Posted on 05/10/2003 1:11:15 PM PDT by DeaconBenjamin
HONGKONG health officials said on Saturday they have adjusted their treatment of Sars as they revealed that 10 per cent of patients thought to have recovered from the virus could suffer lasting damage to their lungs.
The government's decision to adjust the treatment protocol came as the city recorded two more deaths and seven new Sars cases, bringing the territory's death toll to 212 from 1,674 infections.
Director of Health, Dr Yeoh Eng Kiong, said that the decision to adjust the treatment for Severe Acute Respiratory Syndrome (Sars) had been taken after studies from the Hong Kong University and Chinese University showed the virus struck in three stages, each lasting approximately seven days.
In the first phase the virus replicates. The next -- the immune hyperactive phase -- is when the body's immune system is activated and fights the virus so vigorously that the lungs are damaged.
The last phase is pulmonary destruction, or lung scarring.
Dr Yeoh said the controversial anti-viral drug Ribavirin -- which US experts say is not effective in tackling Sars -- would continue to be used in the first stage of the illness.
But in some cases the protease inhibitor Kaletra would be used singly or in combination with Ribavirin to tackle virus replication after it had been shown in laboratory tests to be efficient in battling the virus, he said.
The use of steroids, which have side-effects, would now be used in the second rather than the first stage to reduce the drug load on patients, Dr Yeoh said.
While 80-85 per cent of patients would show signs of recovery, about 20 per cent entered the third stage where they would require a respirator to help them breathe. New drugs would be assigned to help these patients, he added.
For the past seven days the territory has reported a single-digit increase in Sars infections, in an encouraging sign the city is bringing the spread of the deadly virus under control.
However, health officials also revealed for the first time that 10 per cent of convalescent patients did not completely recover from Sars and continued to suffer effects such as shortness of breath caused by damage to their lung tissue.
Dr Yu Wai Cho, a consultant at the Department of Medicine at Princess Margaret Hospital, said X-rays taken from 10 per cent of recovered patients continued to show abnormal imaging.
Dr. Chan Kin Sang, chief-of-service of the Pulmonary Care Unit at Haven of Hope Hospital, admitted doctors were very concerned about this group of patients as they seem healthy, but when they have to work or exercise, their lungs are 'not back to 100 per cent of what they were before the illness.'
Dr Chan added this was common for patients who suffered other respiratory illnesses such as typical pneumonia and stressed that although their lungs were damaged 'most had lung reserves and the patient had to learn to use their lungs more effectively to compensate for the loss in lung capacity'.
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