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Health Officials Think Respiratory Illness Could Be Virus

Hong Kong doubles its victim numbers as toll in at least eight countries continues to mount.

MONDAY, March 17, 2003 (HealthDayNews) -- Health officials are still scrambling to determine the source of a deadly respiratory illness that has stricken hundreds and killed nine people in at least eight countries.

However, preliminary findings point to a virus.

The illness, called Severe Acute Respiratory Syndrome (SARS) and described as an "atypical pneumonia," does not fully respond to antibiotics and antiviral drugs. Its increasing toll of victims prompted a worldwide emergency travel alert and a U.S. health alert over the weekend.

Health officials now say several of its features suggest it is caused by a virus, the Associated Press reports. That can make it difficult to pinpoint quickly using standard lab tests.

The illness takes a few days to develop and often begins with a high fever and flu-like symptoms such as a headache and sore throat. Its victims develop coughs, pneumonia, shortness of breath and other breathing difficulties. Death results from respiratory failure, the AP says.

The dead include an American businessman in Hong Kong, a mother and son in Canada, and a nurse in Vietnam. Among the stricken are many hospital workers in southeast Asia and others who came in contact with some of the infected. And the toll keeps mounting:

On Monday, Hong Kong health officials doubled their estimates of victims to 83, with 12 other suspected cases, The New York Times reports. The newly confirmed cases include 37 in the Prince of Wales Hospital: 22 relatives of and visitors to infected patients, and 15 medical students, the paper said.

However, The Standard in Hong Kong reports that the hospital was treating 100 patients, 68 of them confirmed cases, according to a dean at the Chinese University. The dean, Sydney Chung, said 12 of the confirmed cases were in intensive care, including two who were on respirators.

It was not clear whether any of these cases were connected to the death March 6 of the still-unidentified American businessman. The man, based in Singapore, had apparently infected at least 37 hospital worker in Hanoi, where he was treated before being moved to Hong Kong. One of the Hanoi victims, a nurse, died Sunday.

Elsewhere in the world, there were these reports:

  • In Canada, a 10th case was reported Sunday. One of two suspected cases there is the doctor who treated infected family members of the two people who died, according to the Canadian Press.

    Canadian health authorities had announced Friday that Kwan Sui-chu died March 5 soon after returning from Hong Kong. Her son, Chi Kwai Tse, died on Thursday, and four other family members are hospitalized, the agency said.

  • In New York, city leaders said Sunday it was highly unlikely that a Singapore doctor, who is now hospitalized in Germany, passed on the infection to anyone during the two days he spent in the city, the Times reports.

    The 32-year-old doctor, who was not identified, was taken off a Singapore Airlines New York-to-Singapore flight during a stopover in Frankfurt Saturday. He had treated one of the earliest cases in Singapore, and had then flown to an infectious disease conference held at the Crowne Plaza Hotel in New York City, according to the Times.

  • In southeast Asia, Hanoi has reported at least 42 cases; Taipei reported three people hospitalized with flu-like symptoms; and Singapore's toll has jumped to 20.

    Singapore's Ministry of Health said Sunday that three Singapore residents who were in Hong Kong returned home ill and infected 10 family members and friends along with seven hospital workers who treated them, according to the Times.

  • And in China, health officials released a rare report Sunday on a similar outbreak in the Guangdong province that had stricken 300 and killed five people by mid-February.

    "The epidemic situation has been controlled and the patients are being cured one by one," the China Ministry of Health report said, noting that 7 percent of those stricken had required breathing tubes, but most eventually got better, the AP reports.

The World Health Organization (WHO) travel advisory, which was sent Saturday to all airlines, warned the illness was becoming "a worldwide health threat."

"Until we can get a grip on it, I don't see how it will slow down," WHO spokesman Dick Thompson said at the agency's headquarters in Geneva Saturday. "People are not responding to antibiotics or antivirals; it's a highly contagious disease, and it's moving around by jet. It's bad."

The U.S. Centers for Disease Control and Prevention (CDC) moved into emergency mode Saturday to alert health authorities at state and local levels. Among other things, the agency is issuing health alert cards to give to travelers returning from southeast Asia.

While no formal travel restrictions are in place, travelers may wish to postpone nonessential trips to the countries at risk, the CDC says.

Health officials are encouraged that some recent victims seem to be recovering, although they don't know whether that is because of treatment or the illness running its course.

Dr. David Heymann, communicable diseases chief for WHO, said three or four patients had stabilized enough to be moved out of intensive care Sunday in Hanoi, although all still had breathing problems, the AP reports.

WHO estimates that perhaps 500 people in all have been sickened if the China outbreak turns out to be part of the same disease.

WHO officials, who earlier this week issued their first global health alert in 10 years on the outbreaks, urged all countries to help.

The emergency travel advisory, while not calling for restrictions on travel, urged travelers who may have come in contact with an infected person to watch for such symptoms as high fever, coughing and shortness of breath. Health officials also urged people who suspect they may have the illness to seek medical attention and not travel until they recover.

More information

Updates on the respiratory illness and travel advisories can be found at the U.S. Centers for Disease Control and Prevention or the World Health Organization.

SOURCES: March 15, 2003, U.S. Centers for Disease Control and Prevention, news release; March 15, 2003, New York City Department of Health and Mental Hygiene, news release; The New York Times; The Associated Press; Canadian Press; The Standard
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