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Honk Kong Health Secretary calls for calm as SARS cases double, (83 up from 42 on Sunday)
IOL ^ | 03-17-03

Posted on 03/17/2003 7:57:03 AM PST by Mother Abigail

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To: Domestic Church
It may surprise you to hear this, but Mother Nature has been spawning these bugs for thousands of years....sorry to burst your bubble.
41 posted on 03/17/2003 10:24:01 AM PST by ContemptofCourt
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To: Mother Abigail
http://nypost.com/news/worldnews/71008.htm

And the Chinese only recently have begun discussing the outbreak with outside health officials, who are conducting an intensive effort to track the disease.

China yesterday gave the World Health Organization written observations about the spread of the syndrome.

But University of Michigan epidemiologist Arnold Monto said the delay meant that health officials are nearly five months behind in discovering the syndrome's cause, finding medicine to combat it and taking steps to prevent its spread Five MONTHS?

42 posted on 03/17/2003 10:26:22 AM PST by Judith Anne (What's another word for Thesaurus? -S.Wright)
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To: Mother Abigail; All
Sorry about my lousy html there, all comments are from the post article except my last one: Five MONTHS?
43 posted on 03/17/2003 10:27:39 AM PST by Judith Anne (What's another word for Thesaurus? -S.Wright)
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To: Domestic Church
That is what my mother has been saying for a while. My grandfather had a vision of the North Koreans rolling through South Korea and into Japan and China rolling through southern Japan, Taiwan, the Philipines, Hawaii, and wouthern California. If I recall he had that vision about five years before his death.
44 posted on 03/17/2003 10:30:49 AM PST by Maeve (Siobhan's daughter and sometime banshee.)
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To: ContemptofCourt
It may surprise you to know I have a medical and analytical background. As I posted earlier... this is conjecture.
45 posted on 03/17/2003 10:36:45 AM PST by Domestic Church (AMDG...)
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To: Mother Abigail
Love your screen name. Fitting...grins.

sw

46 posted on 03/17/2003 10:42:45 AM PST by spectre (spectre's wife (EAGLES UP!))
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To: Domestic Church
But why chose a close contact contagion? Why not airbourne?
47 posted on 03/17/2003 10:43:34 AM PST by CathyRyan
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To: spectre
Thank you,

Had quite a bit of fun with it yesterday.

Gallows humor I suppose..

You come see me child...
48 posted on 03/17/2003 10:55:53 AM PST by Mother Abigail
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To: CathyRyan
We don't know if it is airborne or not at this point. We just know their have been tissue samples taken and that should help determine what it is (I pray.)There are 2 unrelated cases in Paris now as well. I am hoping that this is just a new flu.
49 posted on 03/17/2003 11:01:10 AM PST by Domestic Church (AMDG...)
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To: Domestic Church
The two cases in France are very troubling. Two individuals travel, one to Hong Kong and one to Vietnam, both return with SARS (to be determined).

That is virulent...
50 posted on 03/17/2003 11:34:00 AM PST by Mother Abigail
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To: All
TORONTO (CP) - The World Health Organization has called the mystery pneumonia that is quickly spreading around the globe a new communicable disease.

As more countries reported cases of the atypical pneumonia which health officials are calling severe acute respiratory syndrome or SARS, Health Canada adjusted downward the number of confirmed cases in this country. The department said Monday there have been seven confirmed cases of SARS, all seen in people who either recently travelled to the Far East or who were in close contact with a person who contracted the ailment while travelling in that part of the world.

On Sunday, it was estimated that as many as 10 Canadians - including two people who have died - had SARS or were suspected of having it.

The discrepancy over the numbers was not immediately clear, but both Health Canada and Toronto public health officials were expected to clarify matters at briefings later Monday.
Health Canada did say in a release that one of the suspected cases in Ontario had subsequently been found not to be SARS.

Laboratories around the world continued to scramble Monday to determine the cause of the mystery ailment, which originated in Southeast Asia but has since spread as far afield as Canada, Slovenia, Australia and France. International travellers appear to be spreading the disease.

Experts say the culprit for the frightening outbreak is probably a virus, and refuse to rule out the possibility that it might be a hitherto unknown strain of influenza. Others say that appears unlikely, as laboratories are well versed at identifying influenza strains.

If it is influenza, experts worry this may be the start of a pandemic that will sweep the globe. It's generally believed the world is overdue for an influenza pandemic; there are generally three or four a century and the last hit in 1968-69.

In a pandemic, normal circulating influenza viruses mutate and become highly virulent. The Spanish Flu, which struck just after the First World War, killed upwards of 20 million people - more than who died on the battlefields of Europe in what is routinely called the deadliest war in the history of the world.

"If it really is the flu, it could be we have a new organism that could cause a pandemic," said Dr. Bradley Sack, director of Johns Hopkins University's international travel clinic. "People immediately start thinking of 1917," when a worldwide flu epidemic began that killed at least 20 million people.
So far, the disease has killed nine people - seven in Asia and two in North America. Its rapid spread, and the discovery of two clusters in Canada, caused a rare worldwide health alert to be issued on Saturday.

Health officials in China said Monday the disease that infected about 300 people and killed five in Guangdong province "seems amenable to treatment," although they stressed there is still no link to cases in other countries.

