Cluster of Severe Acute Respiratory Syndrome Cases Among Protected Health Care Workers

Canada Communicable Disease Report ^ | May 15, 2003 | CCDR staff

[Judith Anne]

Wondering what it's like? Here's some information.

[Judith Anne]

This article is from May 15, 2003, but I'm hoping it's recent enough to post, because it contains a lot of information that we can find no where else--and I do mean a LOT.

It will greatly add to our FR knowledge base.

[Judith Anne]

Case history, and discussion of how HCWs got sick...very illuminating.

[xJones]

Soon after his arrival in the ICU, his measured oxygen saturation decreased to 60%, and he was placed on positive pressure ventilation through facemask (BiPAP). Because of severe cough and agitation, he removed the mask repeatedly despite administration of intravenous (IV) sedation. After an approximately 2-hour attempt to provide oxygen through BiPAP, the patient was intubated. During intubation, he had frothy secretions that later obstructed the ventilator tubing, requiring disconnection and drainage. Once supported with mechanical ventilation, the patient was sedated further by using IV midazolam/morphine sulfate.

His lungs were clogged and his was drowning in his own secretions. Shades of the Spanish influenza (1918-1919), although this is a new flu...

[aristeides]

I'm just now reading a book about the Congress of Vienna at the end of the Napoleonic Wars. Diplomats were already gathered at Vienna in the fall of 1814, before Napoleon's return to power and Waterloo. A lot of the diplomats came down with a severe flu in the fall of that year, while in Vienna. Similarly, many of the diplomats at the peace conference at Versailles in 1919 after WWI came down with the Spanish flu (and, in that case, some of them died.)

[CathyRyan]

And they say sars is hype and just a bad cold. I will book mark this and point them to it the next time one of those kown it alls post their crap.

[maica]

Thanks for this post. It is extremely informative. Death by drowning from a viral pneumonia is so horrible.

Maybe other doctors will now realize that infection control precautions really are valid and important.

I certainly hope that this article has been widely disseminated through the health care system in Canada and the US, at least in the areas where one would be likely to encounter a suspected SARS case!

[fuzzthatwuz]

Thank you for this timely and highly informative post. I am printing the report for my wife to share with her fellow E.R. staff members with a copy to the hospital training department.

[CobaltBlue]

Every time I read the story of the male nurse with the small beard feeling air on his face even though he was wearing a mask, I wonder how dense you have to be to wear a surgical mask over a beard.

I have never seen a surgeon or a scrub tech with a beard - I was a scrub tech for a while - you keep your nails cut very short so you can clean under them.

When I see male nurses with beards and female nurses with elaborate nail wraps, I question the sanity of the hospital administrators - unless they are working in a ward where there is no chance of spreading infection - the only one I can think of is mental health.

[CobaltBlue]

>>His lungs were clogged and his was drowning in his own secretions. <<

That's typical of severe pneumonia.

My 70 year old mother refused to go to the doctor for a chest infection until she was near death - I finally forced her to go and wish I had taken her sooner but she kept insisting she was getting better.

I was present when she was intubated - if you've never been intubated you have no idea how difficult it is - really they should spray the palate with anesthetic because you gag and that forces the tube back up - they tried for a long time and there was blood and sputum everywhere. It was horrible.

[Judith Anne]

You're welcome. Knowledge is empowering.

I would be extremely interested in any anecdotal response you and/or your wife have, after passing out the information...without identifying anyone, would you please post anything you can?

[Judith Anne]

It's very tough to watch, as a family member. I will never be intubated, I have it in my advance directive.

[Judith Anne]

I'd like it to be posted in every ER in the US. I'd like it to be sent to every doctor's office, read by everyone possible.

[xJones]

I am so sorry to hear of your mother's illness, and the intubation. That is horrible.

I don't understand about SARS; is this coronavirus some super-pneumonia and that's why it is so easily mis-diagnosed in the early stages?

[xJones]

Judith, I should also have directed my simple (but honest) question in #14 to you. Thanks in advance.

[xJones]

I just read your article click. Thanks, the more information, the better.

[Judith Anne]

I think the reason it's easy to miss is this: Fever is the only consistent reliable early symptom of SARS. A lot of times, the cough only comes after being sick for a week or better, and pneumonia doesn't show on an x-ray right away, either. There's no reliable test for SARS, and especially no reliable EARLY test for SARS. The best ones aren't positive for up to three weeks after somebody gets sick.

Hope that helps...

[Judith Anne]

Thanks. I hope that article helps to let people know what ERs and doctors are up against....

[riri]

A lot of times, the cough only comes after being sick for a week or better, and pneumonia doesn't show on an x-ray right away, either.

Yikes! My neighbor comes to mind. As of Thursday evening, he had a fever for 8 days, no cough.

I want to call over there and see how he is doing but I know she will know I am being nosey...

[Judith Anne]

Take a casserole, wear a mask...;-D