Hong Kong SARS Turns Deadlier.

perloin

[per loin]

Hospitalized Hong Kong SARS (Chicom Flu) Cases

Time			Cases				Increase			Disposition														Dead as % of prior time
Day	Date		New	Week	Total		One Day	Week		Got well			Dead			Total Gone			Now In Hospitals			Total Hosp Days		Week	2 Week	3 Week
										Day	Total	%	Day	Total	%	Day	Total	%	Day	Total	%
Wed	03/12		10		10														10	10	100.0%	10
Thu	03/13		14		24		140.0%												14	24	100.0%	34
Fri	03/14		5		29		20.8%												5	29	100.0%	63
Sat	03/15		8		37		27.6%												8	37	100.0%	100
Sun	03/16		5		42		13.5%												5	42	100.0%	142
Mon	03/17		53		95		126.2%												53	95	100.0%	237
Tue	03/18		28	123	123		29.5%												28	123	100.0%	360
Wed	03/19		27	140	150		22.0%	1400.0%		5	5	3.3%	5	5	3.3%	10	10	6.7%	17	140	93.3%	500		50.0%
Thu	03/20		23	149	173		15.3%	620.8%		0	5	2.9%	1	6	3.5%	1	11	6.4%	22	162	93.6%	662		25.0%
Fri	03/21		30	174	203		17.3%	600.0%		2	7	3.4%	0	6	3.0%	2	13	6.4%	28	190	93.6%	852		20.7%
Sat	03/22		19	185	222		9.4%	500.0%		0	7	3.2%	2	8	3.6%	2	15	6.8%	17	207	93.2%	1,059		21.6%
Sun	03/23		25	205	247		11.3%	488.1%		0	7	2.8%	2	10	4.0%	2	17	6.9%	23	230	93.1%	1,289		23.8%
Mon	03/24		13	165	260		5.3%	173.7%		5	12	4.6%	0	10	3.8%	5	22	8.5%	8	238	91.5%	1,527		10.5%
Tue	03/25		26	163	286		10.0%	132.5%		2	14	4.9%	0	10	3.5%	2	24	8.4%	24	262	91.6%	1,789		8.1%
Wed	03/26		30	166	316		10.5%	110.7%		2	16	5.1%	0	10	3.2%	2	26	8.2%	28	290	91.8%	2,079		6.7%	100.0%
Thu	03/27		51	194	367		16.1%	112.1%		3	19	5.2%	0	10	2.7%	3	29	7.9%	48	338	92.1%	2,417		5.8%	41.7%
Fri	03/28		58	222	425		15.8%	109.4%		6	25	5.9%	1	11	2.6%	7	36	8.5%	51	389	91.5%	2,806		5.4%	37.9%
Sat	03/29		45	248	470		10.6%	111.7%		18	43	9.1%	1	12	2.6%	19	55	11.7%	26	415	88.3%	3,221		5.4%	32.4%
Sun	03/30		60	283	530		12.8%	114.6%		21	64	12.1%	1	13	2.5%	22	77	14.5%	38	453	85.5%	3,674		5.3%	31.0%
Mon	03/31		80	350	610		15.1%	134.6%		15	79	13.0%	2	15	2.5%	17	94	15.4%	63	516	84.6%	4,190		5.8%	15.8%
