Possible SARS in Toronto High School?

Reuters ^ | 5/28/2003 | Rajiv Sekhri

[jacquej]

TORONTO (Reuters) - Canadian officials will discuss on Wednesday whether the deadly SARS virus escaped from hospitals to the broader community after a Toronto-area high school student went to class last week with symptoms of the illness.

Health services said late on Tuesday they would hold a news conference on Wednesday to discuss "possible SARS exposure" at the school, as authorities tried to contact everyone who attended the school between last Wednesday and last Friday.

The investigation into a possible case at the school comes as medical staff at some Toronto hospitals, fearing they allowed SARS back into a city that thought the battle was over, have resumed donning face masks and layers of gloves to guard against the spread of the killer virus.

[jacquej]

This needs to be followed. Once it gets in the schools, we are in big trouble! I am worried about the description "possible", as I suspect they are playing with semantics here.

[jacquej]

looking for more info on the "possible" case in the high school, I found this...


According to official figures released Tuesday, those two clusters have led to nine new probable cases of SARS - an increase of one from Monday - and 23 suspect cases. Two of the probable cases have died, including the man who is considered, for now, the first or index case in the group.

Meanwhile, health officials closed a high school north of Toronto late Tuesday and moved to send 1,700 students and staff into quarantine after one student went to Father Michael McGivney Catholic Academy last week showing symptoms of SARS.

The student is considered a suspect case and is in hospital, Dr. Murray McQuigge, a consultant with York Region, said late Tuesday.

"We are confident that there is a definite link" to North York General, said McQuigge, who didn't release details on the extent of the connection to the hospital.

The school in Markham, Ont., will be closed until June 3. .....

the entire article can be found here..

http://www.canada.com/health/story.html?id=FAE85BBF-6B33-4376-A057-4D336E325B53

[Prince Charles]

Did they say how the high schooler acquired SARS? The Toronto medical bigwigs have been crowing about this being "contained" to hospitals only.

[jacquej]

All I could get is that there might be a connection to one of the hospitals, North York, I think...

My research on this is that the Canadian system for reporting is disorganized, compared to that in the US, and that they are constantly changing the criteria for categorizing the cases, and therefore the rules for reporting.

Some of the nurses at the hospitals tried to warn the administrators, etc, about patients having SARS, but were ignored. The nurses are really ticked off.

Remember, the Canadian Health Care system is very different than ours, and so is the politics....

I live just across the border from Canada, in western NY, and the Canadians own a lot of the property in resort areas around here, so I am assuming that if it gets into the community in Toronto, it will be here in short order.

That is why I am watching for evidence of community spread so closely.

[harpseal]

ping

[Dog Gone]

The logical connection is that this high school student visited someone at North York where SARS was spreading unbeknownst to the staff. A few days later he started feeling sick at school, and we hope had not yet developed the SARS cough.

I'm guessing here, but I'm not sure what else it could possibly be, unless the kid is a relative of a hospital worker who also contracted SARS.

[jacquej]

I am wondering how best to follow news items that might indicate unusual respiratory problems in major cities near the border with Toronto, as this might be an indicator that our "officials" are playing around with "definitions" of communicable illness.

Do you or anyone else have any ideas on how best to track this issue?

We really have no idea on how early folks are contagious, who is a superspreader, even though unsymptomatic, etc... There was a report of a man with SARS who had recently visited Toronto, from Wheeling, West Virginia, I believe. So, in that sense, it is out of the hospitals and in the community, as I do not recall that he had visited the hospitals.

We have a neighbor who regularly travels to Toronto on business, and plan on keeping tabs on his health, and a safe distance, of course, as we are in the not-so-hot age bracket for having "mild" cases of SARS!

[jacquej]

Could you add my name to the "ping" list for SARS? I follow the story closely here and on other sites, and find it very interesting and important to stay informed about whether it is going to die down for the summer, re-activate in the fall, or die out, hopefully... not becoming a pandemic...

[aristeides]

Can Kitty pass Sars virus to you? Not likely .

[aristeides]

SARS closes Toronto-area school .

Ontario really should shut its schools, the way Hong Kong did for a few weeks. They can't be that far from vacation anyway.

