Scary.Airlines to screen travelers for SARS
Illness spreading
more quickly than thought, officials say
A security guard wearing a respirator mask stands Wednesday outside the emergency ward entrance at the Scarborough Hospital in Toronto, which has been closed due to the SARS outbreak.
NBC, MSNBC AND NEWS SERVICES
March 27 — According to U.S. and United Nations health officials, the mysterious respiratory illness plaguing southeast Asia has begun spreading around the world at an alarming rate, NBC News’ Robert Bazell reported Thursday. As more cases were announced, The World Health Organization called on airlines to begin screening passengers for the deadly flu-like disease. Meanwhile, Hong Kong said it would quarantine more than 1,000 people and the Canadian province of Ontario declared a health emergency.
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TESTIFYING BEFORE Congress Thursday about the outbreak of severe acute respiratory syndrome, or SARS, Health and Human Services Secretary Tommy Thompson said, “It’s spreading a little bit faster than we anticipated.”
He said SARS is believed to have infected 1,500 people; the WHO is reporting over 1,300 cases. The number of deaths Thursday rose to 54, based on information from government officials.
NEW SCREENING GUIDELINES
The WHO ordered all airlines with international flights leaving affected areas - Toronto, Hong Kong, Singapore, Hanoi, Taiwan and Guangdong province, China — to begin screening passengers. All passengers should be asked if they have flu-like symptoms or if they may have had contact with anyone infected with SARS. Anyone answering yes should not be permitted to fly, said WHO officials.
The new warning about airline travel reflects heightened concern by the world health agency after Hong Kong reported that nine passengers became ill from exposure to one passenger on a flight earlier this month. The agency previously had said the disease was unlikely to spread on airplanes.
The WHO’s screening guidelines will be issued to world governments, and it will be up to them to decide whether to enforce it with their airlines.
WHO officials said close contact in a plane — which they described as sitting within two rows of an infected person — was compounded by the length of flights.
“Exposure in a plane is much longer than, say, in an elevator,” said the WHO’s infectious diseases chief, Dr. David Heymann.
There is currently no treatment for the disease, which is believed to be caused by a virus.
WashPost: SARS spread on plane?
CASES ON RISE IN U.S.
The CDC reported it was monitoring 51 suspected cases of SARS in 21 U.S. states.
“So far, happily, there have been no deaths attributed to SARS in patients in the United States,” Dr. Jim Hughes, head of the CDC’s infectious disease branch, told reporters.
Hughes said 44 of the U.S. cases involved people who had traveled to Vietnam, China or elsewhere in Southeast Asia.
“Five cases are in people who have had contact with people who were ill with SARS and there are two health-care workers who are ill as a result of caring for one patient,” he said.
Although the disease has been characterized by pneumonia, Hughes said many of the U.S. patients have had no evidence of pneumonia — defined as an infection of the lung tissue. SARS is characterized by a high fever, cough and respiratory symptoms, which could involve the bronchial passages, the lung tissue or both.
Only one U.S. patient has become so ill as to require help breathing with a respirator, Hughes said.
‘WE MUST WIN THIS BATTLE’
In Canada, health authorities in Ontario, the nation’s most populous province, have advised hundreds of people to quarantine themselves to try to stop the spread of the illness. The move is part of a health emergency declared Wednesday in Ontario due to an outbreak of SARS that has killed three people there and sickened dozens of others.
Meanwhile, Asian officials continued to take stringent measures to control the spread of the disease. Those steps came a day after mainland China disclosed a sharply higher death toll for the flu-like illness, spreading fears of a wider outbreak.
Hong Kong’s government leader, Chief Executive Tung Chee-hwa, said Thursday night that officials had ordered the quarantine of 1,080 people believed to have been in close contact with SARS victims. They are being urged to stay home and must check in regularly with health officials over a 10-day period starting Monday or they could be fined or jailed.
Tung said Hong Kong schools, except for universities, will shut down early for spring break, closing from Saturday to April 6 as a precaution.
“For the sake of our health and for the sake of the health in our community, we must win this battle,” Tung told a news conference.
A teacher washes toy blocks with disinfectant at a child-care center in Singapore on Thursday, a day after the government announced it would shut all schools until April 6 to contain a mystery illness.
The quarantine affects those who have visited SARS victims in hospitals or people who recently spent time on the ninth floor of Hong Kong’s Metropole Hotel, where an infected mainland Chinese medical professor passed the disease to seven other people and started a global outbreak.
Thousands of Hong Kong residents wore surgical masks while going about town, giving this vibrant city the feel of a sprawling hospital ward. The Health Department recommended masks only for people with flu-like symptoms so they won’t infect others.
“If people feel more safe wearing a mask, it is up to them to decide,” Hong Kong Health Department spokeswoman Sally Kong said.
The Rolling Stones postponed a pair of weekend rock concerts in Hong Kong due to disease fears, and three rugby teams - France, Italy and Argentina - pulled out of a weekend tournament in the former British colony.
The Taiwanese capital of Taipei declared a full medical alert Thursday after a major engineering company temporarily closed because five of its employees were suspected of being infected. They had recently traveled to mainland China.
Singapore, which has suffered two deaths, has already quarantined 840 people and on Thursday shut all of its schools through April 6.
- select a question -What are the symptoms?How does the illness spread?What causes it?How is SARS treated?How deadly is SARS?Is it safe to travel?Where have SARS cases been reported?What if I have SARS symptoms?