Investigators suspect a virus is involved, because victims do not seem to respond well to standard antibiotics, which kill only bacteria, and because their white blood counts drop. That typically happens with viral infections but not bacterial ones.
51 posted on 03/17/2003 11:39:37 AM PST by Mother Abigail
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To: All
Deadly illness in York: Officials
PATRICIA ORWEN AND GAIL SWAINSON
STAFF REPORTERS

York Region health officials say they have confirmed a new case of a deadly pneumonia-like illness and are notifying hundreds of people who came into contact with the victim that they might be infected.

The latest local case involves a 62-year-old City of Vaughan man who was admitted to Sunnybrook hospital yesterday after he fell sick with what health officials are calling severe acute respiratory syndrome, or SARS.

The man, who returned to Toronto on an Air Canada flight from Hong Kong early Saturday morning, came down with symptoms of the disease three days earlier, which means he was sick while on the airplane home, said Bill Mindell, the director of infectious diseases control for York Region health services.

"He had been travelling for some time in South Korea, Thailand, China and Hong Kong," Mindell said.

Meanwhile, hospital staff, ambulance workers and four relatives in the sick man's immediate family — all the people he came in contact with after arriving in Toronto — are also being closely watched by York officials, Mindell said.

The York Region case is the first case of the syndrome identified in Greater Toronto that has no connection to the original "Toronto cluster, " York's Mindell said.

"The significance of this is that it is independent of the Toronto group. This is another travel-related case," Mindell added.

The Toronto cluster includes Sui-chu Kwan, 78, who died on March 5, and her son, Chi Kwai Tse, 44, who died March 13. Kwan, her husband and another son, had recently returned from a visit to Hong Kong.


Local health officials urged calm.
"There's no need to panic ..
52 posted on 03/17/2003 11:52:44 AM PST by Mother Abigail
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To: Judith Anne
bump to me
53 posted on 03/17/2003 11:58:47 AM PST by Judith Anne (What's another word for Thesaurus? -S.Wright)
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To: Domestic Church
Whose to say this virus wasn't carried into China to begin with? But has gained recognition because it has florished there. Captain Tripps?
54 posted on 03/17/2003 12:14:26 PM PST by BriarBey
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To: BriarBey
Who do you think would have done that and for what reason? It certainly isn't in our interest.
55 posted on 03/17/2003 12:18:02 PM PST by Domestic Church (AMDG...)
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To: doc30
Wouldn't that be a great time for foreign troops to come in to "keep the peace". Just like the UN'ers have always wanted
56 posted on 03/17/2003 12:28:06 PM PST by Milesdavislover
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To: Domestic Church
Germany reports four new suspected killer bug cases

BERLIN, March 17 (Reuters) - Germany reported four new suspected cases of a killer pneumonia that has spread from Asia to Europe and Canada, and confirmed a man being treated in Frankfurt since Saturday was probably also suffering from it.

Two women who had recently been in Asia were being held in quarantine in a hospital in the city of Leipzig on suspicion they had contracted Severe Acute Respiratory Syndrome (SARS), the doctor treating them told Reuters.

One man was being treated in Berlin after arriving back on Sunday from a trip to Shanghai complaining of fever and a sore throat, Berlin's health department said.

The fourth new suspected victim is the wife of the Singapore doctor being held in quarantine in Frankfurt. The doctor was diagnosed on Monday as most probably suffering from SARS.

Health ministries and airport authorities around the globe were on high alert on Monday as Hong Kong's Health Minister Yeoh Eng-kiong announced the number of people infected with the illness there had nearly doubled.




57 posted on 03/17/2003 12:30:24 PM PST by Mother Abigail
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To: BriarBey

Killer bug may have hit Australia

By Steve Creedy and Helen Tobler
18mar03

AIRLINES are telling staff to deny boarding to passengers showing flu-like symptoms amid fears the first Australian case of the deadly pneumonia outbreak that has triggered a global alert may have surfaced in Western Australia.

The West Australian Health Department confirmed last night it was investigating a person with symptoms similar to Severe Acute Respiratory Syndrome, which has killed nine people in eight countries.

58 posted on 03/17/2003 12:59:48 PM PST by Mother Abigail
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To: snickeroon
Has anyone read whether the digestive part of this comes at the beginning or towards the end of the illness?
59 posted on 03/17/2003 1:07:07 PM PST by birdwoman
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To: Domestic Church; Nix 2; LindaSOG; 68-69TonkinGulfYatchClub
If its bio warefare and originating from China

It does appear to have possibly originated in China (Guangdong). In any case, it seems that Hong Kong, Vietnam, China, is now a highly risky area to travel to.

This is the some of the latest from ProMed:


SEVERE ACUTE RESPIRATORY DISEASE - WORLDWIDE: ALERT (03)
***************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases



[1] Singapore - Ministry of Health
[2] Hong Kong - Department of Health
[3] Canada - Univ. of Toronto Medical Staff/Ontario
[4] Worldwide update - WHO
[5] Worldwide update - newswire
[6] Sovenia - newswire



******
[1]

Date: 16 Mar 2003
From: ProMED-mail 
Source: Singapore MOH Press Release  16 Mar 2003


Press Releases

Update III on atypical pneumonia cases in Singapore [Severe Acute 
Respiratory Syndrome (SARS)]
--------------------------
The World Health Organisation has revised the name of this disease to 
Severe Acute Respiratory Syndrome (SARS). SARS is an atypical pneumonia for 
which the cause has not yet been determined.

