Mystery Illness Thread (press Conference @ 1pm est.)

Is this about the plane and passengers that have been quarantined in Germany with that outbreak of pneumonia that I partially heard on Fox a little while ago?

Seems to be. Threads here and here.

They're not certain. First idenitified case an American in Hanoi, who'd just come from Guagdong province in China, where they had an outbreak of "atypical pneumonia." But they haven't tied the two together (or separated them) yet.

Lethal "flu" hits Asia, Canada: unknown cause, no cure

At least six people have died and several hundred others have been stricken down in China, Hong Kong and VietNam with a mysterious ailment the World Health Organisation is calling an "atypical" pneumonia, a term often used to describe nonbacterial pneumonia.

The illness has also been diagnosed in Canada and Singapore. The Toronto Star reports that two members of an infected family have died of the illness, which would bring the global death total to eight by Friday night.

Two suspected cases have also developed in Taiwan, Malaysia's The Star reports. According to the Star, the pair are a married couple who came down with symptoms resembling those of the mystery flu after the husband travelled to China's Guangdong province, where the disease may have originated.

On Friday, the World Health Organisation recognised the severity of the problem by issuing a global alert, its first in ten years.

WHO officials said tests by leading laboratories in four countries have failed to find a cause and the illness is responding to neither antiviral nor antibiotic drugs.

"It is not a very good situation," Dr. David L. Heymann, a top WHO expert in communicable diseases told the New York Times. "It is a very difficult disease to figure out, and this has been going on for the last 10 days to two weeks."

The alert comes immediately following a global scare about so-called "bird flu", which also appears to have sprung out of China and which may have been confused in some quarters with the initial outbreak of the "atypical pneumonia."

The Times reports that in addition to breathing problems typical of pneumonia, the illness can cause a dry cough and other flulike symptoms, which apparently develop about four to five days after exposure. They usually start with a sudden onset of high fever and go on to include muscle aches, headache, sore throat and shortness of breath. Standard laboratory tests often show low numbers of white blood cells and platelets, which help blood clot.

Although some victims remain stable and others seem to get better for two to three days, they eventually relapse, developing acute respiratory distress. Some need to have a tube inserted in their windpipe to help them breathe.

Among the survivors, "no one has gotten well yet," Dr. Heymann said in an interview with the Times. "It is not clear what is going on, and it is not clear what the extent of spread will be," particularly because "these are areas where there is a lot of international travel," he added.

A Toronto woman, Kwan Sui-chu, apparently died on March 5 of the ailment, shortly after returning from Hong Kong, which she visited with several other family members who are all ill.

As late as yesterday, health officials were trying to inject calm into the situation by claiming that the disease had been traced to a "typhoid Mary" type carrier, an American businessman, after which all reported instances had been among hospital personnel.

That is no longer the official line.

In Canada alone, five other family members who had not been to Hong Kong recently have since become ill, the Times reports; four are still in the hospital while the fifth, Mrs. Kwan's son, Chi Kwai Tse, died on March 13, according to Mary Margaret Crapper, a spokeswoman for Toronto Public Health.

Ms. Crapper told the Times that her agency was aware of two other cases in Canada, both in Vancouver and involving people who had also traveled recently to Hong Kong.

"To see a cluster of such severe illnesses over a short period of time ... that's obviously quite serious, with two deaths," Dr. Barbara Yaffe, associate medical officer of health with Toronto Public Health told the Sun.

Toronto health authorities have interviewed the family members extensively and a provincial coroner is examining one death. Testing is currently being done at a provincial lab in Ontario and the National Microbiology Laboratory in Winnipeg.

"They're looking for anything and everything," Yaffe said yesterday after a news conference at Mount Sinai Hospital. "We're dealing with an unknown causative agent."

Contagion does seem to be via respiratory droplets, authorities say, which may be why most of the victims have been hospital workers. But the sneezing and coughing common to flu has the potential to spread the disease far more widely than in treatment centres.

Hanoi has had at least 42 cases and Hong Kong 43, the Times reports. Guangdong province, which adjoins Hong Kong in China, reported 305 cases by mid-February, including 5 deaths. Officials in Singapore said yesterday that there had been nine cases there — three recent arrivals from Hong Kong and six people who cared for them, two of whom were hospital workers.

Officials in China had said that the February Guangdong outbreak of a disease that appears to closely resemble the mystery illness was over, but that has not been confirmed, WHO revealed.

But in spite of widely circulated rumours, the disease appears to be unrelated to a very contained outbreak of of avian influenza that killed a father and sickened his eight-year-old son in Hong Kong last month. Still, doctors are ruling nothing out at this stage.