Also, people feeling sick should be instructed to stay home, rather than going to school or work or whatever.

[Chemist_Geek]

Also, people feeling sick should be instructed to stay home, rather than going to school or work or whatever.

That'd never fly here, I'm afraid - too many people are scared that if they call in sick or don't show up for mild symptoms, then their bosses will realize that they can be done without...

And too many bosses are looking for any excuse to cut staff...

[Centurion2000]

bump ... this is not good.

[jacquej]

From the article you posted...

"Families or other household members of a quarantined student or staff member are not required to remain at home in isolation."

Can someone here more up on the effectiveness of the quarantine process explain how this works? It seems to me that there is still not solid information on how this is transmitted, and I wonder if it is possible for a quarantined person to transmit the illness to a non-quarantined family member. This non-quarantined family member could then transmit it to the persons he comes into contact with...

I realize the impracticality of quarantining everyone in a household. My daughter and son-in-law both teach at a good-size small city high school. If they were both quarantined, they would be dependant on someone to get them food, etc...

I plan on telling her to get ready for quarantine, jic... mostly to have plenty of things to do to pass the time. I can see her shake her head in my mind's eye right now... saying "Oh, Mom"... (lol)

[Judith Anne]

jacquej, I think you are asking some really good questions. The answers may determine the outcome of any outbreaks in the US...

[Judith Anne]

I don't know how we can keep track of potential US outbreaks especially along the Canada/US border...I hope people will mention what they've heard, along with any source so it can be evaluated for accuracy...

[jacquej]

Thanks. We need to be careful to ask ourselves the right questions, and not make quick assumptions...

Just found this... and what botheres me about it is the loosey-goosey way a case is categorized. Makes it hard to ask the right questions, in my opinion.


"Officially, there are 12 probable cases of SARS in the Toronto area. Dr. Donald Low says the real number is closer to 30.

He says SARS continues to be a major health crisis in the city.

"There's a lot more patients out there that have SARS than we're letting the rest of the world believe," he said.

Low says Health Canada's new definitions make it nearly impossible to declare a probable case of SARS.

"Right now we're playing this game of trying to classify patients as either 'under investigation,' 'suspect' or 'probable.' It becomes semantics," said Low, chief microbiologist at Mount Sinai Hospital in Toronto.

Under Health Canada's new definitions, a suspect case requires a fever, respiratory problems, close contact with a suspect or probable case and no other known cause of illness.

To be a probable case, a person also needs to be suffering from a serious respiratory illness.

He says that includes the original cluster of seven cases at North York General plus more than two dozen health-care workers who have gone to the hospital's emergency room with symptoms.

"They might not meet a definition, but to me, you have to assume they have disease," said Low.

Low says health officials in Ontario fear the consequences of telling the World Health Organization about all the cases under investigation. "

here's the link...

http://www.cbc.ca/stories/2003/05/28/sars_underreport030528

[Judith Anne]

As you know, we've all been concerned about the "loosey-goosey" SARS definition...it seems to have been formulated with less than public health in mind, in my opinion.

[jacquej]

An interesting article in the Wash Post about what Italy is worrying about, and there is a comment in it about the long incubation period, and the futility of checking temps for arriving travelers...

Judith Anne might be able to explain that a bit further. I am reluctant to make any assumptions about the "communicable" phase of the illness, mostly because I read so many conflicting opinions on exactly when a person is capable of transmitting the virus.

I think it is important to keep Toronto's problems with SARS in perspective, and to follow the concerns of other countries. I am convinced that Toronto has had some very bad luck with this, and that we should be very cautious in assigning "blame".

The comments excerpted from the Post article support my opinion, I think.

"Italian health officials said they continue to worry about SARS, notably a possible panic this fall and winter -- flu season. In February, a virulent flu swept the country.

"If in the fall, SARS intersects with influenza, we're ruined," said Mario Falcone, president of the Federation of Family Medicine."

http://www.washingtonpost.com/wp-dyn/articles/A46804-2003May27.html

[per loin]

Again, Low seems like the only honest man on the scene.

[Alouette]

one student went to Father Michael McGivney Catholic Academy last week showing symptoms of SARS.

The Catholic school teachers were on strike, and the government just ordered them to go back to work. Way to go.