World health experts are trying to identify the cause of severe acute respiratory syndrome, or SARS, a new form of deadly pneumonia that is spreading rapidly through Southeast Asia and other parts of the world. For more information about the illness, click on a question above.
Most patients start out with a fever greater than 100.4 ° F (38° C) and often have accompanying chills, headache, malaise, body aches and mild respiratory symptoms. In the early stage, many patients have a decreased white blood cell count and may also have diarrhea. After 3 to 7 days, the patient may develop a dry, non-productive cough that increases in severity. As the disease progresses, chest x-rays may show significant congestion in the lungs. Eventually not enough oxygen can get to the blood and, in 10 to 20 percent of cases, patients will require mechanical ventilation. The severity of illness among patients is highly variable, ranging from mild symptoms to death. Only patients who have traveled within 10 days of the onset of symptoms to an area with suspected SARS cases, or have had contact with a person suspected of having SARS, are considered possible carriers of the disease.
SARS appears to spread through close contact, such as between family members or between patient and doctor. Experts believe it is transmitted through coughing, sneezing and other contact with nasal fluids. Researchers are also looking into the possibility that it is spread through the air, but this has not yet been confirmed. Once someone has been exposed to the illness, it takes three to seven days for symptoms to develop.
Researchers are not yet certain what pathogen is behind the illness. CDC scientists recently said the disease may be caused by a new form of the coronavirus, one of a few viruses that can cause the common cold. Other researchers have found signs of another germ family, the paramyxovirus, which causes measles, mumps and other diseases. SARS may be caused by one of those two viruses or it’s possible they are working together.
Patients suspected of having the illness are being quarantined in hospitals. Until health officials learn its cause, there is no definite course of treatment. Some doctors have reported that patients respond well to treatment with antiviral medications and steroids.
The fatality rate among persons with SARS is approximately 3 percent, according to the World Health Organization.
The CDC says travelers should consider postponing trips to countries at risk, including Hong Kong and China. In addition, the U.S. State Department has warned citizens not to travel to Vietnam because the country lacks medical facilities to deal with the outbreak there. The CDC has begun handing out notices to travelers returning from Hong Kong, China and Vietnam warning them to be on the lookout for symptoms of SARS. Americans living abroad are urged to avoid activities, such as visits to hospitals, that might bring them into contact with people who have SARS. Airline crew members are asked to be on the lookout for sick passengers and quickly isolate them from other passengers if possible.
Suspected cases of SARS have been reported in China, Hong Kong, Taiwan, Singapore, Thailand, Vietnam, Canada, United States, France, Germany, Switzerland, Italy, Britain and Ireland. So far China, Hong Kong, Vietnam, Singapore and Canada are the only countries with reported deaths from the illness.
In the United States, people who think they may have SARS and have recently traveled to Asia, or have been in contact with someone who has, should contact their doctor for a full evaluation. Health workers who suspect cases of SARS are asked to report them to their state health departments. The CDC requests that reports of suspected cases from state health departments, international airlines, cruise ships, or cargo carriers be directed to the SARS Investigative Team at the CDC Emergency Operations Center (770-488-7100). Outside the United States, health workers who suspect cases of SARS are requested to report them to their local public health authorities.
Source: World Health Organization; U.S. Centers for Disease Control and Prevention; Associated Press
Printable version
CHINA REVEALS LARGER OUTBREAK
WHO officials now suspect the epidemic in southern China is far larger than the Chinese government has let on, but the Chinese government is still refusing to cooperate with WHO requests to send in research teams, Bazell reported.
Chinese authorities revealed Wednesday that 34 people in the mainland had died from SARS, including 31 in Guangdong province, where officials had previously acknowledged just 305 infections and five deaths. China said almost 800 people had been infected.
WHO doctors said Wednesday for the first time that they were treating the Guangdong cases as part of the wider SARS outbreak.
China made its latest disclosures on the disease - with three deaths also reported in Beijing - after coming under sharp international criticism and repeated requests by WHO to be more forthcoming in its cooperation and more diligent in tracking cases.
SARS CAUSE IDENTIFIED
Microbiologists from the University of Hong Kong said Thursday a new strain from the family of coronaviruses, which are the second-leading cause of colds in humans, was to blame for the illness.
The CDC, which had earlier identified the virus as a possible cause, said more tests were needed before a definite conclusion could be drawn.
“The evidence in favor of this illness being caused by a previously unrecognized virus in a group of viruses called coronaviruses continues to mount,” the CDC’s Hughes said. “I am not ready to say it is definitive evidence yet.”
But the CDC made up kits to allow the quick identification of the virus and sent them to labs around the world, which were able to confirm the finding, said Dr. Larry Anderson, a virus expert at the CDC.
Anderson said it is possible that at least some SARS patients have a second infection that causes the severe symptoms. He noted that some labs, mostly in Hong Kong and a Canadian lab checking patients infected via Hong Kong, found evidence of a virus called metapneumovirus. It is a member of a large family of viruses called paramyxoviruses, which include measles and a virus that endangers infants called respiratory syncytial virus.
Anderson said the CDC had asked U.S. Army researchers for help in treating the virus.
“We have sent the virus to the Department of Defense and they are testing it against different potential antiviral agents,” he said in a telephone interview.
Earlier reports suggested that ribavirin, a drug used to treat influenza and hepatitis, might helps some SARS patients.
The Associated Press and Reuters contributed to this report. |