Four new patients with SARS have been admitted since the MOH Press Release 
yesterday. As at 16 March 2003, we have a total of 20 patients of SARS. 
Other than the initial three cases, there are an additional 17 patients who 
have been admitted to hospital. All these have been in close contact with 
patients of SARS. Ten are family members and friends, and seven are 
hospital staff who had attended to the patients when they were first 
admitted to the hospitals. All these patients are stable. Patients are 
being isolated and the hospital staff have been informed to observe 
enhanced infection control procedures when attending to suspected cases.

The Ministry advises you to seek immediate medical attention if you have:
- Fever (>38 C) and respiratory symptoms including cough, shortness of 
breath or breathing difficulty;
AND
- have travelled to Hong Kong, Hanoi or Guangdong province in China, within 
2 weeks of onset of the symptoms;
OR
- are a close contact of persons diagnosed with SARS. (Close contact means 
having cared for, having lived with, or having had direct contact with 
respiratory secretions and body fluids of a person with SARS)

As a precautionary measure, the Ministry strongly advises you to avoid 
travel to Hong Kong, Hanoi and Guangdong province in China for the time 
being, unless absolutely necessary.

******
[2]

Date: 16 Mar 2003
From: ProMED-mail 
Source:  Department of Health Honk Kong SAR 16 Mar 2003


Number of Healthcare Workers Infected

The following is jointly issued by the Department of Health and the 
Hospital Authority:

As at 1pm today (16 Mar 2003), the admission statistics of healthcare 
workers who suffered from respiratory tract infection are as follow:

Total Admissions (The numbers in bracket are those with Pneumonia Symptoms)

Staff of Prince of Wales Hospital admitted to:
    Prince of Wales Hosptial 36 (29)
    Kwong Wah Hospital 1 (1)
    Princess Margaret Hosptial 1 (1)
Staff of Kwong Wah Hospital admitted to:
    Kwong Wah Hosptial 2 (2)
Staff of Pamela Youde Nethersole Eastern Hospital  admitted to:
    Pamela Youde Nethersole Eastern Hospital  6 (6)
Staff of Private Clinic admitted to:
    Princess Margaret Hospital 3 (3)

Total  admissions  49 (42)

******
[3]

Date: 16 Mar 2003
From:  Susan Poutanen MD for "Donald E. Lowe MD" 
Source: University of Toronto (16 Mar 16 2003 21:00 EST)

Update re Severe Acute Respiratory Syndrome - Toronto Experience
------
There are now 6 probable and 2 suspect adult cases of severe acute 
respiratory syndrome (SARS) of unknown etiology in the Greater Toronto Area 
(GTA).  (See Health Canada's preliminary definitions of probable and 
suspect cases at the end of this report.)

The first 6 cases involved 6 adults in one family (composed of 7 adults and 
3 children) who have been admitted to hospitals in the GTA with 
probable/suspect SARS.  The index case and her husband had traveled to Hong 
Kong 13 Feb  2003 to 23 Feb  2003.  She had respiratory symptoms upon her 
return to Toronto and died at home on 5 Mar  2003.  Four of her adult 
children/children-in-law (3 of whom lived with her) and her husband 
ultimately developed symptoms and were diagnosed with 
probable(4)/suspect(1) SARS.  None of the 3 young children in the family 
have shown signs of SARS although one (5 months old) has been admitted to 
hospital for observation.  This child was noted to have a rash described as 
erythema multiforme minor after exposure to probable cases in his family 
noted by his family doctor on 6 Mar 2003 but which resolved by 10 Mar 
2003.  Two probable cases from this family have died.  One probable case 
from this family is requiring mechanical ventilation but is stable.  The 
remaining probable/suspect cases from this family are stable on medical wards.

The seventh case involves the family physician who assessed at least one 
probable and one suspect case from this family.  She has also been 
diagnosed with suspect SARS and has been admitted to a medical ward and is 
currently stable.  She saw these patients on 6 Mar 2003 for approximately 
45 minutes and on 9 Mar  2003 she developed a temperature of 40 C (104 F) 
which has persisted to date (16 Mar  2003).  On 14 Mar  2003, she developed 
a dry non-productive cough with adventitious sounds in the left lower lobe 
but has had a normal chest x-ray.

The eighth case has been diagnosed on 16 Mar  2003 with probable SARS.  He 
is not related to the first 6 cases and is the first non-Asian case in 
Toronto.  For the first 2 weeks of Mar 2003, he was traveling in Southeast 
Asia (including Hong Kong on 10 Mar  2003).  He developed symptoms on 12 
Mar  2003 with pleuritic chest pain, sore throat and light headedness that 
developed into productive cough with hemoptysis [coughing up blood] and 
shortness of breath on 14 Mar 2003.  He was assessed and noted to have a 
temperature of 40 C (104  F) on 15 Mar  2003 and is requiring 40 percent 
oxygen by mask.  Pulmonary embolism has been ruled out.

