LATEST SARS UPDATE - DETAILED MEDICAL INFORMATION

ProMed ^ | 03-17-03 | WOlfgang Preiser

[MichaelDammit]

It gets worse....those bugs can do amazing things

[Mother Abigail]

In matters like this always consult your family doctor, for a number of reasons.

Hope it's not to Paris...LOL

[Future Useless Eater]

• He got on a plane in Singapore WITH A FEVER
• He arrived and went thru customs WITH A FEVER
• He was ALLOWED into this country WITH A FEVER

  What ever happened to the good-old Ellis Island days where we screened incoming foreigners and let in NOBODY who was sick?

  Entire families used to be turned away if just one family member was sick. That's how lots of Europeans ended up in South America.

  Now we waive everybody thru, give 'em free healthcare and move them to the TOP OF THE TRANSPLANT lists, just as long as they are foreigners.

[Axenolith]

1. Does not act like inf.

Isn't that nearly the exact manifestation of the 1918 strain? Early high fever, dry cough, extreme respiratory distress?

[Mother Abigail]

Yes the clinical symptoms are exact, however it is the transmission that is different.

If this were a typical influenza outbreak we would be knee deep in cases by now.

It appears that it takes some pretty serious contact to spread - that is a blessing, as bad as this bug is...

[bonesmccoy]

Yes, I agree. I posted that same observation two days ago.

Four corners like, isn't it?

[bonesmccoy]

Thanks for the ping.

I also agree with you. This does not seem to be spread by respiratory route. It would seem to be spread by contact.

Standard contact isolation appears to limit spread.

Germany's experience in the next four days will be interesting. Since the passengers on the flight were clearly exposed to the index case for their area, you can plot the seating and guess the amount of exposure.

Those sitting in front, behind, or adjacent to the man in question may be vulnerable.

On the other hand, the man's wife was not ill until today. So, the symptoms does appear to take a while to manifest.

[DAnconia55]

Hmmm.... what does that mean for someone like me? I never take flu shots (not in 20 years), because (Well until this year), I almost never get sick.

When people around me get sick, I recover quicker, and have less symptoms. (Again, except this year - which has been really odd.)...

Should I be taking flu shots?? Does it make me more vulnerable overall because I don't?

[birdwoman]

Flu shots don't have anything to do with SARS as flu shots are for certain KNOWN flu strains, I believe. Since SARS is unknown at this point, a flu shot will not help. (At least that is my understanding, please correct me if I am wrong, somebody, anybody)

[Mother Abigail]

Exxxactly,

The seating in the plane will give us a range of exposure

[lilsparky]

Wonder about the other attendees at the medical meeting? Where are they and what's their status?

[Mother Abigail]

Doug had an interesting observation in picking a Morbillivirus as a likely agent.

Hendra and Nipah are both zoonotic and it might well be a mutant of the Paramyxoviridae family. Symptoms are right.

Just because I have had tooooo much coffee, I will mention that both Hendra and Nipah have been given their own genus (Henipavirus).

Henipavirus becomes the fourth genus within the Paramyxovirinae subfamily of the Paramyxoviridae family. The other genera within the subfamily are Rubulavirus, Morbillivirus and Respirovirus.

So technically we might want to lay a few chips on a Henipavirus mutant. I believe the morbillivirus genus is largely measles virus only (not sure)

No more coffee!!!!!

[Mother Abigail]

Have not heard a word, but you can believe that they are getting a lot of very interesting phone calls.

[Mother Abigail]

Deadly virus might be in Illinois

SPRINGFIELD -- The state Health Department is investigating whether four Illinois residents have contracted a deadly flu-like illness that has spread across the globe, officials said Monday.

Four people in Illinois are suspected of having the illness -- two in MacLean County and two who live in the Chicago area, said health department spokeswoman Jena Welliever. All have recently traveled to Asia.

[birdwoman]

According to an interview with Mayor Bloomberg of NYC this morning (Monday), the doctor who was ill did not have much contact with the other conference attendees and did not stay in NYC very long. (only a couple of hours @ conference, I believe)

How much truth there is to that I do not know. But I did happen to catch that on the morning news as I was getting ready for work. (FNC - I beleive, but don't hold me to it as I tend to channel surf)

[Dr. Eckleburg]

There are 64 squares on a chessboard.

If the first square contains one grain of sand, and each successive square holds twice as many grains of sand as the one before it, by the end of the 64 squares, all the sand of the world's beaches would be on the chessboard.

Or so I've been told.

A disease that increases exponentially can be catastrophic if not cured quickly.

[Mother Abigail]

Don't panic - too much

Yesterday a Briton became the latest person to contract a deadly new disease that the WHO has branded 'a worldwide threat'.

