Guangdong doctor linked to SARS outbreak

The Scientist ^ | 03-20-03 | Robert Walgate

[Mother Abigail]

Guangdong doctor linked to SARS outbreak International effort reveals links between SARS outbreak and Chinese pneumonia, and possible agent. | By Robert Walgate

Margaret Chan, Health Director of Hong Kong, said today that the source of the current international outbreak of Severe Acute Respiratory Syndrome (SARS) seems to be a doctor from Guangzhou, the capital of Guangdong, the southernmost region of China, which saw 300 cases of a mystery pneumonia between November 2002 and February 2003. Chan's comments are reported in the Hong Kong Standard.

China only recently agreed to cooperate with the World Health Organisation (WHO) and the US Centers for Disease Control to share data and samples from that earlier outbreak.

The doctor stayed on February 21 with six other first ("index") cases of the current outbreak on the same floor of the Metropole Hotel in Mong Kok, Hong Kong. He died later in hospital.

The importance of this observation is to link the two outbreaks, so data can be pooled. For example China earlier claimed that the Guangdong disease had weakened after successive transmissions, although David Lowe, the Canadian doctor attending to the nine cases in Toronto ? the first of whom, a 65-year-old woman, is believed to have stayed at the Metropole Hotel during the Chinese doctor's visit ? told The Scientist that in his experience so far the disease had been equally severe in each successive case. Julie Hall of WHO's Global Alert, Response and Operations Department ? which is managing the WHO response to SARS ? told The Scientist that the Chinese government had requested assistance in analysing its own data. "They have a mass of data from November through to February ? epidemiological data and samples. The first wave of the investigation will be epidemiological, and WHO is helping China select experts who could help, and facilitating with the government in Beijing."

Meanwhile tentative identification in Germany and then Hong Kong of the causative agent as a member of the paramyxovirus family ? viruses associated with other respiratory infections including the parainfluenza viruses and respiratory syncytial virus (RSV), as well as mumps and measles ? is being treated with caution.

Hall warned "What [the German team] saw under the electron microscope were particles ? not a whole virus, just fragments from one sample ? of a paramyxovirus. The whole family look the same. It gives us a clue, but doesn't definitively diagnose it. We don't know which member of the family it is, and some of them are incredibly common, like RSV, which causes coughs and colds in children and is very prevalent. If it's a little bit of that it means absolutely nothing."

"But what the collaborating laboratories are doing now is PCR tests to check the DNA to try to identify which member of the family it may be, and antibody tests in patients against a whole range of paramyxoviruses. WHO is coordinating that," said Hall.

John Tam of the department of microbiology of The Chinese University of Hong Kong later confirmed detection of a paramyxovirus in local samples by electron microscopy, and subsequently with PCR, but it is still not clear if SARS can definitively be attributed to such a virus.

The Paramyxovirinae is a huge family also found in monkeys, cattle, pigs, dogs, mice, pigeons, and even seals, dolphins and rattlesnakes, and it is conceivable an animal form has "crossed over" into humans in South China and begun the present outbreak of SARS.

[Mother Abigail]

Another patient has died after contracting Severe Acute Respiratory Syndrome (SARS), bringing the total number of deaths in Hong Kong linked to the illness to six.

The latest fatality was the brother-in-law of the sick Chinese professor from southern Guangdong province, Health Secretary Yeoh Eng-kiong said.

Twenty more people are confirmed to have been infected with the deadly virus, bringing the total number of confirmed cases to 165.
Eight others are under observation.

Health authorities made a breakthrough when they gained some insights into where it all began -- at the Metropole Hotel in Kowloon.

Eight of those who were infected with the virus had used the same lift and either lived on the 9th floor or visited it.

It started with the 64-year-old mainland professor, who was very ill with pneumonia when he checked in.

He died the next day in hospital.
The virus then fatally hit an American businessman who travelled from Hanoi and a Canadian hotel guest.

Others struck included a Canadian, three Singaporeans, and a local who is believed to have been the key patient who spread the virus at the Prince of Wales Hospital and caused over 60 health workers there to fall sick.

[aristeides]

Article in today's Washington Times seems to say it's a new strain of pneumonia: Americans sequestered amid fears of infection .

[Mother Abigail]

Hospital diagnoses Finnish patient as having SARS

Microbiological tests fail to give 100% confirmation

A middle-aged woman suffering from pneumonia symptoms after returning from a trip to Vietnam is believed to have the dangerous Severe Acute Respiratory Syndrome, or SARS, which broke out recently in East Asia.

[Mother Abigail]

First suspected case of SARS in France

The patient, who is being treated in a hospital at Orleans, central France, had recently returned from Vietnam, which is one of the locations that has been worst affected by the epidemic, he said.

Two other people who were on the same trip to Vietnam are under observation, he said.

[CathyRyan]

One of the seven was a Hong Kong resident whose illness spread to dozens of employees at the Prince of Wales Hotel in that city.