Clinical specimens from all cases, including autopsy specimens from one of 
the probable cases that died have been sent to local, regional, and 
national laboratories for diagnostic testing.  Initial results have 
revealed no etiology.  Histological examination of lung from one of the 
deceased patients was compatible with adult respiratory distress syndrome.

Description of the Toronto SARS Cases:

In 3 probable cases where there was a defined exposure, the estimated 
incubation period ranged from 2-5 days. In all 8 cases, the initial 
symptoms were primarily fever and malaise. Some, but not all also had 
headache and myalgias [muscle pains].  While respiratory symptoms were 
common to all cases (primarily dry cough and shortness of breath), it is 
worth noting that respiratory symptoms occurred later in the illness in 
some patients.  At presentation to hospital, most have been febrile, short 
of breath and hypoxic. However, some have not had a fever in 
hospital.  Several patients have had gastrointestinal upset and diarrhea. 
The chest x-ray abnormalities have been subtle initially, and despite 
respiratory symptoms, some have had normal chest x-rays.  As illness 
progressed, most developed bilateral and symmetrical pulmonary 
infiltrates.  Total white blood cell counts have been slightly abnormal and 
4 patients have been lymphopenic [low number of lymphocytes].  Most 
patients have had some elevation in transaminases (AST/ALT/GGT 1- 3x upper 
limit of normal) [these are indicative of liver abnormalities - 
Mod.MPP].  Three patients have had elevations in creatine kinase [this is 
indicative of muscle cell damage - Mod.MPP].

Addendum:

Severe Acute Respiratory Syndrome (SARS)
Case Definitions  (Recommended by Health Canada as of 16 Mar  2003)

Suspect Case:

A person presenting with a history of:
- Fever (over 38 degrees Celsius)
        AND
- One or more respiratory symptoms including cough, shortness of breath, 
difficulty breathing
        AND
One or more of the following:
- Close contact* with a probable case
- Recent history of travel (within 10 days) to Asia, especially in areas 
reporting cases of SARS (see below)

*Close contact means having cared for, lived with or had face-to-face 
(within 1 metre) contact with, or having had direct contact with 
respiratory secretions and/or body fluids of a person with SARS.

Probable Case:
A person meeting the suspect case definition together with severe 
progressive respiratory illness suggestive of atypical pneumonia or acute 
respiratory distress syndrome with no known cause.
        OR
A person with an unexplained acute respiratory illness resulting in death, 
with an autopsy examination demonstrating the pathology of acute 
respiratory distress syndrome with no known cause.

Comments:
- In addition to fever and respiratory symptoms, SARS may be associated 
with other symptoms including: headache, myalgia, loss of appetite, 
malaise, confusion, rash and diarrhea.
- Severe respiratory illness may be characterized by decreased oxygen 
saturation requiring oxygen support including ventilation. Chest X-ray 
abnormalities may or may not be present.

Areas in Asia Reporting Cases of SARS (16 Mar  2003 14:00 EST)
China: Guangdong province, Hong Kong SAR
Vietnam: City of Hanoi
Singapore


Source of Information:
Allison McGeer  MD
Susan M. Poutanen MD MPH
Irving Salit MD
Andrew Simor MD
Donald E. Low  MD
University of Toronto

--
Donald E. Low MD
Mount Sinai Hospital
600 University Avenue, Room 1487
Toronto, ON   Canada M5G 1X5


[Our gratitude to the medical staff from the University of Toronto for 
sharing this excellent report on the current situation of SARS in Ontario 
Canada.  This is the first concise medical description of the actual 
clinical picture of cases, including supportive studies such as laboratory 
and radiologic results.  We are very grateful to the staff for taking the 
time to prepare this report for ProMED-mail. - Mod.MPP]


******
[4]

Date: 16 Mar 2003
From: ProMED-mail 
Source: WHO /CSR update  16 Mar 2003



Severe Acute Respiratory Syndrome (SARS) - multi-country outbreak - Update
----------------------
As of 15 March 2003, reports of over 150 cases of Severe Acute Respiratory 
Syndrome (SARS), an atypical pneumonia of unknown aetiology, have been 
received by the World Health Organization (WHO) since 26 Feb 2003. WHO is 
co-ordinating the international investigation of this outbreak and is 
working closely with health authorities in the affected countries to 
provide epidemiological, clinical and logistical support as required.

SARS was first recognised on 26 Feb 2003 in Hanoi, Viet Nam. The causative 
agent has yet to be identified. The main symptoms and signs include high 
fever (greater than 38 degrees C), cough, shortness of breath or breathing 
difficulties. A proportion of patients with SARS develop severe pneumonia; 
some of whom have needed ventilator support. As of 15 Mar 2003, 4 deaths 
have been reported.

As of 15 Mar 2003 the majority of cases have occurred in people who have 
had very close contact with other cases and over 90 percent of cases have 
occurred in health care workers.

The mode of transmission and the causative agent have yet to be determined. 
Aerosol and/or droplet spread is possible as is transmission from body 
fluids. Respiratory isolation, strict respiratory and mucosal barrier 
nursing are recommended for cases. Cases should be treated as clinically 
indicated. (see below for further details).

- Hospital Infection Control Guidance
- Management of Severe Acute Respiratory Syndrome (SARS)

An epidemic of atypical pneumonia had previously been reported by the 
Chinese government starting in November 2002 in Guangdong Province. This 
epidemic is reported to be under control.

