View Full Version : Info on SARS (Severe Acute Respiratory Syndrome)


KConnor56
03-19-2003, 01:47 PM
Thought I would pass this on

SARS Clinical Presentation: SARS appears to be characterized by
secondary transmission in health care settings, including to health care
providers, and in households. Cases have generally had a brief
incubation period, 2 - 5 days. There is very limited clinical
information regarding SARS available at present. However, Dr. Susan
Poutanen from the University of Toronto recently described the 6
probable and 2 suspect SARS patients treated in the Greater Toronto Area
on ProMED.

Treatment: Because the etiology of SARS has not been determined no
specific treatment recommendations are available. Empiric therapy
should include coverage for organisms associated with any
community-acquired pneumonia of unclear etiology, including agents with
activity against both typical and atypical respiratory pathogens.
Treatment choices may be influenced by severity of illness. Infectious
disease consultation is recommended.

Isolation Measures: For hospitalized patients CDC currently recommends
standard and respiratory precautions with use of a personal respirator
and eye protection during any close contact with cases and suspect
cases. At the time of admission, hospital infection control staff
should be contacted for any subsequent modifications to these
recommendations.

As with any outbreak or disease, I recommend ProMED. Check out:
>http://www.fas.org/promed/

Horses' mouth: http://www.promedmail.org/

One of the best things on the web. Also does e-mail updates in
several disease categories. e-mail goes to a searchable archive.

Alec

His men would follow him anywhere, but only out of curiosity.


The CDC is conducting regular updates on the possibility of a SARS epidemic. The text below is from this link, http://www.cdc.gov/ncidod/sars/warden_notice_031703.htm.

Warden Notice: Guidance about Severe Acute Respiratory Syndrome for Americans Living Abroad
3/15/2003 8:00 pm Eastern Standard Time

Download PDF version formatted for print (86 KB/2 pages)

The Centers for Disease Control and Prevention, HHS, has received reports of outbreaks of a severe form of pneumonia (also being referred to as Severe Acute Respiratory Syndrome, or SARS) in Hong Kong SAR, Vietnam, and Guangdong Province in China, Canada, Singapore, Thailand, Germany and Switzerland. Approximately 170 suspected cases had been reported as of March 17. Cases appear to primarily involve health-care workers caring for patients with SARS and close family contacts. CDC is working closely with WHO and country partners in efforts to define the etiology of this infection, to track patterns of its transmission, and to determine effective strategies for its control and prevention. At the present time, a CDC travel advisory recommends that persons with elective or non-essential travel to Hong Kong SAR, Guangdong Province and Hanoi, Vietnam consider postponing such travel. Additional information is available at http://www.cdc.gov and http://www.who.int.


In light of the evolving nature of this situation, it is recommended that the CDC and WHO websites be consulted regularly for updates.

Menally-Ill
03-19-2003, 04:11 PM
TODAY'S UPDATE ON SARS IN CANADA.

Canada now has/had 11 SARS patients, 9 are in isolation here in Toronto, at 4 hospitals. Mount Sinai, Scarborough Grace, Toronto Western and Sunnybrook. (The other two cases are in British Columbia). Only two have died, and both of them in Toronto.

The CDC is up here, because one of the patients here, flew to Toronto from Atlanta, Ga, on March 5, and was hospitalized here on Mar. 12.

So far there are 498 cases worldwide.

305 in China
94 in Hong Kong
49 in Viet Nam
20 in Singapore
15 in the U.S.
11 in Canada
1 in Australia
1 in Germany
1 in Slovenia
1 in the U.K.

The one case in Germany was treated for pneumonia in Singapore, then flew to New York, where he attended a conference, then flew onto Germany. Several plane passengers who were on his flights are now in quarantine.

The World Health Organization has issued an "emergency travel alert" for the first time ever!

~~~~~~~~~
For anyone with an epidemiological bent;

All patient samples are being handled in a Lab Bio-level 4. YIKES! That's the same as Ebola!!!

BUT, the good news is that they've found that it is a VIRUS, not a BACTERIA, thus patients are starting to respond to mega-doses of RIBAVARIN!

The virus is a paramyxovirus, of the type that usually causes measles and mumps in children. They don't know yet if it is a mutated measles or mumps virus, or merely of the same family of viruses. The paramyxovirus has been confirmed in labs in Germany, Hong Kong and here, in Toronto.

~~~~~~~~~
Regarding travelling, we had an incident here today, where Toronto airport staff absolutely REFUSED to unload a plane that arrived from Hong Kong! So, the travel industry is getting antsy!