Sally Weale reports

Tuesday March 18, 2003

The Guardian

The World Health Organisation is not a body noted for its hyperbole. So when it issued a stark warning last week about a new disease which it described as "a worldwide health threat", a shiver of fear ran through public-health authorities around the globe. The new disease, which has been given a new name - severe acute respiratory syndrome (SARS) - was spreading from continent to continent unhindered. Antibiotics appeared to be useless in the battle to contain the sickness, which was merrily winging its way on board the hundreds of international airliners criss-crossing the planet every hour.

It was a terrifying prospect, made no less alarming by the WHO's subsequent emergency travel advisory notice urging travellers to see their doctor if they developed symptoms, which include a high fever (38.6F), muscle aches, headache, sore throat, dry cough and shortness of breath.

Last night the deadly disease seemed to have landed in the UK. A man, who had travelled from Hong Kong to Manchester via Amsterdam on Saturday, was being held in isolation at the specialist infectious diseases unit at North Manchester General Hospital. According to Christine McNab, spokeswoman at the WHO, suspected cases, yet to be confirmed, were cropping up all over the world.

Panic is setting in. In Hong Kong, one of the key sites of the disease, everyone from taxi drivers to tourists is wearing masks in a desperate attempt to avoid infection. Passengers boarding aeroplanes are discreetly examined for symptoms and turned away if there are any suspicions. Some countries are spraying aircraft interiors with disinfectant and antiviral treatments to try to combat the disease.

Like ebola, CJD and Aids, SARS is frightening because it is incurable. So far, laboratories in five countries have failed to detect a cause. The prime minister of New Zealand, Helen Clark, raised panic levels even higher when she warned that SARS could be as deadly as the 1918 flu pandemic that killed up to 50 million people around the world.

So far, nine people have died from the condition, which is believed to be linked to an earlier outbreak in China last November. Many others, however, are critically ill with a severe, atypical pneumonia, and are breathing through respirators.
McNab admits that it is rare for the WHO to issue such alerts.

"There is a certain level of alarm out there," she says. "People are calling us wanting to know if they should travel. But to put it in perspective, we are looking at 500 cases globally on this, largely confined to three sites - Hong Kong, Vietnam and China. Of those countries, 90% of the cases have been in a hospital setting, with nurses and doctors treating those affected.

"The rest of the cases seem to be people in very close contact with affected people. That narrows the risk to the general population. The pattern of how this is moving does not indicate at this point that there is a widespread risk to the general population. The reason we issued the alert is because we have not been able to determine exactly what it is. What we want is to make travellers and airlines aware of the symptoms of this.

"The alert has greatly helped. We are getting a good picture overall of what's going on globally.

Surveillance is much more sensitive because people are aware. People should not panic. We have not issued any kind of travel restrictions. The number of cases is still relatively low. It's premature to equate it to any previous outbreaks or pandemics."
The New Zealand prime minister's warning may have been unnecessarily alarmist, but the WHO is in an ongoing state of high alert because of fears about a new flu pandemic. Public-health authorities around the world have been bracing themselves for a new strain of influenza, which is among the most infectious and deadly diseases known to man.

"Influenza is the big number-one virus that would spread around the world and cause mayhem," says John Oxford, professor of virology at the Queen Mary School of Medicine in London. "Influenza is very aggressive with a considerable punch. That's why we're all on tenterhooks. There hasn't been an outbreak for a while and we're expecting another one.

"As far as I can see at the moment, they've excluded influenza. No one is talking about influenza, so you move down the shopping list of micro-organisms, none of which is quite as bad as influenza. One is concerned about SARS, but not alarmed. There are no alarm bells ringing in my head."

The one factor worrying him, he says, is the age of people dying from the disease. Usually it is the elderly who are vulnerable to such illnesses, but in this case apparently healthy working people are falling victim and dying. X-rays of victims' lungs show pneumonia or respiratory-distress disorder; lab tests show low numbers of white blood cells and platelets.

[Mother Abigail]

Hong Kong reported 95 suspected cases, including one death;

--Singapore had 20 suspected cases and no deaths;

--Vietnam had 40 cases with one death;

--Canada had eight suspected cases, including two deaths; and

--Switzerland had two suspected cases, Thailand one case and Germany one case with no deaths so far.

Additional reports late Monday indicated two suspected SARS cases have turned up in Australia and one each in Indonesia, England and Israel.

The two Australians -- one in Ballarat and the other in Perth -- showed suspicious symptoms after returning from Asia recently.

Antara, the Indonesian national news agency, reported Health Minister Achmad Sujudi disclosed a citizen had been discovered with SARS.

[meadsjn]

Thanks for all the info.

One note on the range of exposure on an airliner: those results might not be reliable, if it is airborne, due to the recirculation of the cabin air. I don't know the current percentage of fresh air to old, but it might be that some passengers get a more direct blast from the outlets than others. Some might keep the air jets turned off the whole flight.

[texasbluebell]

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