SARS scare

The growing fear of SARS, Severe Acute Respiratory Syndrome, throughout the world has made it necessary for the Centers for Disease Control and Prevention to advise American health care workers, students and citizens to be wary. The Associated Press and U.S.A. TODAY reported on April 8 that the director of the Centers for Disease Control and Prevention, Dr. Julie Gerbergding, was scheduled to speak on April 2 at the University of California at Berkeley about how prepared the national health system is for another terrorist attack. But instead, Gerberding’s presentation was dominated by concern regarding the mysterious disease Severe Acute Respiratory Syndrome, the contagious virus that has spread rapidly from Asia to the United States and Canada. Gerberding told the audience of students that for the first time a U.S. health care worker caring for a suspected SARS patient had come down with the disease, although she did not provide any further information about the stricken health care worker. Most of Gerberding’s information focused on what CDC health officials understand about SARS, which as of November 1 had infected 3, 293 people worldwide. The global death toll from infections reached 101 as of April 1. However, the disease is spreading at such a rapid pace that CDC officials have released an update of new victims over the past week, bringing the worldwide death toll to 159 as of April 16, 2003. The New York Times on April 11 reported that a Utah man teaching English in China died of severe acute respiratory syndrome on his way to a Hong Kong hospital on April 9, leaving a 6-year-old son who is now under observation at another Hong Kong hospital due to exhibiting flu-like symptoms. The man, James E. Salisbury, who was 52 of Orem, Utah, taught in China for about a year. He was first admitted to a hospital in his home city, Shenzhen, across the border from Hong Kong. After 10 days doctors confirmed that Salisbury was suffering from the virus that has exploded in one month and presently has claimed 159 deaths in 22 countries, according to the World Health Organization. Both Salisbury and his son Mickey were taken by ambulance for the three-hour ride to Hong Kong. Officials in North Carolina in a separate case said they believe a female health care worker in the state has contracted SARS. They reported she came into contact with a suspected SARS patient for 15 minutes before becoming sick herself. Ironically, unlike other U.S. victims, she had not traveled to Asia, where it is believed the mysterious disease originated. “We’ve seen it spread rapidly and dramatically to a number of countries,” James Huges of the Centers for Disease Control and Prevention said in a briefing Friday. “We’re not totally on top of this by any means.” Since the announcement of the outbreak in March, officials in Canada have been working ardently to contain the outbreak. Canada has been struck harder than any country outside of Asia. Thirteen people in Canada have died since the outbreak arrived in March, and over 5,000 people have been quarantined. Officials are tracking down anyone suspected who has been exposed. The government in Hong Kong and several governments overseas are setting 10 days as the interval for quarantines because most infected people fall ill during the 10-day period. The SARS outbreak is milder in the United States than other countries, with 174 reported cases nation-wide and 41 suspected cases in California. Of the 174 cases nation-wide, no deaths have been reported. President Bush has signed a revised list of quarantinable communicable diseases. Executive Order 13295 allows “the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases.”

The subdivision (a) list includes “Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers ( Lassa, Marsburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).” Added to the list is subdivision (b): “Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs of pneumonia or other respiratory illness, is transmitted from person to person predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences.” “It’s not panic mode yet, but it’s getting there,” said John DiScala, a travel expert in Los Angeles “It’s no wonder. The messages coming from health authorities have been distinctly ominous,” said Surgeon General Richard Carmona. “A quick health screening for passengers before boarding international flights from SARS-affected countries might be a good idea, and President Bush gave U.S. health officials the power to involuntarily quarantine people suspected of having the disease.” Statuses of clinical knowledge data available to the World Health Organization indicate that 96 percent of persons developing SARS recover spontaneously and 4 percent die.