Posted on 05/02/2003 7:31:13 PM PDT by Nov3
SARS PUZZLERS
GENEVA - Researchers are trying to get to the bottom of a number of baffling patterns emerging as the outbreak of the deadly Sars virus progresses. These include puzzling details such as why death rates are variable and may be higher in countries with more advanced health systems, such as Singapore.
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Other questions baffling health experts are why children do not appear to be as affected, and why some patients develop a more severe form of the virus.
'The case fatality rate remains at 6 to 10 per cent although there is considerable variation from countries around the world,' said Dr Mark Salter, a World Health Organisation (WHO) virologist and clinician.
'We seem to be seeing a significantly higher death rate in areas where there are more advanced forms of health care such as in Singapore or Canada, and areas recognised to have less-developed health-care infrastructures have a lower death rate.'
While noting that the reason for this trend was still a mystery, Dr Salter pointed out that the Sars death rate looks likely to rise from the current 6 to 10 per cent.
But he added that it is too soon to say how much higher it will go. At the initial stages of the Sars outbreak, the average mortality rate of Sars patients was 4 per cent. 'It is going up. We are concerned, but it is not a surprise to us,' he said.
He added that the disease was still in its early stages and that it was normal for death rates to increase in such circumstances.
'We are only six weeks into it. There are a lot of people who went into intensive care and do not seem to be getting better, and unfortunately a large number of them will die.'
There has been dispute over the way authorities are calculating the Sars mortality rate.
For example, in Hongkong, the death rate is obtained by dividing the number of deaths by the total number of confirmed cases.
But some say this formula assumes that all hospitalised patients will not die of Sars, and this questionable assumption leads to an under-estimate of fatality rate.
A more appropriate estimate, it has been argued, would be the ratio of deaths over the number of people who have either recovered or died of Sars. Using this method, Hongkong's Sars mortality rate would have been three times higher than the 6 per cent declared by the government.
Dr Salter said the variation in mortality rates might be due to cultural differences in the way patients are handled, with nurses and doctors in wealthier countries spending more time not only treating but also caring for patients.
People in some countries spontaneously put on a mask as soon as they feel any sign of illness, further reducing the risk of transmission, he noted.
Researchers have also found that patients reached a crossroads after about two weeks, with about 10 per cent progressing to a more severe stage of Sars, while the rest tend to spontaneously recover. Dr Salter said: 'What we are still trying to ascertain is what makes people progress to that more severe group.'
He said there was no evidence that people might carry the virus without developing symptoms and infect others.
The WHO will also be examining why children do not appear to develop full-blown Sars.
'This is a little bit of a conundrum for everybody and we are actively talking to a lot of people about this. Children still seem to be significantly unrepresented,' Dr Salter said.
Nonetheless, the WHO expert added that the ability to identify these patterns showed progress in tackling the disease.
'I can't think of another disease where we've known so much in such a short space of time,' he said. -- AFP, Reuters
Maybe it is because they are being truthful!
This thing can be stopped. People let's do it. Pray for the ChiComs to clean this up as their last gasp effort.
No
I have been saying for a few days that there are several different strains of SARS and this has proven true. The strain from the metropole hotel in Hong Kong is what went to Toronto. It is the real deal. The cases we have had in America haven't been all that serious.
The doctor that started the Metropole outbreak as another freeper noted had probably been exposed to a witches brew of different strains while he was treating patients.
Oooooooooooooooooooooh--good catch!
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