Posted on 04/20/2003 9:05:28 AM PDT by CathyRyan
TORONTO - In a frightening new twist, health officials say the SARS virus is able to survive outside the human body -- and pose a danger -- for at least 24 hours, in addition to being spread by face-to-face contact.
The tenacity of the mysterious severe acute respiratory syndrome virus may explain a new cluster of infections in Toronto.
Hospital workers there have caught the disease despite being protected from head to toe by gowns, gloves, masks and eye shields.
"We know that the (precautionary) measures that have been recommended should be adequate to deal with those (patients)," said Dr. Andrew Simor, head of microbiology at Toronto's Sunnybrook Hospital.
"But we're also impressed with just how easily the virus is spread, how it might contaminate the environment."
Simor added that, in a Friday night conference call with Health Canada and the U.S. Centers for Disease Control and Prevention, in Atlanta, Ga., a CDC expert surprised participants by revealing that the virus can remain alive and potent on inanimate objects much longer than previously thought.
"What the CDC mentioned to us last night was that, in their studies, they found that you could still culture viable virus from surfaces after as much as 24 hours, which is longer than we normally expect viruses to be able to survive in the environment," he said.
In a statement Saturday, the World Health Organization said it is also concerned about the possibility of environmental transmission. It's looking closely at how SARS spread through a Hong Kong apartment complex, where the building's sewage system, which carried the virus from an infected person.
However, the health body concluded there is "little risk" that environmental causes are behind a probable SARS case in a Toronto condominium. The incubation period has passed in the building with no further cases, the WHO noted.
The new cluster erupted at Toronto's Sunnybrook and Women's College Health Sciences Centre, which has treated about half the region's SARS patients over the past month. It has 20 to 25 SARS patients admitted at any given time.
As of Saturday afternoon, four staff members, including at least one doctor, a nurse and a respiratory therapist, were in hospital and almost certainly have SARS. Another eight hospital staff members were sent into home quarantine as potential cases.
Hospital officials believe the infections occurred during difficult intubations involving two patients, including one last Sunday that took four hours. Intubation involves placing a tube down a patient's throat to facilitate breathing.
Both patients are now believed to be so-called super spreaders, or viral shedders, who are much more infectious than average SARS patients.
Some staff started feeling symptoms associated with SARS on Wednesday and Thursday. Senior hospital staff became aware of the threat late Thursday night.
Dr. Mary Vearncombe, the hospital's head of infection, prevention and control, said one worker's eye shield slipped during the Sunday intubation procedure but there was no other known breach of the staff's "full-droplet" protection. That protection includes gowns, gloves, eye shields and N-95 masks.
"We were using what both Health Canada and the Centers for Disease Control consider to be maximal precautions for these patients," she said, adding it's possible some potentially infected staff were not present at the intubations.
That raises serious questions about how the virus was spread and whether the current precautions are enough to protect health care workers.
Dr. Gerry Predy, the Edmonton health region's medical officer of health, said the CDC discovery shows how important hand washing and cleanliness are in preventing the spread of a virus such as SARS.
Viruses often spread when an infected person touches a door handle or some other object, after moistening a finger by touching their eye or nose, he explained. Then a healthy person first touches the door handle, then their own eye, and they have the infection.
But where SARS can survive on a door knob for 24 hours, a common cold virus can only survive for two to four hours, Predy said, so more SARS infections may be caused by lapses in hygiene than in droplets coughed into the air.
The new cluster will further tax Toronto's almost-paralysed health care system.
Instead of easing operating restrictions as it had planned, Sunnybrook has effectively closed its critical care, cardiovascular intensive care and SARS units for 10 days as a precaution.
"It's a huge burden on the system,'' said Leo Steven, the hospital's chief executive. He said Sunnybrook, probably the biggest trauma centre in Canada, will have to send trauma patients to hospitals in Toronto, Hamilton and beyond.
Vearncombe predicted that even if containment measures are successful, Canada will have to learn to live with the SARS threat.
"I have some level of optimism that we can contain it in Toronto," she told reporters.
"I have no optimism that we can contain it in developing areas of the world like mainland China so we will continue to import cases and we're going to have to remain absolutely vigilant."
Canada has about 300 probable and suspect cases of SARS in six provinces, mostly in Ontario.
The World Health Organization reported 86 new cases Saturday, bringing the global total to more than 3,500. To date, 182 people have died.
You know that and I know that, but is the general public going to believe it, or are they going to play it safe?
Then again, if a virus can survive 24 hours on a surface, what's the upper limit to its survival in a dark shipping container?
2008?
Maybe it should be reconsidered...
One would think that gamma radiation could do the trick. I don't know if it would be effective against viruses but I'd bet it would.
Gamma does not leave the irradiated product 'radioactive' and boy does it kill organic stuff.
--Boris
They sure do.
Incidentally, back in February there were quite a few deaths to mostly children and teens. If I recall correctly, Ohio, Michigan one of the Virginias and some place else. Were the symptoms in those deaths similar to SARS?? Anyone know?
| Country | Cases | Death Rate |
| Canada | 132 | 9% |
| United States | 220 | 0% |
| World Wide | 3547 | 5% |
So when is the news media going to jump on the Canadian health care system's 9% SARS death rate?
It is quite difficult to reconcile the following quote from the article with the postulate requiring that the disease causing agent be present in all cases of infection. "We have only identified the corona virus in 50% of the people being treated for Sars," health ministry spokesperson Paul Gully told the Sunday edition of the Montreal newspaper La Presse."
My guess is that they just haven't tried hard enough yet. The alternative is that we are still facing something that as you indicated we know nothing about. I would love to see some more about this since my guess and $1.75 might get you a cup of coffee at Denny's.
But seriously, this thing has the earmarks of something really big. Hope I'm wrong.
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