HK deals with SARS patients not showing typical symptoms

Channel news Asia ^

[per loin]

HK deals with SARS patients not showing typical symptoms 

By Amy Or

It seems that some SARS patients in Hong Kong may have been infecting others even before they themselves show any symptoms.

This has led the Hong Kong government to enforce stricter measures in all hospitals to control the spread of Severe Acute Respiratory Syndrome (SARS).

Advertisement

Anyone who comes to hospital with even mild symptoms like a low-grade fever will have to be admitted for observation.

But some doctors say this policy could backfire.

Most people in Hong Kong are aware that the SARS virus is transmitted through close contact via droplets.

But there are now signs that the virus is mutating.

The recent cases involved highly infectious patients who did not have the typical SARS symptoms of high fever and cough.

Among them are elderly people who have a lower body temperature, making it even more difficult to detect SARS cases.

They now come under a newly-created category -- those with mild SARS symptoms.

They will be put under observation in hospitals.

So far, about 20 percent of the patients under observation are later confirmed to have contracted the disease.

But some doctors say hospitalising patients under this mild category may actually help spread the virus to non-SARS patients in the same ward.

"In some cases of assisted ventilation using what we call the 'BI-PAP' device, because the facial mask is not 100 percent air-tight, some of the virus might leak around the mask under the positive pressure within the mask," said Leung Ka-lau, president of the Hong Kong Public Doctors' Association.

It is not known how many patients and health workers have contracted the disease in this way.

But a week ago, a medical worker at a private hospital contracted SARS when she attended to an elderly man who had a stroke.

So it looks like there is no sure way to determine just who is carrying the disease.

But there is no reason to doubt the stranger next to you while in public.

"There are around 30 new cases per day and if the incubation period is around at the most 10 days, we can assume that there may be around 300 such people in the city who are capable of infecting others. On the other hand, 300 in a city of six million, the chances are at the most one in 20,000," said Dr Leung.

Still, Dr Leung says it is best to don a mask in crowded areas and on public transport in Hong Kong.

[per loin]

I don't think this is good news for containing this disease.

[11B3]

I'd say not.

[Prince Charles]

But a week ago, a medical worker at a private hospital contracted SARS when she attended to an elderly man who had a stroke. So it looks like there is no sure way to determine just who is carrying the disease.

Things are looking up!

/sarcasm

[11B3]

Hey per loin - since you've been following SARS so closely, what's your personal opinion on whether or not we're seeing a pandemic in its' infancy?

There's a few questions that I hope you can answer regarding the virus as it is known so far (with the current sets of mutations):

1. What kills it on surfaces - bleach I know, but how about UV, gamma, etc.?

2. What percent of people who are exposed to the virus become infected? (If there are 100 people in a room with the virus airborne, how many come down with SARS?)

3. Have you heard any reasons for the variations in the death rate between the major affected areas?

Thanks so much for all your work on tracking this - I certainly appreciate it as much as so many others do. The lack of awareness regarding SARS among the idiotic masses amazes me to no end. Some of the people I've talked to in stores or on the street are completely ignorant about it, with some not even having heard about it yet. (They'd probably be the ones who would survive it as a pandemic.)

[Prince Charles]

WHO warns of 'explosive' SARS

[per loin]

I've not the expertise to give much of an answer to your questions. I'm just an info-junkie who became intrigued by the first reports I heard back in February on the panic in Guangdong, and started keeping stats on Hong Kong because I could not find adequate ones elsewhere.

At present no one seems to really know if this will go pandemic or not. Expert opinion goes both ways (kinda like in a trial). Time and its enclosed events will tell the story, and I'll read it as it's written.

[per loin]

That article makes it sound as though they will soon be paying a bounty on those caught with the disease.

[Prince Charles]

Yes, they sound serious about tracking down every single Typhoid Mary... good luck.

[per loin]

The Washington Post is saying that journalists in Beijing estimate that over a million people have already fled the city.

[per loin]

Oooops. Make that almost a million.

[Prince Charles]

Bingo. I posted a story last weekend (I think) which detailed the panic in the city back then... and now the bug is out and about in the countryside.

[per loin]

This story makes it sound like China is coming unraveled.

[Prince Charles]

Sheesh... about 10 days from now those time bombs will be going off all over mainland China. That's where this battle will be won or lost.

And to further pile on, here's another one: SARS Diagnostic Test Could Be Yielding False Negatives

[FreepForever]

That article makes it sound as though they will soon be paying a bounty on those caught with the disease.

That's what Singapore is doing now. they pay $50 for each informer. Looks like Taiwan will follow suit too. Wold that send you looking for some suspects on the street now?

[Ma Li]

The Chinese use a kind of coal in their daily cooking that causes anyone not used to is (i.e. foreigners) to cough uncontrollably when around it. The information is so poor around here, that the locals are accusing foreigners of bringing it to this town, and calling us "the SARS people" when we go by, especially if we cough on that cooking smoke.

People are arriving in masses from Beijing and Wuhan. The police are trying to herd them straight from the trains to the hospitals, to be tested for SARS, but, of course, the tests aren't always accurate, and the people often don't want to go. Who would? If I break my leg here, I'll set it myself in my apartment. There is no way I would go to the hospital.

[FreepForever]

That's exactly what I have predicted a few days ago.

The exodus from Beijing is exactly what it needs to spread the decease nationwide. Even a couple of SARS carriers among the dozens of trains leaving Beijing (600 passengers each) can bring it to rural China where medical facility is primitive.

WuYi, the new Health Minister now, had warned that when the virus strike China's heartland, it will spread like wild fire. Yet, those jack ass officials can still neglet to set up any quarantine procedures (ie: temperature check, filling forms of their destination's contact address, etc.) before they let that one million people swamp back to their hometown and scatter.

THIS IS ONE GIGANTIC SCREW-UP. Now, they are all gone and untraceable, it is too late to do anything. Take extra precaustion if you are still in China now.

[Ma Li]

Don't worry....I am on my way out next week. Have to get re-entry visa, health check to be allowed on a plane, and pack up, but it's just getting worse all the time. I don't go out unless I must, and carry hand sanitizer with me everywhere. Use it till my hands chap. :-) We're also having a minor tremor here right now, which is SO exciting given that the new largest dam in the world is about 30 minutes away.

[riri]

I am on my way out next week

Are you leaving due to SARS? Are you leaving permanently?

[Dec31,1999]

They now come under a newly-created category -- those with mild SARS symptoms.

This could be good news. It could mean that there are now mutations of the virus out there that are not deadly, but that will provide immunity from the more deadly strain or strains.

Or it could mean that the virus is more widespread than previously believed, meaning that reported fatality rates are higher than they actually are.

One can hope!