Hanoi, Viet Nam

On 26 Feb 2003, a man (index case) was admitted to hospital in Hanoi with a 
high fever, dry cough, myalgia and mild sore throat. Over the next 4 days 
he developed increasing breathing difficulties, severe thrombocytopenia, 
and signs of Adult Respiratory Distress Syndrome and required ventilator 
support. Despite intensive therapy he died on 13 Mar 2003 after being 
transferred to Hong Kong Special Administrative Region of China.

On 5 Mar 2003, seven health care workers who had cared for the index case 
also became ill (high fever, myalgia, headache and less often sore throat). 
The onset of illness ranged from 4 to 7 days after admission of the index case.

As of 15 Mar 2003, 43 cases have been reported in Viet Nam. At least 5 of 
these patients are currently requiring ventilator support. Two deaths have 
occurred. With the exception of one case (the son of a health care worker) 
all cases to date have had direct contact with the hospital where the index 
case had first received treatment.

Hong Kong Special Administrative Region of China

Influenza A(H5N1) reported in February

On 12 Mar 2003, 20 health care workers developed influenza-like symptoms 
(high fever, headache and lower respiratory symptoms). Since then the 
number of reported cases has increased daily.

As of 15 Mar 2003, over 100 reported cases have been hospitalised, at least 
2 of whom are receiving ventilatory support. One death (index case from 
Viet Nam) has been reported.

Singapore

On 13 Mar 2003, the Ministry of Health in Singapore reported three cases of 
SARS in people who had recently returned to Singapore after travelling to 
Hong Kong Special Administrative Region of China.

As of 15 Mar 2003, 13 additional cases have been reported. All 13 of these 
cases have had very close contact with one or more of the initial three cases.

All 16 cases are reported to be in a stable condition and are being cared 
for in isolation.

Thailand

As of 15 March 2003, one imported case has been reported in Thailand. The 
case (a health care worker) travelled to Thailand on the 11 Mar 2003 from 
Hanoi, Viet Nam. The case is known to have had close contact with the Hanoi 
index case and to have been unwell on arrival in Thailand. The case was 
immediately isolated on arrival in Thailand and reported to be in a stable 
condition and is being cared for in isolation. There is no evidence of 
transmission of SARS in Thailand.

Canada

As of 15 Mar 2003, 7 cases have been reported in Canada; 2 of whom have 
died. The cases have occurred in 2 separate extended family clusters. In 
both clusters at least one member of the family had travelled to Hong Kong 
Special Administrative Region of China within a week of developing symptoms.

Philippines and Indonesia

Unconfirmed reports of a single case in the Philippines to date. However 
one close contact of the Hanoi index case is under observation in an 
isolation facility. This person is reported to be well.

Unconfirmed reports of a single case in Indonesia were received on the 15 
Mar 2003. However further reports have confirmed that this person does not 
fulfill the case definition. As of 16 Mar 2003, there are therefore no 
reported cases in Indonesia.

New York, USA – Frankfurt, Germany

On 15 Mar 2003, a health care worker from Singapore who was visiting New 
York boarded a flight from New York to Frankfurt. The health care worker 
was known to be unwell and to have had recent close contact with a reported 
case of SARS in Singapore. German health authorities were notified and the 
health care worker was transferred to an isolation unit in Frankfurt as 
soon as the flight landed. There is no evidence of transmission in Germany.

Laboratory Investigation

Various specimens have been collected from cases and post-mortum 
examinations. A wide range of laboratory tests have been conducted to date 
but no agent has been definitively identified. Laboratory investigations 
are continuing.

International Response

WHO is assisting affected countries in responding to the various outbreaks. 
Extensive epidemiological and clinical investigation are ongoing in all 
affected countries.

WHO/ Global Outbreak Alert and Response Network team of epidemiologists, 
case management, infection control experts and laboratory experts is 
assisting the Vietnamese health authorities. The following organisations 
are contributing personnel and materials to the Hanoi team:

Centers for Disease Control and Prevention, Atlanta, United States
Centre of International Health, Australia
Epicentre
Institut National de Veille Sanitaire, France
Institut Pasteur, France and Viet Nam
Médecins Sans Frontières
National Health Service, Department of Health, United Kingdom
Robert Koch Institute, Germany
Central Field Epidemiology Group Smittskyddsinstitutet (SMI), Sweden
Bilateral assistance has also been mobilised from France and Japan. WHO is 
providing epidemiological support to health authorities in Hong Kong.

Travel Advice

There is presently no recommendations to restrict travel to any 
destination. However, guidance has been issued by WHO and is available. 
World Health Organization issues emergency travel advisory

Further Information

Throughout this outbreak, WHO plans to update its web site on a daily basis.

***************
[5]

Date: 16 Mar 2003
From: ProMED-mail 
Source:  ABC News [edited]



The illness, which carries flu-like symptoms, has killed 9 people, 7 in 
Asia and 2 in North America. Its rapid spread in southeast Asia in recent 
weeks caused a rare worldwide health alert to be issued on Saturday.

Health officials say it may be several more days before they are able to 
identify the disease. However, they said several of its features suggest it 
is caused by a virus, which can often be difficult to pinpoint quickly 
using standard lab tests.

