Posted on 05/31/2003 1:57:32 AM PDT by sarcasm
Severe acute respiratory syndrome has proved such a resilient disease that health authorities believe it cannot be eliminated, the director of the Centers for Disease Control and Prevention said Friday.
"I am not optimistic that we will be able to completely eradicate this infection," Dr. Julie Gerberding said at the CNN World Forum, an annual Atlanta gathering of newsmakers and journalists.
Gerberding's remarks, delivered by videolink from Washington, reflected the frustration of international health authorities who are dealing with fresh outbreaks in areas where SARS appeared to have been controlled.
"The best case scenario [is], all the efforts that are going on globally will get the genie back in the bottle; the worst case scenario [is] it will continue to expand and ultimately become a problem in every corner of the world," she said. "The most likely scenario right now is that we are going to have to work hard to keep it contained."
In the past week, SARS has surged in Toronto, resulting in 43 probable and 15 less serious suspect cases and causing Canada's 30th death from the disease.
On Friday, Hong Kong reported four new cases of the disease.
In both cities, patients appear to have been infected with SARS after they were admitted to hospitals for other health problems.
Chain spreads
The Toronto outbreak began with an elderly patient who became infected while recovering from surgery but who was misdiagnosed as a case of common pneumonia. Authorities have not been able to explain how the man was infected. They suggested equipment in the hospital may have remained contaminated, or a health worker may have had a mild case of SARS that went unrecognized because he or she did not have the disease's main symptoms of fever and cough.
The chain of infection from the elderly man, who died May 1, extends into Toronto's outermost suburbs and has put almost 8,000 people into quarantine, according to Ontario's Ministry of Health.
It also may have spread across the U.S. border. The Pennsylvania Department of Health announced Friday that a Canadian nurse who was treated for a sinus infection May 18 in a clinic in Shippensburg, Pa., near Gettysburg, was hospitalized as a probable SARS case after returning to Toronto. Doctors and nurses at the Pennsylvania clinic, which the state would not identify, have been warned to monitor their health but are not showing symptoms, the department said.
'Most challenging' yet
Up to four Canadians associated with the new Toronto outbreak may have come to the United States before learning they had been exposed, Dr. Donald Low, chief of microbiology at Toronto's Mount Sinai Hospital, said during the CNN conference.
The resurgent cases cropped up after health workers in Asia and Canada controlled earlier hospital outbreaks by instituting stringent measures: isolation rooms for patients, quarantine for any staff members believed to be exposed, and gloves, gowns, masks and face shields for workers who remained on the job.
"This has got to be one of the most challenging infectious diseases we have ever had to deal with because it can be so efficiently spread," Gerberding said. "We have seen, in places that have implemented the very best infection control, that there still can be some transmission to health care personnel."
Keeping on guard
The persistence of SARS despite those measures has left health officials concerned. The front line of defense appears to depend on workers precisely following elaborate precautions even though they may be tired, stressed or ill.
"You can imagine how disheartening this is for public health officials who have been on the front lines, and doctors and nurses in Toronto who have been on the front lines fighting this for weeks," Anne McLellan, Canada's minister of health, said Friday in Atlanta. "One cannot let down one's guard."
McLellan spoke after a fact-finding visit to CDC headquarters in Atlanta. The Canadian government has been discussing setting up a similar agency to coordinate its public health efforts, which are run by the provinces.
Like Gerberding, McLellan expressed pessimism that SARS will be eliminated, predicting instead that it will permanently change how doctors, nurses and patients interact.
"Unless we are able to with confidence eradicate SARS . . . we have to learn to live with it," the Canadian health minister said. "We have all started to live with a new reality as it relates to our physical security, after Sept. 11. I think probably we have to start thinking about a new normal as it relates to our health."
The challenge, other health experts said, is not just becoming more alert to the disease, but learning how to sustain vigilance over the long term.
"This is a disease that is not going to be easy to conquer, because so many people who have it are difficult to recognize," said Low, who was quarantined for 10 days at the start of Toronto's epidemic and then became a leader in the city's fight against SARS. "For the future, the question will be: How do we make sure, when we say it is over, that it is really over?"
Valid question...
Well, with this as offical CDC guidance (5/14/03), I would certainly be expecting US outbreaks:
"Thousands of people arrive in the United States from areas where SARS outbreaks are occurring to participate in gatherings such as academic courses, business meetings, or sporting events. Guidance is needed to provide a consistent, rational approach to SARS prevention without unnecessarily stigmatizing these groups or interfering with collegial pursuits, commerce, and other important activities. At this time, CDC does not recommend canceling or postponing classes, meetings or other gatherings that will include persons traveling to the United States from areas with SARS"
(italics mine, bold CDC)
Wouldn't you?
While I agree that Political correctness kills even that does not seem to stop PC. Case in point: The objections to sceening out Homosexual men from being blood donors.
We already are seeing that. The government is refusing to even say which hospitals or clinics are treating SARS patients. If that policy is not soon changed, the rumor mill takes over.
BTW, thanks for all of you input on these threads. I try to read them all and I'm quite afraid for all of us in the immediate future.
The news is not good, not good at all....
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