Posted on 04/25/2003 9:32:48 AM PDT by Dog Gone
THE Chinese-American businessman settled into his aisle seat on board a flight from Shanghai to Hanoi, thankful to be out of the biting northern winter wind which seemed to make his persistent fever worse.
He hoped the flight would pass quickly.
He was feverish, suffering shortness of breath and when he could gasp air it usually resulted in a coughing fit.
He thought little of his symptoms; winter in mainland China can be cruel, often resulting in debilitating colds and, to make matters worse, he was run down from a hectic work schedule.
His fever came and went as he sat in his seat, ignoring all around him, trying to get some rest.
During a stopover in Hong Kong to pick up more Hanoi-bound passengers, his condition worsened, he was shaking and his temperature had risen sharply.
Within hours of landing in Vietnam on February 24, the man was at the Hanoi French Hospital being examined by Dr Carlo Urbani, an epidemiologist for the World Health Organisation.
His symptoms indicated pneumonia but Dr Urbani remained suspicious; he had a nagging feeling he had seen or heard of this type of case before.
Staff at the hospital continued to treat the businessman and, as his conditioned worsened, he was flown to Hong Kong and placed in isolation.
When 22 hospital workers in Hanoi became ill on March 10 after treating the man, alarm bells rang in Dr Urbani's head.
He recalled an outbreak of an atypical respiratory disease in Guandong Province, China, first diagnosed in November and affecting 305 people. Five died.
Chinese authorities said it was avian influenza or "bird flu".
However, Dr Urbani linked the cases to the illness being suffered by the businessman, dismissing the bird flu theory and alerting the World Health Organisation to his suspicions.
On March 12, WHO issued its first global alert to cases of atypical pneumonia. On March 13, the businessman died and became known as the "Hanoi index case", his death serving as a map to identifying this worrying disease.
With Dr Urbani's help, a team of scientists in Hong Kong – on March 23 – identified the deadly virus as Severe Acute Respiratory Syndrome or SARS.
Sadly, within days of that announcement, it killed Dr Urbani after being transmitted by the businessman.
A new, dangerous and certainly potentially deadly disease had been discovered.
In the early stages SARS symptoms include initial flu-like illness with rapid onset of high fever followed by muscle aches, headache and sore throat and later research has found the disease also produces low white blood cell count and low platelet count, a lowered ability to coagulate blood.
Cases progress to acute respiratory distress and severe coughing which may lead to the patient being placed on a respirator.
WHO revealed this week the virus was a new strain of a coronavirus – usually responsible for some forms of the common cold – that apparently "jumped" from animals to humans in a Guandong family and never before seen in humans.
Like a massive jigsaw puzzle, countries around the world began to piece together details of mystery illnesses they had been unable to identify previously but had all the hallmarks of SARS.
Even before it was identified, the businessman's death sent shock waves around the world.
It was 2.30am on March 15 in Geneva, headquarters for WHO, and Dr Mike Ryan, who heads the group's Global Outbreak Alert and Response Network, was sleeping soundly.
The ringing of his phone shattered his rest and the almost-panicked chatter on the end of the line didn't do much for his still cloudy frame of mind.
It was a top health official in Singapore calling, saying there was a report of a doctor who had been in their country and was heading home to New York, possibly carrying the as-yet-unknown "mysterious Asian bug" and his journey needed to be stopped.
Dr Ryan's name had been at the top of a contact list and so followed frantic calls around the world to track down the travelling doctor who might be ill.
After a couple of hours, Dr Ryan discovered the man would be passing through Frankfurt that morning and German quarantine authorities were waiting for him when he landed.
"Things began to develop very rapidly over the weekend," Dr Ryan recalled.
Slowly, health authorities realised that Dr Urbani's "hunch" about the deadly disease was right – it had emerged from China in November.
And they pieced together further parts of the puzzle. SARS began in China but Hong Kong had become the centre of the global outbreak, introduced by 64-year-old Dr Liu Jianlun who had been treating patients with the disease in Guangdong.
Infected, he had gone to Hong Kong for a wedding and sneezed while in an elevator at the Hotel Metropole, passing on the disease to a group of people – including the Chinese American businessman who took it to Vietnam.
The magnitude of what was facing world health authorities emerged and WHO began sending out global warnings, revised travel alerts on countries to avoid.
It soon became obvious SARS knew no boundaries and, unlike many other diseases, it was not confined to poorer people living in less-than-perfect hygienic conditions.
In fact, SARS has earned the name the "jet-set plague" because it was at first spread beyond China on aircraft and in hotels used by travellers.
Within days, that sneeze in the Metropole elevator had led to thedisease being detected in Canada then Singapore, Thailand and later Indonesia, the Philippines, Malaysia, New Zealand and several suspected cases in Australia.
In the past couple of days the World Health Organisation has added Toronto and other parts of mainland China such as Shanxi as potential hot spots to be avoided.
The rapid spread of this newest killer disease of the new millennium has prompted unprecedented action by governments around the world and Australia is far from immune.
The South Australian Health Commission's director of communicable disease control, chief quarantine officer Dr Rod Givney, has issued a warning.
"I think what we have to be very realistic about is we eventually will get genuine cases of SARS in Australia," he said.
"The important thing is we recognise them quickly and minimise the chance that the virus gets transmitted to other people."
WHO has called on world governments to be open, alert and cautious during this critical stage as scientists work tirelessly to find out more about SARS and then find a cure which, at the moment, doesn't exist.
In Hong Kong, where it is now commonplace to wear protective face masks, thousands of people have been affected by the outbreak with entire apartment blocks evacuated.
However, openness seems to stop at the border with China where the communist leaders have been in denial.
Government and health officials denied the massive ramifications of SARS from the start, when it could possibly have been contained within southern provinces.
Nice reference.
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