Killer Virus (SARS) Identified

ProMed ^ | 03-18-03

[Mother Abigail]

Killer virus identified

A team from the Prince of Wales Hospital and Chinese University of Hong Kong have identified the virus that has caused the recent outbreak of severe acute respiratory syndrome worldwide, confirming that the current anti-viral treatment applied to patients has been the right choice. Identifying the virus as a member of the Paramyxoviridae family, Professor John Tam of the department of microbiology of the Chinese University said it was detected by electron microscopy. The finding, announced late last night, was further confirmed by a molecular technique that revealed the nucleic acid sequence of the virus.

Asked if the virus was curable, Tam reiterated that the finding last night had indicated that the current treatment applied to patients suffering from the syndrome, more commonly known as atypical pneumonia, had been the right choice. But he added that they still needed to monitor individual patients' reactions before they could conclude that the virus was curable.

Lo Wing-lok, Medical Association president and legislator, said the Paramyxoviridae family incorporated different viruses that could affect humans and, as such, further studies were needed to establish whether it was a new virus. Earlier it was revealed that at least 6 patients were responsible for spreading the pneumonia in Hong Kong. Health chief Yeoh Eng-kiong also said that a mainland professor who died in [Hong Kong] SAR on 4 Mar 2003 was a victim of the atypical pneumonia.

The new information from officials indicated the disease had been more widespread in the SAR than originally believed. Yeoh said the pneumonia and suspected cases had now been isolated into 6 "clusters". Yeoh again stressed the government was not hiding anything. He insisted there was no sign of an outbreak at the community level.

[This is the second identification of a paramyovirus-like organism from a patient with SARS (see ProMED-mail posting Severe acute respiratory syndrome - worldwide (06) 20030318.0677). The first identification was made by investigators in Frankfurt am Main and Hamburg from specimens taken from a physician from Singapore who had treated some of the earlier cases seen in Singapore and was admitted to hospital in Frankfurt, Germany en route back to Singapore over the weekend. As mentioned in our earlier posting, it is important to confirm these findings and to identify a similar agent from other cases of SARS before it can be concluded that this agent is the cause of SARS.

That being said, this second identification of a paramxovirus-like organism from patients with SARS offers hope that the etiology of this outbreak may be identified soon. - Mod.MPP]

[Mother Abigail]

That is a very interesting idea

[Mother Abigail]

As of 19 Mar 2003, a total of 31 people with SARS have been reported. All are in hospital, except for 2 patients who have since recovered and been discharged. These 2 patients were the initial cohort who had travelled to Hong Kong. All the patients are stable except for 4 patients who are in serious
condition.

The 8 additional patients reported today comprise 3 family members and friends of patients, and 5 hospital staff who had attended to the patients. Apart from the 3 initial people who had travelled to Hong Kong, a total of 15 family and friends of cases, and 13 hospital staff have been diagnosed with SARS. So far, all the cases of SARS have been linked to the initial 3 cases. No new index cases have been reported. In addition, no further cases have occurred among health care workers after the implementation of enhanced infection control precautions.

Preliminary investigations by the Pathology Department at the Singapore General Hospital and the Defence Medical Research Institute have identified the likely infective agent to belong to the paramyxovirus family. This corroborates early investigation results by overseas centers in Germany and Hong Kong.

The Ministry of Health would like to appeal to the public to avoid travel to Hong Kong, Hanoi and Guangdong province in China for the time being, unless absolutely necessary. This would help us greatly in our efforts to contain the number of new cases.

[Mother Abigail]

The following is jointly issued by the Department of Health and the Hospital Authority: As at 3pm today (19 Mar 2003), the admission statistics of patients who have been in close contacts with atypical pneumonia patients are as follows:

A. Staff of Hospitals/Clinics (numbers in brackets are those with symptoms of pneumonia)

Staff of Prince of Wales Hospital (PWH) admitted to: Prince of Wales Hospital 49 (49)

Kwong Wah
Hospital 3

(1) Princess Margaret Hospital (PMH) 1 (1)

Tseung Kwan O

Hospital (TKOH) 1 (1)

