U.S. man who visited Toronto has SARS [N.C.]

Jun. 9, 2003. 10:23 PM
U.S. man who visited Toronto has SARS

FROM CANADIAN PRESS

U.S. officials confirmed today that Toronto has exported a case of SARS to the United States. To make matters worse, figuring out how the man caught the disease in the first place is stumping local SARS experts.

The man, a 47-year-old from North Carolina, developed fever and pneumonia late last month after a stay in Toronto during which he visited a patient in a health-care facility.

Two people who shared the room with the person he visited came down with SARS - but only several days after the man's visit.

The situation doesn't add up, said Dr. Allison McGeer, head of infection control at Mount Sinai Hospital and a key member of the SARS containment team.

The health-care facility, which McGeer would not name, is not Mount Sinai. Nor is it North York General, the epicentre of Toronto's second SARS outbreak and a place where, on selective wards, many people were falling ill at the time when the North Carolina man visited the city.

Confirmation of the case came from tests run by the U.S. Centers for Disease Control, said Carol Schriber, a spokeswoman for North Carolina's department of health and human services.

The man is recuperating at home in isolation. None of his family members, who are also quarantined, has shown any symptoms of the disease.

"He is doing fine," Schriber said. "His symptoms are abating. . . . He was never hospitalized - he was never that ill."

While that is reassuring, the circumstances surrounding how he contracted SARS are not.

The man visited the Toronto facility in question on May 16 and 17. The patient he visited never contracted SARS. But two other people who shared the room later came down with the disease.

The dates of onset of symptoms for the two were May 21 and either May 22 or May 23 respectively, McGeer said.

"They give very clear stories of developing illness - there is no reason to doubt them," she said. "And their illness developed five and seven days after this patient in North Carolina was exposed."

People who come down with SARS aren't believed to be infectious until they are suffering symptoms of the disease. To be on the safe side, though, public health officials consider the 24 hours before symptoms set in as part of the infectious period when they are determining who has been exposed and who must go into quarantine.

The two patients who went on to develop the disease had been exposed to it at another health-care centre before they transferred into the unnamed facility, McGeer said. So they were incubating the disease when the North Carolina man visited their room.

- The man doesn't have SARS. "Clinically he's very convincing - there's no denying it."

- He had some other exposure in Toronto that officials here don't know about. McGeer said it "defies coincidence" to think that was the case.

- He was infected by a person who had SARS and was infectious but showed no symptoms. While some medical figures have hypothesized that this is possible, it's a scenario `that we've not seen before," McGeer said.

- One of the patients who developed SARS had a fever, but no other symptoms of SARS, several days before being transferred to the facility. Experts know some SARS patients experience very mild malaise in the hours or even day before full onset, a period called the disease's prodrome. Maybe this patient's prodrome was extremely protracted?

"But now we're talking about him having to have it (the prodrome) for days and days - and to be infectious," McGeer said.

SARS Mortality Rates [reflects treatment] for 'PROBABLE' cases only Based on World Health Organization daily tables (Revised: Jun 09 pm)
Area	Recoveries to date	Deaths to date	Recent** Death Rate	Active Cases still in Danger	Projected Future Deaths	Projected Cumulative Mortality
China [bogus]	4186	340	1.4%	802	11	6.6%
Taiwan [bogus]	257	81	0.0%	342	0	11.9%
Hong Kong	1365	288	12.7%	100	13	17.2%
elsewhere [30 countries]	472	75	17.9%	113	20	14.4%
** Recent deaths are based on findings from the Imperial College of London...... that deaths take 12 days longer on average than recoveries on average..... = (12-day recent deaths) / (12-day recent deaths + prior 12-day recoveries)

Taiwan used to report 'probable' cases ONLY when they were in CRITICAL condition, resulting in a HUGE mortality rate.
Then to make up for their obvious phoney data, Taiwan STOPPED reporting any 'probable' case deaths, [hence their unlikely 0% recent death rate]
Taiwan maintains an additional shamelessly high 'suspected' SARS count exceeding 1400 patients.
China's numbers are also grossly underreported, in different ways.
China abruptly STOPPED classifying ANY NEW 'PROBABLE' cases in most areas besides Beijing about May 10th.
China has also chosen to report VERY FEW 'probable' deaths recently.

Trend - Active Cases Still in Danger [reflects containment] for 'PROBABLE' cases only
Date	China [Bogus]	Taiwan [Bogus]	Hong Kong	elsewhere 30 countries	World-wide all 33 countries
May 26	2170	401	183	58	2812
May 27	2057	408	174	59	2698
May 28	1962	418	165	61	2606
May 29	1877	457	157	56	2547
May 30	1750	461	158	65	2434
May 31	1625	469	151	87	2332
Jun 01	1565	466	143	97	2271
Jun 02	1499	469	145	99	2212
Jun 03	1437	462	137	113	2149
Jun 04	1321	325	126	112	1884
Jun 05	1223	339	121	115	1798
Jun 06	1122	338	114	113	1687
Jun 07	1058	339	106	115	1618
Jun 08	932	338	101	112	1483
Jun 09	802	342	100	113	1357
Jun 10	...	348	...	...	...
(includes new daily cases... excludes cases resolved by death or recovery) (some tables are supplemented with government data when WHO data is missing)

Earler, Taiwan was withholding less-serious 'probable' cases and calling them 'suspected'.
Taiwan's 'probable' count should be FIVE or SIX HUNDRED higher.
On June 4th Taiwan declared 140 patients 'recovered', hence the drop below.

ALSO Starting about June 4th, Taiwan NEARLY STOPPED classifying 'probable cases' even though their 'suspected cases' were still climbing.
-

China's 'official' numbers in the charts and their recent 'improvements' are bogus.
They abruptly stopped ALL REPORTS of NEW 'PROBABLE' cases in most places (besides Beijing) about May 10th or May 14th.
Here are some examples...

[abrupt change occurred May 10]

...vertical scale = 1350 to 1520

[abrupt change occurred May 14]

[abrupt change about May 14]

...vertical scale = 200 to 450

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