I bet that should read Prince of Wales Hospital..

[Mother Abigail]

20mar03

FOUR new cases of the deadly pneumonia that has broken out around the world are being investigated in Australia.

[Mother Abigail]

March 20 , 2003 21:54PM

Three More Down With SARS In
S'pore, Toll Hits 34

SINGAPORE, March 20 (Bernama) --

Three more people have been infected with atypical pneumonia or Acute Respiratory Syndrome (SARS) in Singapore, bringing the total number struck by the killer virus to 34, the Health Ministry said Thursday.

The three additional patients reported today comprise family members and friends of patients.
Of the 34 people infected, five are in serious condition, while two have been discharged.

[Mother Abigail]

Yes.

[ksen]

Can any of these people be traced to Kevin Bacon yet? ;^)

[Consort]

Guangdong

[Mother Abigail]

THURSDAY, March 20

(HealthScoutNews) -- One person in Los Angeles and one in the Washington, D.C., area are among 11 people in 10 states who are being scrutinized for the country's first cases of a deadly global respiratory illness.

 In Los Angeles, an unidentified man got sick March 11 shortly after returning from a visit to Vietnam, Hong Kong and China, the Los Angeles Times reports. Also sickened was his child, who was hospitalized earlier this week but has now largely recovered, according to the Los Angeles County Department of Health Services.

In Virginia, state health officials said there was one case in the Hampton Roads area, but withheld other details, the Washington Post reports.

Eight other states also have suspected cases of severe acute respiratory syndrome (SARS), according to the U.S. Centers for Disease Control and Prevention (news - web sites). They are: Arizona, Colorado, New Jersey, New Mexico, North Carolina, Tennessee and Wisconsin, each with one case, and Hawaii, which has two.
The illness has killed 15 people and sickened hundreds in eight other countries.

"The 11 people have a travel history, fever and respiratory symptoms, which are part of the case definition," Dr. Julie Gerberding, the director of the U.S. Centers for Disease Control and Prevention (CDC), told a news conference Wednesday.

[Mother Abigail]

Vietnam Airlines flight attendant, passenger suspected of being infected by mystery illness

Thu Mar 20, 7:35 AM ET

By MARGIE MASON, Associated Press Writer

HANOI, Vietnam - An attendant and a passenger on Vietnam Airlines flights to Hanoi were admitted to a hospital with high fevers, amid concern they may have contracted the mystery illness health officials believe has been spread by air travelers, officials said Thursday.

 Vu Minh Khue of the state Northern Airports Authority said a female flight attendant on a flight from Hong Kong and a female passenger on a flight from Taipei were admitted to Hanoi's Bach Mai Hospital on Wednesday afternoon.


One more flight crew...

[Judith Anne]

Thank you for the ping...seems to be spreading.

[Mother Abigail]

OBSERVATIONS:

With the rising number of tourists returning infected, and the cases of flight crew illness, taken together with the full explanation of the index case exposing (what seems to be) anyone who visited the ninth floor during his stay - we can take a stab at determining just how virulent/infectious this agent is.

At this point it seems less than airborne but more than casual contact. A safe guess might be:

1. Within range of aerosol droplets from sneezes or coughs

2. Skin to skin contact

3. Possible surface transfer (i.e) victim sneezes, wipes nose, presses the 9th floor lift button

Remember that staff use a different elevator


One of our freeper friends here suggested early on that you wash your hands often with soap and warm water. It is still very good advice...

[jiggyboy]

China earlier claimed that the Guangdong disease had weakened after successive transmissions

We'll get no real help from China on this disease. As a group, they still really don't believe all that new-fangled mumbo-jumbo about "viruses" and "bacteria" -- it's still usually a question of "energy" or "balance" or "harmony", things that don't replicate themselves or jump from one person to another.

[Mother Abigail]

Two suspected SARS cases in NZ
 

-Doctors treating possible SARS case (01.47)

Medical staff in Auckland are working to treat two patients who may have a deadly pneumonia-like illness that has broken out around the world.

The Auckland Medical Officer of Health Doctor Craig Thornley says both patients have recently travelled in Asia, where Severe Acute Respiratory Syndrome has taken hold.

He says the patients, who are being treated in Greenlane and North Shore hospitals, have the symptoms of SARS, including a high fever and difficulty breathing.

Thornley says the two are being kept in isolation and their care is being managed under strict infection control guidelines.

The disease has infected hundreds of people, and killed up to 14 people worldwide in the past three weeks.

Published on Mar 21, 2003

[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

[Mother Abigail]

Health authorities investigate two possible SARS cases in NYC

NEW YORK -- Two New York City residents are possibly suffering from a mysterious respiratory illness that has killed at least 14 people around the world, health officials announced Thursday.

The 67-year-old man and the 27-year-old woman both recently traveled to China and Hong Kong. Most of the suspected cases of severe acute respiratory syndrome, or SARS, have occurred in Asia since late February.

[Mother Abigail]

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