Ironically, some airlines are suggesting you sit as far back in the plane as you can, since the front of the plane (First Class) has the most air circulation, and they still don't know if this is an airborne pathogen. So the cheap seats are best!

~~~~~~~~~
Ken, out of all the things I worried about, when flying to California and back (ON MARCH 2!) I forgot to worry about KILLER GERMS! I'll have to add it to my list. HAHAHAHAHAHAHAHAHA

Menolly

emme
03-19-2003, 06:04 PM
wow, thanks for this info...i recently read *the hot zone* so when i read about sars...ick ick ick...

Frisco's Girl
03-19-2003, 06:20 PM
We have one in Chesapeake now from I just heard on the radio.

Linda and Patti

~cheenna~
04-03-2003, 07:36 PM
I recently heard that SARS is a kin to the common cold... just a very resistent, nastty strain.

With all our antibiotic use and misuse for the last few decades, what have we created???

Not withstanding hindsight and spilt milk... I don't see things getting better any time soon especially with demon seeds like Saddam running around and wanting to make up new "germs" ... maybe mixed with resisted old ones?

How many new diseases/syndroms have surfaced in just the last 10 years? It's pretty scary... but I for one have no intentions of crawling under a rock.

On the other hand, we ain't seen nothing yet! JMO

Valerie
04-03-2003, 07:59 PM
Ken, I heard today of two cases of SARS in Santa Ana.

flygirlaa2
04-04-2003, 04:46 AM
A couple days ago, the CDC sent out to the airlines guidelines on working in airplanes. I am afraid of what this could do.

Budwoman
04-04-2003, 08:21 AM
Yes, one has been diagnosed in Charlotte, N. C. They have contacted all passengers on the plane she flew into US also.

This is a scarry thing, but I am so gald to know that they have found something to treat it with.... I have Asma and sure don't need this things..

Donna

~cheenna~
04-04-2003, 04:29 PM
I found this last night, it is from the Milwaukee Journal Sentenal...



SARS' spread will be hard to contain, federal official says
Prospects for pandemic unclear, but new cases show disease is on rise globally
By MARILYNN MARCHIONE

Last Updated: April 3, 2003
It's too soon to tell whether a deadly new respiratory illness will become a global pandemic, but itwould take extreme luck for it to be contained now, says the director of the U.S. Centers for Disease Control and Prevention."It is entirely too soon to predict its ultimate scope or magnitude," Julie
Gerberding wrote in an editorial published online by the New England Journal of Medicine on Wednesday.
Severe acute respiratory syndrome, or SARS, seems to be well contained in the United States, with 85 suspected cases in 27 states, little secondary spread and no deaths. But it continues to grow globally, in numbers and geographically. There are more than 2,200 cases in 16 countries, and it has now reached a fourth continent - South America - with Brazil reporting its first case. It's also worsening in Canada, where a seventh SARS patient died Thursday and a conference of
16,000 cancer experts was canceled out of fear that doctors would catch the disease and spread it to vulnerable cancer patients. The American Association for Cancer Research meeting had been scheduled to begin Saturday in Toronto.
"Unfortunately, it's an epidemic now that will become a pandemic," predicted Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital.
Two other Toronto hospitals that treated SARS patients have been closed, and hundreds of people have been asked to stay in their homes to prevent spreading the disease. About 144 cases have been reported in Canada, according to officials.
"It's a crisis for us in Toronto, but we have the resources and the experience to deal with it," Low said. "What's going to happen when it goes into South America, Africa, India?"
Emerging disease SARS is an emerging infectious disease that health officials think is caused by a new coronavirus, a
group of germs known to cause respiratory illnesses, including the common cold.
Most people with SARS have had a rapidly developing, serious pneumonia. About 10% have needed breathing machines, and nearly 4% have died. The first case is thought to have occurred in November in China's Guangdong Province, where a World Health Organization team was just allowed in Thursday to investigate.
"We have strong suspicion . . . that the epidemic is not actually over there," Gerberding said in a news conference Wednesday.
From that Chinese province, SARS spread throughout Asia and to parts of Europe and Canada. The big concern now is a deadly world outbreak like the 1918 flu that killed more than 20 million people.