Staff of Kwong Wah Hospital (KWH) admitted to: Kwong Wah Hospital 2 (2) * Note 1

Staff of Pamela Youde Nethersole Eastern Hospital (PYNEH) admitted to: Pamela Youde Nethersole Eastern Hospital 7 (7)

Staff of Queen Elizabeth Hospital (QEH) admitted to: Queen Elizabeth Hospital 4 (2)

Staff of a Private Clinic in Mong Kok admitted to: Princess Margaret Hospital 4 (4)

Tuen Mun Hospital 1 (0)

Staff of a private hospital on HK Island admitted to: Pamela Youde Nethersole Eastern Hospital 3 (3)
Sub-total (A) 75 (70)

B. Medical students (numbers in brackets are those with symptoms of pneumonia) Medical students Prince of Wales Hospital 17 (17) * Note 2

C. Other Patients * Note 3 (numbers in brackets are those with symptoms of pneumonia)

Patients, patients' family members & visitors PWH, PMH, KWH, PYNEH, QEH, TKOH & Queen Mary Hospital 58 (58)

Total admissions (A + B + C) 150 (145)

Note 1: One of the health care workers was discharged.

Note 2: One of the medical students was discharged.

Note 3: The Department of Health and Hospital Authority have been closely monitoring the clinical condition of inpatients with pnuemonia symptoms. The total number of admission is released after collating, analysing, and confirming the clinical symptoms and test results of the patients concerned. The total number of "other patients" included those who have been admitted earlier.
Meanwhile, 5 patients with atypical pneumonia died recently in the following public hospitals:
Kwong Wah Hospital (1 patient);

Princess Margaret Hospital (1);

Pamela Youde Nethersole Eastern Hospital (1);

Prince of Wales Hospital (2).

The Department of Health has launched a dedicated website on atypical pneumonia to provide health advice on the prevention of respiratory tract infection and latest information on the cases. The websites are (English content) and (Chinese content).

[Mother Abigail]

From: 1 Feb 2003 To: 19 Mar 2003,
16:00 GMT+1 Country:

Cumulative no. case(s) (including deaths) / no. deaths / local transmission

Canada: 8 / 2 / yes China+

Germany: 1 / 0 / none*

Hong Kong SAR China: 150 / 5** / yes

Singapore: 31 / 0 / yes

Slovenia: 1 / 0 / none*

Spain: 1 / 0 / to be determined

Taiwan China: 3 / 0 / yes

Thailand: 1 / 0 / none

* United Kingdom: 1 / 0 / none

* United
States: 11 / 0 / to be determined

Viet Nam: 56 / 2 / yes

Total: 264 /9

It is possible for the status of a reported case to change over time. SARS is a diagnosis of exclusion. This means that whenever a known cause is found that could fully account for a patient's clinical condition, this patient should no longer be considered to be a case of SARS.

+The Chinese authorities have reported suspect and probable cases in Guangdong province. Figures are being updated.

* No documented secondary transmission in-country. No affected areas.

**One death attributed to Hong Kong Special Administrative Region of China occurred in a case medically transferred from Viet Nam.

[Judith Anne]

So all of the cases in your last two posts are in the far east, this does not count the possible cases in the US, Australia, Spain, Germany, Canada, etc.?

[Mother Abigail]

Due to its ongoing investigation, the Department of Health (DH) confirmed that a total of 7 people who had contracted atypical pneumonia recently had stayed in or visited a hotel in Kowloon last month (February 2003). Speaking at a press conference today (19 Mar 2003), the director of health, Dr Margaret Chan, said the 7 people comprised 3 visitors from Singapore, 2 from Canada, one Mainland visitor, and a local [Hong Kong, SAR] resident.

DH's epidemiological investigations revealed that the 7 visitors stayed on the same floor of the hotel between 12 Feb 2003 and 2 Mar 2003. They developed pneumonia symptoms between 15 and 27 Feb 2003. The local resident, who has been identified as the index patient in the outbreak of Prince of Wales Hospital, had visited his friend staying in the hotel from 15 to 23 Feb 2003. One patient, who became sick one week before staying at the hotel, is believed to be the source of the infection.