Tue	04/1		75	399	685		12.3%	139.5%		5	84	12.3%	1	16	2.3%	6	100	14.6%	69	585	85.4%	4,775		5.6%	13.0%
Wed	04/2		23	392	708		3.4%	124.1%		5	89	12.6%	0	16	2.3%	5	105	14.8%	18	603	85.2%	5,378		5.1%	10.7%	160.0%
Thu	04/3		26	367	734		3.7%	100.0%		9	98	13.4%	1	17	2.3%	10	115	15.7%	16	619	84.3%	5,997		4.6%	9.8%	70.8%
Fri	04/4		27	336	761		3.7%	79.1%		1	99	13.0%	0	17	2.2%	1	116	15.2%	26	645	84.8%	6,642		4.0%	8.4%	58.6%
Sat	04/5		39	330	800		5.1%	70.2%		8	107	13.4%	3	20	2.5%	11	127	15.9%	28	673	84.1%	7,315		4.3%	9.0%	54.1%
Sun	04/6		42	312	842		5.3%	58.9%		9	116	13.8%	2	22	2.6%	11	138	16.4%	31	704	83.6%	8,019		4.2%	8.9%	52.4%
Mon	04/7		41	273	883		4.9%	44.8%		11	127	14.4%	1	23	2.6%	12	150	17.0%	29	733	83.0%	8,752		3.8%	8.8%	24.2%
Tue	04/8		45	243	928		5.1%	35.5%		11	138	14.9%	2	25	2.7%	13	163	17.6%	32	765	82.4%	9,517		3.6%	8.7%	20.3%
Wed	04/9		42	262	970		4.5%	37.0%		4	142	14.6%	2	27	2.8%	6	169	17.4%	36	801	82.6%	10,318		3.8%	8.5%	18.0%
Thu	04/10		28	264	998		2.9%	36.0%		12	154	15.4%	3	30	3.0%	15	184	18.4%	13	814	81.6%	11,132		4.1%	8.2%	17.3%
Fri	04/11		61	298	1,059		6.1%	39.2%		15	169	16.0%	2	32	3.0%	17	201	19.0%	44	858	81.0%	11,990		4.2%	7.5%	15.8%
Sat	04/12		49	308	1,108		4.6%	38.5%		46	215	19.4%	3	35	3.2%	49	250	22.6%	0	858	77.4%	12,848		4.4%	7.4%	15.8%
Sun	04/13		42	308	1,150		3.8%	36.6%		8	223	19.4%	5	40	3.5%	13	263	22.9%	29	887	77.1%	13,735		4.8%	7.5%	16.2%
Mon	04/14		40	307	1,190		3.5%	34.8%		6	229	19.2%	7	47	3.9%	13	276	23.2%	27	914	76.8%	14,649		5.3%	7.7%	18.1%
Tue	04/15		42	304	1,232		3.5%	32.8%		14	243	19.7%	9	56	4.5%	23	299	24.3%	19	933	75.7%	15,582		6.0%	8.2%	19.6%
Averages			35	258			17.7%	197.0%		9		11.0%	2		3.0%	11		14.0%	27		88.8%			9.3%	18.6%	40.1%
										Day	Total	%	Day	Total	%	Day	Total	%	Day	Total	%
Day	Date		New	Week	Total		One Day	Week		Got well			Dead			Total Gone			Now In Hospitals			Total Hosp Days		Week	2 Week	3 Week
Time			Cases				Increase			Disposition														Dead as % of prior time

