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Biotech / Medical : SARS and Avian Flu -- Ignore unavailable to you. Want to Upgrade?

To: Biomaven who wrote (739)	5/7/2003 8:12:07 AM
From: Condor	Respond to of 4232

Hong Kong's SARS Death Rate Estimated (AP News) By EMMA ROSS 05/07/2003 06:29:43 EST The first major study of SARS trends estimates that about 20 percent of the people hospitalized with the disease in Hong Kong are dying from it, and that more than half of those over 60 die. The findings are similar to earlier, cruder estimates for Hong Kong, one of the areas hardest-hit by SARS. However, experts warn that the figures do not reflect the chances of an average person anywhere dying from a bout of SARS once it is contracted. The average age of the SARS patients in the study - those hospitalized in Hong Kong - is 50, and disease experts generally agree that the virus is much more deadly in people over 60. Nearly 200 of the more than 1,600 people believed to have the respiratory disease in Hong Kong have died. Led by Roy Anderson, regarded as one of the world's leading infectious disease experts, the new research is the latest in a weekslong debate about the true death rate for SARS. The rate has risen sharply from below 5 percent in the weeks that SARS was first spreading around the globe. Worldwide, the World Health Organization, which is leading the effort to stop SARS' spread, says the death rate ranges from 6 percent to 10 percent, depending on location. The U.S. Centers for Disease Control and Prevention puts the rate at 6.6 percent. One WHO official noted that the death rate is lower in places where the outbreak has ended or is nearing an end. "We know that in a real situation where the outbreak has completed itself from beginning to end - in Hanoi, Vietnam - they had an 8 percent case fatality rate," said WHO spokesman Dick Thompson. And in Canada, where patients have been older, the death rate is 15 percent, he said. "What we do see is that in people under 40 the death rate is generally lower and in people over 60 the numbers are much higher," Thompson said. The Lancet study, conducted by scientists at Imperial College in London, the University of Hong Kong and the Hong Kong health authorities, estimated that the death rate could be as high as 55 percent in people over the age of 60. In younger people - those under 60 - the death rate could be as low as 6.8 percent, the study found. "That's sadly still very high for a respiratory infection," said Anderson, a professor of infectious disease epidemiology at London's Imperial College. "In other common respiratory infections it is much less than 1 percent in the vulnerable elderly." The former head of the U.S. Centers for Disease Control and Prevention said quibbling over the death rate "really doesn't matter one whit." "It's a serious illness, whether it's 5 percent or 25 percent," said Dr. Jeffrey Koplan, now vice president of academic health affairs at Emory University in Atlanta. "It's much higher than a cold or influenza or most other infectious diseases that we commonly encounter." Officials with the CDC and WHO would not comment immediately on the new research. Calculating the death rate has been a sore point for the world's epidemiologists. Two methods dominate among scientists: The method used by the WHO and CDC is to divide the total number of deaths by the total number of SARS cases. The second approach involves dividing the deaths by the total of those recovered plus those who died. Anderson said both those methods are deeply flawed and underestimate the death rate because they ignore the fate of people who are still ill. His method involves sophisticated mathematical calculations to estimate how many of those who are ill will eventually die. He acknowledged his method still has the drawback of not knowing how many people are infected with SARS but do not get sick enough for the infection to be noticed. "This is the death rate based on those who have been admitted to hospital, and they tend to be the more severe end of the cases," Anderson said. The Lancet study, based on 1,425 SARS cases in Hong Kong up to April 28, also found that the maximum incubation period - the time it takes between getting infected and becoming ill - may be as long as 14 days. Quarantine measures have been based on a maximum incubation period of 10 days. If the incubation period is truly longer than 10 days, people who are being quarantined because they have been in close contact with a SARS patient may not be in isolation long enough. "The article does raise the caution that maybe we need to move the curve out a little bit by four days and that's well worth further study," Koplan said. WHO said it is possible that the incubation period could be longer than 10 days because the U.N. agency calculates it starting from the last day a person was exposed to SARS. ___ On the Net: World Health Organization: who.int Centers for Disease Control and Prevention:http://www.who.int/csr/sars/en/ cdc.gov