"Certainly influenza is on the minds of many people," said Dr. David 
Heymann, communicable diseases chief for the World Health Organization.

Lab tests have ruled out some varieties of flu as well as some viruses that 
cause hemorrhagic fever. However, many other possibilities remain, Heymann 
said.

Those include "a new strain of influenza" or such exotic diseases as the 
closely related Hendra and Nipah viruses both newly recognized, causing 
flu-like symptoms and capable of being spread from animals to people.

Experts discounted the possibility that terrorism is the source and believe 
it almost certainly is a contagious infection that spreads most easily from 
victims to their doctors, nurses and families through coughing, sneezing 
and other contact with nasal fluids.  "Nothing about that pattern suggests 
bioterrorism," said Dr. Julie Gerberding, head of the U.S. Centers for 
Disease Control and Prevention in Atlanta.

Officials said they are encouraged that some recent victims seem to be 
recovering, although they are unsure whether that is because of the many 
antibiotic and antiviral drugs they have been given or simply the natural 
course of the disease.  Heymann said 3 or 4 patients had stabilized enough 
to be moved out of intensive care Sunday in Hanoi, Vietnam, although all 
still had breathing problems.

The illness is being called "severe acute respiratory syndrome," or SARS. 
The incubation period appears to be 3 to 7 days. It often begins with a 
high fever and other flu-like symptoms, such as headache and sore throat. 
Victims typically develop coughs, pneumonia, shortness of breath and other 
breathing difficulties. Death results from respiratory failure.

The WHO estimates that perhaps 500 people in all have been sickened if an 
earlier outbreak that peaked last month in Guangdong province in China 
turns out to be part of the same disease, as they suspect it is.

Ninety percent of the most recent cases have been in health care workers.

The CDC prepared cards that were being given to travelers arriving from 
Hanoi, Hong Kong or Guangdong province in China, warning they may have been 
exposed. It recommended they see a doctor if they get a fever accompanied 
by a cough or difficulty breathing over the next week.

Investigators suspect a virus is involved, because victims do not seem to 
respond well to standard antibiotics, which kill only bacteria, and because 
their white blood counts drop. That typically happens with viral infections 
but not bacterial ones.

Tests so far have ruled out the H5N1 bird flu, which has popped up 
occasionally in China [see ProMED-mail posting below] and which many fear 
could be catastrophic if it spread widely among humans.

No cases have been confirmed in the United States, but Gerberding said the 
CDC is checking out a few calls. The North American fatalities were a woman 
and her son who died in Toronto after visiting Hong Kong.

A 32-year-old physician from Singapore suspected of having the disease was 
taken off an airliner during a stopover in Frankfurt, Germany, on Saturday 
after being in New York City for a medical conference. He was held in 
quarantine, along with his mother, who had a fever, and his wife, who 
remained healthy.  However, on Sunday, the man's physician, Dr. 
Hanns-Reinhardt Brodt, said he was uncertain the case was SARS; he was 
treating him for ordinary pneumonia.

Also on Sunday, the WHO released a report from the China Ministry of Health 
on the Guangdong outbreak, which said "the epidemic situation has been 
controlled and the patients are being cured one by one."

In that outbreak, the Chinese said, most victims were young adults, and the 
disease apparently was spread similarly to SARS. The outbreak peaked 
between 3 Feb 2003 and 14 Feb 2003 in Guangzhou City and has since 
decreased markedly.

The Chinese said 7 percent of patients required breathing tubes, but most 
eventually got better, especially if they were not also infected with 
bacteria. The disease seemed to weaken as it passed from person to person.

******
[6]

Date: 16 Mar 2003
From: ProMED-mail 
Source:  AP [edited]

A Slovene woman might suffers from atypical pneumonia
-----------------
LJUBLJANA, Slovenia (AP) - A Slovene woman, who came from Vietnam 10 days 
ago, could suffer from a mysterious form of pneumonia that hit parts of 
Asia recently, but her state is relatively good, the health minister, Dusan 
Keber, said late Sunday.

Keber told national television that the woman, who came on a flight via 
Paris, had "symptoms similar to those found in the cases recorded so far" 
of the mystery disease that has claimed at least 9 lives so far. "There is 
a high probability" that she suffers from the atypical pneumonia that has 
sickened 150 people and caused four deaths in recent days, mainly in China, 
Hong Kong, Singapore and Vietnam, Keber said.

Lab tests carried out on the unidentified woman "ruled out all other known 
forms of pneumonia," Keber said. She was put under quarantine within the 
Ljubljana clinic. People who were in contact with her are under medical 
observation and were advised to stay home, Keber said.  Asked about the 
woman's health, Keber said she was "relatively fine."

This weekend, a 32-doctor was quarantined at a Frankfurt hospital and is 
believed to be the first in Europe to be afflicted with the disease. If 
confirmed, the Slovene woman would be the second case in Europe.

Known as acute respiratory syndrome, the disease has been declared a 
"worldwide health threat" in a rare emergency warning by the World Health 
Organization.

Experts are unsure if the cases are caused by bacteria or a virus and also 
don't know whether any or all were caused by the same strain of disease. 
Patients deteriorate quickly after initially coming down with simple 
flu-like symptoms, doctors say.

