U.S. Reclassifies SARS Cases, Number Drops

WASHINGTON (Reuters) - The United States changed the way it classifies patients with the deadly respiratory virus SARS on Thursday, and said the new calculation meant there were only 35 probable cases.

A total of 208 people have suspected Severe Acute Respiratory Syndrome in the United States, but only 35 have pneumonia, a key symptom, the Centers for Disease Control and Prevention said.

The CDC has used a broader definition than other countries in a bid to catch anyone who might spread the disease. But CDC Director Dr. Julie Gerberding said this approach was confusing people.

"I think we did cast a very wide net early on. We know that we have more people in the net than truly have SARS," she told a news briefing.

"We have a test available now and that is going to help us sort out the cases truly related to coronavirus," she added. "We do not want to exaggerate the scope of the problem here."

The World Health Organization reports more than 3,200 people have been infected with SARS and 159 have died.

But there are many more suspect cases and WHO says in China, where the epidemic started last November, there may be five times more cases than have been officially reported.

One stumbling block was uncertainty over the cause of SARS, so health officials have been forced to define the illness by its symptoms, which include fever, a dry cough and a certain pattern of pneumonia as seen in an X-ray.

The CDC said probable cases would now be defined as patients who had developed pneumonia, while suspect cases would have fever, cough and recent travel to affected parts of Asia or contact with a suspected SARS patient.

Now the SARS virus has been identified, tests are being issued to detect the virus in patients and speed diagnosis. The CDC has three such tests, which are being refined so they can be licensed by the U.S. Food and Drug Administration.

The virus is a coronavirus, related to one of the many different common cold viruses and also to viruses seen in birds and animals. The WHO named it SARS Virus on Wednesday.

WHO and U.S. officials have said China could have contained the epidemic if it had been more open from the beginning. The virus is believed to have emerged in southern China.

But it has spread to 22 countries, with most of the infections in China and its special territory of Hong Kong.

"It is important that we remain vigilant because we are watching with great concern the events in other parts of the world, particularly Hong Kong and China and Singapore where the transmission of the virus is at an accelerated pace in some communities," Gerberding said.

She said the CDC handed out 500,000 cards to travelers from affected regions, advising them to contact a doctor if they develop a fever and cough. Even people who do not develop pneumonia are isolated and watched under CDC guidelines.

In another effort to curb the spread of the disease, U.S. officials on Thursday urged precautions to keep the blood supply free from SARS, although they admitted they do not know if the virus can be transmitted through blood.

The Food and Drug Administration advised blood banks to ask donors questions that could identify people who could be infected with the SARS virus but have no symptoms.

People already sick from SARS would be turned away at blood banks under normal procedures that ban donations from anyone who is not in good health, the FDA said.

Last year, during the summer outbreak of West Nile virus, several patients who received donated organs or blood from patients infected with West Nile contracted the virus themselves, so health officials want to take extra care.

So far 19 people in the United States who were in contact with SARS patients have developed respiratory infections -- five health workers caring for patients and 14 household members, including a child, the CDC said.

No one has died, in contrast to Hong Kong, where a single patient infected more than 100 others in one case and where 1,297 people have been infected and 65 have died.

"It may very well be that our isolation system is contributing to that but it also may be just luck ... that we haven't had people who are highly infectious," Gerberding said.

3 posted on 04/18/2003 5:29:13 AM PDT by goldstategop ( In Memory Of A Dearly Beloved Friend Who Lives On In My Heart Forever)

This has me wondering if people of a certain ethnicity are more sensitive to the effects and transmission of SARS? It just seems with a more open society here that is has not spread in the same way and we are more heavily populated by folks of European decent, then those of African and Latin American decent. Just wondering if Asians are particularly sensitive to SARS? Anyone speculation?

Perhaps you mean that we are infected by similar viruses in our population as children and as a result, may get sick, but not as sick as populations who do not have the benefit of related antibodies.

Sure, clearly possible. But, it is less a genetic issue than a characteristic of the diseases that affect the specific population.

And it is similar to the effects of the Spanish / Portuguese conquistadors bringing smallpox and other diseases to the Indians in the 1600s.

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