[Judith Anne]

Bump to myself. Many thanks for all the thoughtful and interesting comments on this thread...

[CathyRyan]

You are right about having to pick a major at the wrong time in life. If I could just have it to do over again (knowing what I know now). I do not know enough to a have an opinion on if this is man made or not but I would really love to be a fly on the wall near a group a professional Bug Hunters. I bet they are all over this topic.

[RedWhiteBlue]

I saw them on TV last week, and he said that he would go back to the same place to pick up another child. Really stupid.

And, as far as Texas goes, I don't know about statewide numbers, but there have already been two cases confirmed in Harris County (Houston) and one in Fort Bend County (just southwest of Houston).

[EternalHope]

I'm not a doctor, but from what I've read a man made virus could go either way (harder, or easier, to cure).

However, the medical response to sequencing the genome seems to be pretty clear: The docs were disappointed.

Although the virus clearly seems to be from the coronavirus family, it did not show a clear link to any of the three coronavirus groups. Hence, they did not get a good read on where it originally came from. Nor did they get a good read on what animals might be useful for testing, nor did they get hints on what treatments and/or vaccine approaches might be most likely to work.

[CathyRyan]

http://www.abs-cbnnews.com/abs_news_body.asp?section=National&oid=20835

The SARS mother's baby was born April 1, according to Hong Kong's Princess Margaret Hospital, which declined to release information on the baby's gender or condition.

The Chinese-language Ming Pao daily said the baby was not full-term but doctors decided the 34-year-old mother was so sick they should go ahead with the birth.

[CathyRyan]

Also today, the WHO hosted a telephone conference of doctors to discuss apparent ``superspreaders,'' SARS patients who have infected many other people. WHO experts said the discussion confirmed what they had long suspected -- that all the superspreaders were people infected very early in the SARS outbreak before doctors know what protective measures to take.

Could this be right? How did the 11 medical staff come down with it? They would have had to be exposed after they started to realize what they were up against. I am starting to think everyone is start to spin control. jmho

[EternalHope]

The Chinese-language Ming Pao daily said the baby was not full-term but doctors decided the 34-year-old mother was so sick they should go ahead with the birth.

We see many articles focused on the overall story, and almost nothing about the huge human tragedy.

[delightfully dingy]

I'm hoping that since this isn't prime flu season and American cases can be quaritined that we will be able to dodge this bullet.

I'm praying anyway.

[EternalHope]

I am starting to think everyone is start to spin control.

Me too.

They would certainly lie if they thought that was necessary in order to keep medical people from becoming afraid to treat SARS patients.

How much more can Hong Kong take before the quality of care starts to fall?

What happens if Hong Kong's medical system collapses?

[CathyRyan]

SARS diagnostic test kit made available to members of WHO network
Scientists participating in the WHO collaborative network of laboratories have developed several diagnostic tests for SARS. These include a so-called “PCR” test, which allows detection of the distinctive genetic information of a virus.

Primers, which are the key pieces for a PCR test, were made publicly available by network laboratories on the open WHO web site (http://www.who.int/csr/sars/primers/en/ ) on 4 April. The primers have since been used by numerous countries around the world.

WHO scientists are now increasingly optimistic that the current PCR diagnostic test for SARS can rapidly be fine-tuned to a stage ready for roll out. Fine-tuning is needed because of important limitations in the ability of the current test to rule out the presence of coronavirus in SARS cases.

Yesterday, the Bernhard-Nocht Institute for Tropical Medicine in Hamburg, Germany informed WHO that primers developed there are being made available, in the form of a ready-to-use kit, by a Hamburg-based biotechnology firm. Apart from ease of use, the test kit has the advantage of built-in quality control. WHO was further informed by the Hamburg Institute that the test will be offered at no cost to laboratories participating in the WHO collaborative network.

The network, which includes leading laboratories from ten countries, was set up last month to expedite identification of the SARS causative agent and, in parallel, to rapidly develop a diagnostic test.

Initial testing of the kit by network members is expected to quickly yield the data needed to assess the test’s performance, in comparison with primers developed by other WHO network laboratories. The ability to detect persons infected with the SARS virus at an early stage is a key measure of performance. WHO has been concerned that weaknesses in earlier experimental tests for SARS would allow too many virus carriers to slip past undetected. Existing PCR tests are very specific but may not detect all patients who are excreting coronavirus. Early and reliable detection of the SARS virus in samples will be of great assistance in helping health care staff determine which persons presenting with fever and other suspicion-arousing symptoms should be immediately isolated and managed according to strict procedures of infection control. Such procedures will, in turn, greatly reduce the likelihood that infection will spread to others.

Various WHO network laboratories are endeavouring to improve their PCR testing protocols and primers to increase their reliability.

The Bernhard-Nocht Institute is a member of the WHO network of collaborating laboratories. The rapid development of the test kit is one example of how scientific knowledge, being generated by dedicated scientists, can be rapidly translated into a practical control tool.

Explanation of so-called SARS “super-spreaders”
“Super-spreader” is a term that has been used to describe certain individuals with atypical pneumonia, now recognized as cases of SARS, who have been implicated in spreading the disease to numerous other individuals.