Keber said doctors will keep examining the woman and a crisis headquarters 
has been set up at the clinic.

-- 
ProMED-mail


[ProMED-mail would like to thank Pablo Nart ,  Joe Shea 
, Rashid Chotani  for submitting 
information on this unfolding outbreak.

The etiology of this outbreaks remains unknown.  As information becomes 
available, ProMED-mail will post the information.  As mentioned in 
yesterday's posting, we are trying to synthesize all information currently 
available, and are attempting to avoid dissemination of rumors and 
unfounded speculations, yet at the same time keep our readers informed on 
current lines of thought.

In the above reports we have included official reports from 
Ministries/Departments of Health, the WHO and 2 newswire reports of newly 
suspected cases - one in Slovenia (reported by the Minister of Health) and 
another case in Ontario Canada with a history of contact with the original 
cases.  Again as mentioned yesterday, we are in the early stages of 
investigation of this outbreak of SARS, and therefore the numbers of 
suspected cases will vary from report to report, with case numbers both 
increasing and decreasing, especially as we are still in the influenza 
season in the Northern Hemisphere so that febrile respiratory illness is 
not an uncommon event.  An example of this fluctuation is the now ruled out 
report of a suspected case in Indonesia (see report [3] Worldwide update - 
WHO).

We are very curious to learn more about the outbreak in Guangdong China as 
information becomes available.  ProMED-mail covered this outbreak in 
February 2003 (see references below).  The etiology of the outbreak in 
Guangdong was not definitively identified, as only 2 of the serious cases 
were reported to have had _chlamydia pneumoniae_ isolated as the 
presumptive diagnosis for their unusual respiratory illness. If that 
outbreak is shown to be related to this current outbreak of SARS, the 
information in the newswire mentioning that 7 percent of cases (it is 
unclear if the 7 percent is of all hospitalized cases or all cases) had 
respiratory distress severe enough to require artificial ventilation is 
somewhat more comforting than current speculations on SARS.  The additional 
curiosity is the last statement in the newswire "The disease seemed to 
weaken as it passed from person to person."  Might this suggest that humans 
are not the natural host of this organism and attenuation of the organism 
occurs with successive passage in humans???? (at the risk of an unfounded 
speculation....)  - Mod.MPP]

[see also:
Severe acute respiratory syndrome - Worldwide (02):alert 20030315.0649
Severe Acute Respiratory Syndrome - Worldwide 20030315.0637
Acute respiratory syndrome - Canada (Ontario) 20030314.0631
Acute respiratory syndrome - East Asia 20030314.0630
Acute respiratory syndrome - China (HK), VietNam (03) 20030313.0624
Acute respiratory syndrome - China (HK), VietNam (02)20030313.0623
Acute respiratory syndrome - China (HK), VietNam 20030312.0602,
Undiagnosed illness - Vietnam (Hanoi): RFI 20030311.0595
Influenza, H5N1 human case - China (Hong Kong) (05) 20030228.0500
Pneumonia - China (Guangdong) (07) 20030221.0452
Pneumonia - China (Guangdong) (02) 20030211.0369
Pneumonia - China (Guangdong) (03) 20030214.0390
Pneumonia - China (Guangdong) (04) 20030219.0427
Pneumonia - China (Guangdong) (05) 20030220.0446
Pneumonia - China (Guangdong) (06) 20030220.0447
Pneumonia - China (Guangdong): RFI 20030210.0357]
............................. jw/mpp


*##########################################################*
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are  posted,  but  the  accuracy  and  completeness  of  the
information,   and  of  any  statements  or  opinions  based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by  ProMED-mail.   ISID
and  its  associated  service  providers  shall not be  held
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or archived material.
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Since the area is a bad place to be, some attention should be paid to the fact that American veterans, veterans children and widows have been travelling there (and perhaps still are) by arrangement of these folks:

 

SONS AND DAUGHTERS IN TOUCH
“They Were Our Fathers…”
P.O. Box 1596, Arlington, VA, 800-894-9994, www.sdit.org

MEDIA ALERT

For Immediate Release

What: Press Conference
Date: Saturday, March 1, 2003
Time: 2:00 PM PST
Location: Bob Hope Hollywood USO Center, 203 World Way, LA Int'l Airport
(LAX arrival level, between terminals 1 & 2; adjacent parking)
 

Contacts:
United States:
Mokie Porter, 800-882-1316, mporter@vva.org
Karen Frost, 512-423-2406, kfrost@frostmedia.com
Vietnam:
Mokie Porter, Rex Hotel, Ho Chi Mihn City
Phone: 011-84-8-829-2185
Fax: 011-84-8-829-6536
Cell Phone: 011-84-918-451-886, VN 0918-451-886
Los Angeles:
Sons and Daughters In Touch, 310-938-1264

 
 
(Los Angeles, CA) Sons and Daughters In Touch, the national support organization representing the grown children of American servicemen lost during the Vietnam War takes 80 of its members to Vietnam to trace the final footsteps their fathers left a generation ago.

Vietnam 2003: In Honor, Peace and Understanding

As such, SDIT will visit Vietnam to: Honor their fathers and all who served in the war; to seek a measure of inner Peace through better comprehension their life-changing loss; and to gain a better Understanding of the people and country where their fathers fought and died.

