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Posted on 03/31/2003 8:46:18 AM PST by Maelstrom

Mar. 29, 2003. 06:29 AM

SARS survival rate higher than pneumonia
Panic, overkill fuel public fears about disease

KAREN PALMER
PUBLIC HEALTH REPORTER

The headlines are bold and scary: Thousands quarantined. Masks flying off store shelves. Panicked residents flooding a local clinic, fearing they've contracted a mysterious and deadly disease that's circling the globe.

But how truly terrifying is Severe Acute Respiratory Syndrome?

"I'd much sooner get SARS than get hit by lightning," said Dr. Lionel Mandel, a pneumonia and infectious disease expert at McMaster University, noting that people are far more likely to survive the mysterious illness than a jolt of atmospheric electricity.

Mandel said he's encouraged by how few deaths the North American arm of the outbreak has seen. There are 66 probable and suspect cases in Toronto, plus 51 suspect cases in the United States. So far, three people have died in Toronto.

"That's about a 5 per cent mortality rate, which is less than the mortality rate we see every week with hospital-acquired pneumonia," he said.

With some pneumonias picked up in long-term care facilities, where residents tend to be frail and elderly and have poor immune systems, more than half of patients can die.

Pneumonia is an inflammation of the lungs, one that causes sufferers to struggle for breath as their lungs are weighed down with fluid. It's usually, but not always, caused by an infection whose root cause might be bacterial, viral, fungal or parasitic.

Symptoms usually include fever, chills, cough, chest pain, and shortness of breath. Vital organs begin shutting down, causing septic shock and a sudden, dangerous rise in blood pressure.

"That doesn't seem to be happening here," Mandel said, noting only 25 per cent of SARS patients actually develop pneumonia. Most patients develop only a fever, muscle aches and respiratory problems, but seem to recover fully.

With SARS, there's a 95 to 98 per cent chance a person will survive the illness.

"There are these steps that make it seem scary," he said, pointing to the quarantine. "You don't do that for a minor thing."

What has prompted the reaction from public health — the severe restrictions on hospital visits, the request for exposed people to stay isolated — stems from the seeming ease with which the disease is passed from one person to another, the fact that doctors don't know where SARS comes from or when it stops being contagious.

"It may seem like overkill, but what they're trying to do is contain the unknown," Mandel said.

"The truth is, the risk is low in social, casual contact," said Dr. Neil Rau, an infectious disease specialist at Credit Valley hospital. However, he said that's no reason to fool around with the disease, throwing his full support behind the quarantine and suggesting public health officials should take even more drastic measures.

"In my career, I've never been as scared as I am of this getting out of control," Rau said.

The scary thing about SARS is that it can kill young, healthy people, such as 44-year-old Chi Kwai Tse who died of SARS at Scarborough Grace hospital on March 14.

"The concern with SARS is that we do not know for sure when people become contagious and we want to take an extra step of precaution for those people who have a visited a place where we know infection has been transmitted, to ensure they have passed through that window of 10 days and are still healthy, before they go out and about in public without restrictions," said Toronto's medical officer of health Dr. Sheela Basrur.

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