To: Biomaven who wrote (739)	5/7/2003 8:14:16 AM
From: Condor	Respond to of 4232

WHO Team Goes to Chinese Area Hit by SARS By WILLIAM FOREMAN 05/07/2003 05:53:07 EST World Health Organization experts were being sent to a crowded province in China where SARS is spreading fast, while new research published Wednesday suggests the illness is much more deadly than other respiratory diseases. As the global death toll from SARS approached 500, Russia considered imposing harsh restrictions along its border with China, where experts say the disease has yet to peak. Chinese officials arrested alleged Internet rumor mongers and revoked the licenses of doctors who refused to treat the infection. In Washington, U.S. Secretary of Health and Human Services Tommy Thompson said China and the United States would work closer on SARS, although a senior Chinese official was noncommittal about providing U.S. scientists with specimens from patients. The U.S. government has authorized immigration and customs inspectors at U.S. airports to use force to detain passengers who appear to have SARS symptoms, The New York Times reported Wednesday. None had been detained so far, it said. New findings in The Lancet medical journal show that SARS is killing one in five of patients hospitalized with the virus in hard-hit Hong Kong, including 55 percent of infected patients aged over 60. In younger patients, the death rate could be as low as 6.8 percent, the study found. "That's sadly still very high for a respiratory infection," said Roy Anderson, the epidemiologist at London's Imperial College who headed the study. "In other common respiratory infections it is much less than 1 percent in the vulnerable elderly." The research, which also involved the University of Hong Kong and Hong Kong health authorities - is the first major study of SARS trends but was based only on data from Hong Kong, where at least 203 people have died. Scientists differ over what the chances are for an average person anywhere dying from it. Worldwide, the U.S. Centers for Disease Control and Prevention puts the death rate at 6.6 percent. The World Health Organization says it ranges from 6 percent to 10 percent. WHO said it will deploy an investigative team on Thursday to the densely populated northern province of Hebei, where the number of SARS infections has "risen sharply" in the past week, doubling to 98 between April 30 and May 4. At least 497 people have died around the world, with 11 new fatalities in Hong Kong, five in China and two in Taiwan reported on Wednesday. More than 6,800 have been infected since the disease surfaced in China's southern province of Guangdong in November. China has had 219 SARS deaths, about half of them in Beijing. Chinese police said Wednesday that pets owned by quarantined people must be isolated or put to death for fear that the animals may carry the disease. In the eastern city of Nanjing, where about 10,000 people are under quarantine, dogs are banned from streets, parks and other public places, authorities said. In northeastern Liaoning province, authorities revoked the licenses of two doctors, one for refusing to see patients with fevers and the other for refusing to attend meetings on SARS prevention, Xinhua said. Another doctor lost her job in the southwestern province of Sichuan when she refused to work with suspected SARS patients, the agency said. In Beijing, four people have been charged with "causing public panic" by spreading SARS rumors on the Internet and through mobile phone messages, the official Xinhua News Agency said. Around the world, countries were trying to find ways to keep SARS away from their borders. Organizers of the Miss Universe pageant said contestants - especially those from countries most affected by SARS - must produce health certificates before they can participate in the contest, scheduled for June 3 in Panama City. In Australia, models visiting from Hong Kong wore decorated surgical masks on the catwalk at a Sydney fashion show. In Europe, health ministers agreed to spend an extra $23 million on research, including the development of a SARS vaccine. But they failed to agree on SARS screening at European airports, fearing such measures would be too heavy-handed. Russia's top health official recommended restrictions on the Russian-Chinese border. "Only Chinese citizens should be allowed to leave and only Russian citizens should be let in," Gennady Onishchenko told Echo of Moscow radio, in remarks shown on Russian television. "This process has been working: no SARS has been brought in," he said. Onishchenko said that he might raise the issue of fully closing Russia's border with China,although this would hurt trade. In the United States, Health Secretary Thompson said Chinese Vice Premier and Health Minister Wu Yi agreed to cooperate in training and lab development while more U.S. health advisers would be put on the ground in China. Thompson said that in a telephone call Monday night, Wu was noncommittal when asked if China would give U.S. experts specimens from Chinese patients at various stages of infection.