Dr Chan stressed that there is no cause for panic among the hotel staff and visitors staying in the hotel as well as residents living in the area as no other new cases have been detected since end of February 2003. "Investigations showed that the general environmental condition of the hotel is good and that hotel staff had not reported any sickness related to the outbreak. The department considered that the source of the virus has now been removed from the hotel. We believe there is no residual risk for residents in the hotel. We believe that the transmission of the virus is by close contact and should have been transient. There is no evidence of active disease currently occurring in the hotel," Dr Chan said.

On the request of DH, the hotel management has isolated the whole floor for thorough cleansing and disinfection as precautionary measures. "The floor will be re-opened upon DH's satisfaction with the process. Health advice will be given to the hotel staff and DH will keep close medical surveillance of them," Dr Chan said.

[Mother Abigail]

A swathe of countries across the world -- among them Singapore, Canada, Taiwan, Australia, Britain, Brunei, Canada, Spain, and the United States -- have reported suspected cases of the disease.

On Wednesday the mystery virus appeared to have jumped to China's capital Beijing, as well as to Japan, Romania, Belgium, Finland and France.

MOH above is very interesting. It appears as though they may have identified the first contact exposure with an ill person visiting Hong Kong, SAR from an unspecified country. The index cases from Hong Kong SAR, Canada and Singapore were all present and residents (or in the case of the Hong Kong contact a visitor to a guest) of the same floor of the same hotel during the same period as the presumed index case introduced SARS to Hong Kong.

The report does not mention if all of the above mentioned individuals/cases knew each other personally, but it does mention "we believe that the transmission of the virus is by close contact and should have been transient.

There is no evidence of active disease currently occurring in the hotel". Before one draws any conclusions on the information given in the press release on the transmission of this disease, it is important to mention that information on the denominator at risk (the number of people staying on that floor of the hotel during that period) was not mentioned in the report.

Other denominator data that will be of interest are the total number of guests and employees who were present in the hotel during the identified time frame. If no additional cases are identified among the general "population" at the hotel during the time frame (guests and employees present in the hotel during the same period of time), it does further suggest that a closer contact is necessary for transmission of this disease. It would be interesting to learn from what part of Mainland China the above mentioned guest was from.

[TaxRelief]

If you're thinking what I'm thinking---somebody smearing the "9" button in the elevator or...

[TaxRelief]

We know the Germany number is at least 3. The Singapore doctor who traveled through NYC is quarantined in Frankfurt with his wife and mother and unborn child. They have confirmed SARS in all three. Am I missing something?

[Judith Anne]

I don't know...I read somewhere here that it was in or suspected in 12 countries...

[Mother Abigail]

RALEIGH, N.C. (AP) - State health officials reported Wednesday two possible cases of a mysterious flu-like illness that has recently appeared in the United States among people who have lived in or traveled to Asia

[Doc On The Bay]

As a "Member of" our Current Generation of "EarthLife," "I," --& MANY OF my fellow Humans-- Expect to CONTINUE to exist as a Rational "Check" on the Behavior of our "Leaders!"

WE must watch "The Leaders!"

Doc

[Mother Abigail]

Trenton-AP, March 19, 2003) — A New Jersey woman who recently traveled to Asia has one of 11 suspected cases of a mysterious flu-like illness under investigation in the United States, health officials said Wednesday.

[TaxRelief]

Where in NC? Where is this report from? I have connections in NC.

[Mother Abigail]

Unknown

[Mother Abigail]

Very nice work...

It fits the data, and effects the transfer to the hands.

[Mother Abigail]

---

A CHRONOLOGICAL COMPILATION OF THE "SARS" OUTBREAK AS REPORTED ON FREE REPUBLIC

---

1. Precognition

2. Hong Kong Health Secretary calls for calm as SARS cases double, (83 up from 42 on Sunday)

3. LATEST SARS UPDATE - DETAILED MEDICAL INFORMATION

4. BREAKING BIG: POSSIBLE PATHOGEN DETECTED IN SARS CASE

5. Killer Virus (SARS) Identified

6. Seven victims of mystery pneumonia stayed on same floor of Hong Kong hotel

7. Guangdong doctor linked to SARS outbreak

[Freedom'sWorthIt]

What is latest on virus today? Thanks.

[Mother Abigail]

See new thread

Thursday