There are many similarities to flu pandemics, said Dennis Maki, a University of Wisconsin-Madison infectious diseases expert who spoke about SARS on Thursday at an American College of Physicians meeting in San Diego.
"When you get a new strain that everyone's susceptible to, you have pandemic disease," he said. "There's a very good likelihood this is going to continue to spread. The main reason is there is very little natural immunity" to a brand-new virus, which SARS appears to be, he said.
Other factors that give SARS pandemic potential:
It's spread easily person to person, unlike other recent emerging infectious diseases such as hantavirus and West Nile virus, which are not communicable. It may have multiple ways to spread. Officials think the main way is through droplets expelled when an infected person coughs or other close contact. But airborne transmission and spread from touching contaminated surfaces, even animals, are possibilities. Officials were testing mice in a Hong Kong apartment complex to see whether rodents were helping to
spread the illness.
It originated and is amplifying in a part of the world that sees many travelers. About 10,000 people enter the U.S. each day from Asian destinations, Maki said. "We're going to have
multiple introductions," and each has the potential to seed a new outbreak, he said.
There is no cure for SARS, nor is there a vaccine. That means that containing SARS depends completely on fast recognition of cases and isolation. Those measures are working in Canada and the U.S., Gerberding noted in her editorial.
"Are we fast enough? Can we prevent a global pandemic of SARS?" she wrote. "If we are extremely lucky, the epidemic will be curtailed, develop a seasonal pattern that will improve prospects for regional containment, or evolve more slowly than it has in this early stage." 'Long, difficult race'
But if not, "we could be in for a long, difficult race" against the germ, she wrote. G. Richard Olds, chairman of medicine at the Medical College of Wisconsin, said SARS' mortality
rate of 4% shouldn't be taken lightly. Mortality "was probably in that range," certainly less than 10%, for the 1918 flu, which virtually everyone got, he said Thursday.
Plague epidemics had a 30% mortality rate and a high rate of infection, Olds said. The attack rate for SARS isn't known, only the outcomes of those who develop pneumonia from it because those are the only cases being recognized now, he said.
"Four percent sounds small, but it isn't. These are otherwise healthy people, remember," Olds said. "If there are a billion people in China and 4 percent die, that's 40 million people, and 40 million Chinese people dying would be terrifying."


A version of this story appeared in the Milwaukee Journal Sentinel on April 4, 2003.

Menally-Ill
04-05-2003, 01:02 PM
I can't stress enough to everyone to NOT PANIC!

I am in the middle of this, and have been for 2 and a half weeks now! I'm stressed beyond belief, but NOT by this illness. I am stressed by OTHER STRESSORS in my life. And I am stressed by the "official reactions" to this, much of which is useless scare tactics, that wouldn't help anyway, if this REALLY was a dangerous disease!

A 4 % mortality rate is NOTHING!!!

There are, at present, more questions than answers. So far, this is what we know.

SOME SARS patients carry a strange kind of CORONAVIRUS. Coronaviruses are the SECOND leading cause of COLDS!

SOME are carrying human Metapneumovirus.(hMPV). That causes pneumonia.

SOME are carrying paramyxovirus. These usually cause things like measles, mumps and canine distemper.

SINCE ALL PATIENTS don't seem to be afflicted with the same virus, they don't know what is going on. And since it takes 2 - 3 weeks for patients to develop SARS antibodies, each case cannot even be CONFIRMED until 21 days AFTER they have recovered!

There is "talk" that it is a new emerging infectious disease. OR a mutated virus. Or somehow a double virus, that hits you with two illnesses at once.

BUT, according to Koch's Postulates, to declare a germ as a cause of a disease, you must:

1) IDENTIFY the virus.
2) GROW IT in a lab.
3) INFECT a test animal.
4) Identify ANTIBODIES later in that animal.

A lot of this panic is being fuelled because we are living in paranoic times anyway!

And scientists and doctors are averse to saying "We don't know what we're talking about." So in order to LOOK LIKE they are in control, they are reacting like this is ebola, or bubonic plague or something!

Patients are responding to RIBAVARIN treatment.

