new anti-virals.
The steroid part of the Hong Kong treatment protocol is probably doing some good.
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