The fathers of these "sons and daughters" were servicemen from each branch of the US Military who fought in every campaign during the Vietnam War.  Today, these "sons and daughters" are in their 30's and 40's, they are fathers and mothers with families of their own. Those leaving for Vietnam come from 24 different states and the District of Columbia.

Beginning March 2, the trip will include visits to many of the sites that played significant roles in America's longest war: Ho Chi Minh City (Saigon), Hue, Da Nang, China Beach, Khe Sanh, Bien Hoa, the Mekong Delta and Hanoi. While in Vietnam, the delegation will break into nine teams to visit different regions of the country and provide each son and daughter an emotional visit to the location where their fathers died.

For ten years, this organization has helped its members confront their loss and realize that they are not alone in that struggle. "Now we have the chance to help them see, touch and experience the land where our fathers died," said SDIT founder Tony Cordero of San Pedro, CA, one of five children of Air Force Major William E. Cordero (KIA 1965).
" I'm not seeking closure. Grief is a journey that has a beginning but never any end. At least not in this life", said Karen Spears-Zacharias of Pendleton, OR daughter of Army SSG David Spears (KIA 1966). 

In its efforts to generate the funding necessary to stage this historic trip, SDIT received major support from Vietnam Veterans of America, Associates of Vietnam Veterans of America, VietNow and the Vietnam Veterans Memorial Fund. An untold number of individuals, many of whom fought alongside these fallen fathers, also contributed to the cause.

For 13 years, SDIT has worked to locate, unite and provide support to the now-grown children of US Servicemen lost in the Vietnam War.In that time, more than 3,000 members have been able to contact veterans who served with their fathers, visit the Vietnam Veterans Memorial, share their life experiences with others and take pride in knowing that the loss of their father was not in vain.

###

This announcement took place on
Saturday, May 26, 2001 on the East Knoll --
adjacent to the Vietnam Veterans Memorial in Washington, D.C.
Adrian Cronauer- Vietnam Veteran "Good Morning Vietnam",
along with leaders of the Vietnam Veterans community were
on hand to support the cause.


For Immediate Release 
For more information: 
                    800-984-9994

SONS AND DAUGHTERS IN TOUCH
“They Were Our Fathers…”

SDIT ANNOUNCES PLANS TO TAKE ITS MEMBERS TO VIETNAM

The largest trip of its kind will give members a chance to
retrace their father’s final footsteps.

WASHINGTON, D.C., May 26, 2001 – Sons and Daughters In Touch, the national organization representing children of American servicemen lost during the Vietnam War, will take its members to Vietnam to retrace the final footsteps their fathers left a generation ago.  Scheduled for the spring of 2003, the trip will include visits to many of the sites that played significant roles in the war: Ho Chi Minh City (Saigon), Bien Hoa, Hue, Da Nang, China Beach, the DMZ, the central highlands, and Hanoi.

“I can’t think of a better time for SDIT and its members to visit Vietnam.  For ten years, this organization has helped its members confront their loss and realize that they are not alone in that struggle.  Now we have the chance to help them touch, see and feel the land where their fathers died,” said SDIT founder Tony Cordero, son of Air Force Major Bill Cordero (KIA 1965).

SDIT anticipates that as many as 200 of its members will make the two-week trip, making it the largest visit of its kind to the country where America fought its longest war.   Interested veterans and other family members will only add to the size of the travel group. With so many SDIT members hoping to visit the actual site where their fathers died, travel planners will arrange for smaller groups to make side visits to these remote battlefields and villages.

To offset many of the planning costs, and to make the trip affordable for its members, SDIT will launch a fund-raising campaign to generate up to $500,000.  The group will look to supportive veterans organizations, corporations, and other individuals for assistance in reaching this goal.

“Two years ago, I was able to visit Vietnam and to make personal contact with my dad.  I couldn’t have done it without the help of some very supportive Vietnam veterans,” said Michelle Baugh, of Centralia, IL, daughter of Army SP4 Richard Githens (KIA 1968). 

With the tremendous support of America’s veterans, SDIT has hosted four major Fathers’ Day ceremonies at the Vietnam Veterans Memorial in Washington, DC.  For many of the attendees, those events provided the initial opportunity to see their father’s name inscribed on the memorial and to meet others who lost their father during the Vietnam War.

Interested participants and contributors can complete information forms at the SDIT web site: www.sdit.org or can call 800-984-9994.

Sons and Daughters In Touch is a fully accredited non-profit 501(c)3 organization that has been meeting the needs of its members since 1990.  SDIT members are the children of men who served at nearly every rank -- in every branch -- of the US military.  Today, these children are testaments to the sacrifice of their fathers.  They have become parents, priests, professional athletes, business-professionals and more. 

###

Photos of the Press Conference



CLICK ONE
The Vision
 
Itinerary
 
Why Should I Go?
How Can I Help?
Press Release
I am interested

Updates- Click Here

Please Come Again Soon

www.SDIT.org
 

One last note: it appears that one of the "agents" for these tours is a political critter with background from Ted Kennedy's staff as well as from "Habitat for Humanity".

60 posted on 03/17/2003 1:17:37 PM PST by Cachelot (~ In waters near you ~)
[ Post Reply | Private Reply | To 35 | View Replies]


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