~~~~~~~~~~

Can someone please email me a sandwich and a cup of coffee? I am so tired, and I've lost 14 pounds in the last few weeks!

I NEED some basic human kindness. And so do my patients! That's why I'm still working this thing!

It isn't the germ I am afraid of.

It's official bungling, racism, the "leperization" of perfectly healthy people, and the terrorism being generated in those few who are sick!

Ah, I wish I had more tiem to sort out my thoughts here. But I am upset about this, and a few other things also.

Forgive me.

lulu
04-05-2003, 01:09 PM
darn menolly, you had me scarred. I hate this beyond words, please keep in touch

Menally-Ill
04-05-2003, 01:12 PM
Updates available at :

<http://www.torontostar.com/sars>

<http://www.cbc.ca/news/>

<http://www.cbc.ca/news/sars/index.html>

Soul SLiver
04-05-2003, 01:18 PM
San Diego has one case being TESTED for SARS. TESTED only...no results back yet


Ribavarin???? don't they use that for AIDS? I thought that was one of the trio drugs they use to treat AIDS.

Menally-Ill
04-05-2003, 01:43 PM
Exactly Soul!

Every high fever and lung difficulty case is being classified as a SUSPECTED SARS case! So we have THOUSANDS of people in quarantine, with HUGE STOP SIGNS on their hospital door, when all they MIGHT have is a nasty cold! And all their contacts (family and friends) are CONFINED BY LAW in their homes, without groceries, etc.

They have over 250 PARAMEDICS in Toronto in home quarantine, and over 90 DOCTORS also! So how's the health care system supposed to work, when there's no staff to care for people. (Let's not forget the chicken-hearted staff, who are REFUSING to come to work, 'cus they're too friggin scared!)

This is total insanity! It is being BUNGLED at all levels! Can you tell I am stressed and angry about it? But, I plod onwards, ever feeling like Alice in Wonderland talking to a blue caterpillar smoking some whacky tabacky in a hookah!

Yes, Ribavarin is an AIDS drug, and a HEP C drug. It BOOSTS the immune system, and kick starts it, when it is run down.

Menally-Ill
04-05-2003, 01:52 PM
I can't BEGIN to tell you of the ramant racism against ORIENTAL people, up here!

No one will go into a convenience store, or Chinese restaurant. They won't even SPEAK to them!
This offends me SOOOO DEEPLY!

I bought a pack of smokes this morning from a Korean store owner. She was practically HUGGING me for DARING to come into her store. I just cried for her!

Menally-Ill
04-05-2003, 02:02 PM
To answer a PRIVATE MESSAGE about MUMPS.

MUMPS is in the same FAMILY of viruses. Mumps is ONE OF the paramyxoviruses.

If your hubby's facility is closed down due to 4 cases of MUMPS, it is because MUMPS itself is very contagious. It is also more dangerous to ADULTS than it is to children. They are just being precautious about MUMPS.

This does not mean it is SARS! SARS has high fevers, and a very viscious pneumonia, that puts you on a respirator real quick. No swollen neck glands etc...

Same family of viruses, but different illnesses!

Thank you sweetie, for asking. It is only by asking, that answers get received!

Love,
Menolly.

P.S: If he had mumps or MUMPS INNOCULATIONS as a child, he will be fine! He would be immune in either case. Ask his MOM about Measles/mumps/rubella shots he had as a kid. MOMS remember such stuff!

Menally-Ill
04-05-2003, 02:10 PM
More questions via PMs.

LIFESPAN OF THIS VIRUS?

No one knows yet.

They are saying a 10 day incubation period. That's from time you are exposed until time you get sick. And no one is released from quarantine until 20 days after all signs of illness are gone.

IS IT AIRBORNE?

Again they don't have a clue. The first 9 cases were all on one FLOOR of a hotel in Hong Kong. (The seventh floor of the Metropole Hotel.) Could it be a surface contaminant? Something in the air conditioning system? Who knows?

It does spread within family members, so whether that is by water droplets from sneezing, coughing, breathing, touching etc. or whether it is from breathing the same air, no one is sure.

LIFESPAN WITHOUT A CARRIER?

I presume you mean how long does it live outside of the human body? So far, they think it is only a few hours. So we are DISINFECTING everything in sight, on an hourly basis. Doorknobs. Telephone receivers. Computer keyboards. OUR HANDS! Me? I'm just living inside latex gloves!

Menally-Ill
04-05-2003, 02:22 PM
(GOD!!! I'm gonna get in trouble AGAIN for my 'sensationalistic' posts! I can't help it. The stuff I know, and info I get, due to the work I do, has to do with people's greatest fears.

So please, no one get mad at me here!!!)

Menally-Ill
04-05-2003, 02:25 PM
AREN'T MOST IMMUNIZED AGAINST MUMPS?

Most North Americans are, but think about who is in your hubby's prison. They might be from Third World countries that does not have mandatory immunizations against childhood diseases.

i'd lay bets that the four mumps cases, are not North American inmates.

IS A LOCKDOWN NORMAL FOR MUMPS?

Absolutely! Isolation is the BEST way to contain ANY contagious disease. And mumps is very contagious! (Again, check if hubby's had mumps in the past, or has been immunized as a child.)

Menally-Ill
04-05-2003, 02:53 PM
Gotta go.

City of Toronto:

<http://www.city.toronto.on.ca/health/pneumonia_report.htm>

Ontario Ministry of Health:

<http://www.health.gov.on.ca/english/public/updates/archives/hu_03/hu_sars.html>

World Health Organization:

<http://www.who.int/csr/don/en/>

Centre for Disease Control in Atlanta, Ga:

<http://www.cdc.gov/ncidod/sars/>

Health Canada:

<http://www.hc-sc.gc.ca/english/index.html>

Menally-Ill
04-19-2003, 02:45 PM
Just wanted to get these weblinks up again, for people asking me...