The phenomenon of a “super-spreader”, which is not a recognized medical condition, dates back to the early days of the outbreak. At that time, when SARS was just becoming known as a severe new disease, many patients were thought to be suffering from atypical pneumonia having another cause, and were therefore not treated as special cases requiring special precautions of isolation and infection control.

As a result, stringent infection control measures were not in place. In the absence of protective measures, many health care workers, relatives, and hospital visitors were exposed to the SARS virus and subsequently developed SARS. Since infection control measures have been put in place, the number of new cases of SARS arising from a single SARS source case has been significantly reduced.

When investigating current chains of continuing transmission, it is important to look for points in the history of case detection and patient management when procedures for infection control may have broken down.

China
The WHO team of experts in Beijing was today granted permission to visit military hospitals. The situation of SARS cases in certain military hospitals has been the source of numerous rumours concerning the magnitude of the SARS outbreak. The WHO team has so far visited one such hospital but hopes to visit others soon.

The decision by Beijing authorities is a welcome indication of China’s willingness to come to terms with the SARS outbreak on the mainland. Yesterday, China’s president Hu Jintao said on state television that he was “very worried” by SARS. The WHO Beijing team is expected to finish its preliminary investigation on the status of SARS in China tomorrow. Additional WHO teams will travel soon to other parts of China.

Update on cases and countries
As of today, a cumulative total of 3235 cases of SARS, with 154 deaths, have been reported from 22 countries. This represents an increase of 66 new cases and ten deaths compared with the previous day. Nine of the ten deaths occurred in Hong Kong SAR. One death was reported in Singapore.

http://www.who.int/csr/don/2003_04_15/en/

[CathyRyan]

If this holds up life is going to be a real b!tch for awhile.

[IYAAYAS]

Is it still true that NO ONE has made a full recovery? It may be possible to become repeatedly infected and it "may spread over the globe again-and-again" OMG!

I live in SE FL and I'm getting the same feeling as when there's a giant hurricane swirling just off the coast.

[aristeides]

This suggests that it will be quite difficult to manufacture a vaccine for SARS as well as to suggest that no one is permanently immune to the disease even if they have recovered from it.

It may suggest that it will be difficult to make a SARS vaccine that provides total immunity, but I think it also suggests it will be possible to manufacture one that provides considerable resistance, probably enough to save most victims' lives.

[Nebullis]

--"Again, I think that we shall see an unstable virus that will either mutate virulent or muate harmless with lower infectivity rate, lower mortality rate. It may be evidenced with symptoms no more than the common cold. I am hoping that it will mutate harmless, and it does appear that will be the case."--

Does Patricia Doyle think that the virulent form will disappear if the virus mutates to something less harmful? The only way a less virulant mutant may be beneficial is if it confers immunity to related viruses.

[aristeides]

Sialodacryoadenitis Virus, Rat Corona Virus.

[riri]

but I think it also suggests it will be possible to manufacture one that provides considerable resistance, probably enough to save most victims' lives.

I was thinking along those lines. Let's face it-this thing can't, in it's current form be allowed to spread around the globe. At least not without ushering in a new dark ages.

I don't think I am being overly dramatic.

[_Jim]

What happens if Hong Kong's medical system collapses?

How would that happen - what would be the result?

[CathyRyan]

Don't panic yet. :) There is a lot they do not know and if you read the older threads you will see that nothing is written in stone yet. This is new to everyone and a lot of what you read can be subject to change.

[aristeides]

SIALODACRYOADENITIS VIRUS (SDAV) also referred to as Rat Corona Virus Infection:

CONTROL: Control requires very strict adherence to preventative measures, including procurement only of SDAV-free rats and adherence to strict barrier housing procedures. Prompt elimination of infected populations is essential to prevent spread of infection to other rodents. A less effective alternative is to place infected animals under strict quarantine, remove all young and pregnant females, suspend all breeding, and discontinue adding other susceptible animals for a period of 6-8 weeks until the infection has run its course and the virus has been eliminated naturally.