The original reported case in the outbreak that has spread to Hong Kong and other locations around the world appears to have been an as yet unnamed 49 year old American businessman who presented with the symptoms in Hanoi, where he lives, after passing through Hong Kong and Shanghai. The man complained on returning to VietNam of feeling unwell and was treated in the private Hanoi French Hospital. He was later moved to Hong Kong's Princess Margaret Hospital when his symptoms worsened and large numbers of Hanoi French Hospital staff began to present with symptoms, forcing the facility to close.

In addition to the Princess Margaret and the Hanoi French hospitals, WHO has started examining tissue samples from staff at Hong Kong's Prince of Wales Hospital who have also been inflicted with the new virus, and staff at several other Hong Kong hospitals are said to be suffering from the sickness.

Sales of surgical masks have surged in Hong Kong as word of the highly infectious virus spreads and the Hong Kong SAR said yesterday that it is not convinced all the reported incidents -- particularly those in Canada and Shanghai -- are related to cases presenting in Hong Kong. SAR has been issuing bulletins about the outbread and an official said in one statement on yesterday:

You can get atypical pneumonia anywhere in the world. It is quite unfortunate that when people report cases, they lump everything together. I know the reports in Toronto relating to individuals who came back from Hong Kong and then developed pneumonia and reportedly two patients died. And we also have cases of people coming from Singapore who then went back to Singapore and reported pneumonia and then also spread to health care workers. These occur in all types of known atypical pneumonia. What we are very interested in is a very unique type of atypical pneumonia which gives concern that there is a new agent. In fact, I will call upon the World Health Organisation (WHO) to do a more clearer definition of what they said they are trying to look for so that there is no confusion in the international community, and for WHO to also collect data on the clinical features of these cases so that we can better understand this phenomenon that we are seeing in Hong Kong and reportedly in Vietnam and Southern China. It is very important to define clearer what is it we are looking for. Otherwise, it will cause a lot of confusion and worry in the international community. This is the current situation.

SAR has said repeatedly that governments should not advise tourists against visiting because Hong Kong is "actually safe at the moment."

In the press release attending its global alert, WHO said:

Until more is known about the cause of these outbreaks, WHO recommends patients with atypical pneumonia who may be related to these outbreaks be isolated with barrier nursing techniques. At the same time, WHO recommends that any suspect cases be reported to national health authorities.

WHO is in close contact with relevant national authorities and has also offered epidemiological, laboratory and clinical support. WHO is working with national authorities to ensure appropriate investigation, reporting and containment of these outbreaks.

No incidents of the disease have so far surfaced in New Zealand or Australia, and authorities have specifically stated they do not believe the outbreak is terrorism related.

BBC News is running a riveting first-person account from a doctor in Hong Kong who is working in the middle of the widening outbreak. According to him, "There has been a total news blackout from Guangzhou, which unfortunately has fed some more lurid imaginations leading to speculation of mutated viruses, 'air-born aids', and experiments gone wrong. Of these, the possibility of a naturally mutated virus seems the most likely.

"The numbers of patients in Hong Kong are rising, more hospitals are affected, and there have now been deaths of local people with no history of travel.

"Operations have been cancelled, wards are being emptied in anticipation of an increased influx over the weekend, staff are being relocated to emergency departments," he writes.

Maybe this CDC press conf. will shed some light. Should begin soon.

Excluding the 5 reported deaths in China, which may or may not be the same thing, (they likely are, but the Chinese are being secretive) there have only been about eight deaths so far. The no-recovery story is a bit premature, as no one yet knows how long this thing hangs on.

Thanks for the help.

http://www.nytimes.com/2003/03/16/health/16INFE.html

March 16, 2003
Rare Health Alert Is Issued by W.H.O. for Mystery Illness
By LAWRENCE K. ALTMAN and KEITH BRADSHER

s a mysterious respiratory illness spread to more countries, the World Health Organization today issued a rare health alert, declaring the ailment "a worldwide health threat" and urged all countries to help in seeking its cause and control.

The agency said that in the last week it had received reports of more than 150 new suspected cases of the illness, now known as Severe Acute Respiratory Syndrome, or SARS. The syndrome has caused at least six deaths and not one of the survivors has fully recovered. It apparently does not respond to antiviral and antibiotic drugs.

The cause has not been identified. Scientists do not know whether it is a virus or even an infectious agent. Although health officials have suspected avian influenza, which has infected a small number of people sporadically in Hong Kong since 1997, laboratory tests have not detected that rare strain, known as influenza A(H5N1). As a result, laboratory scientists are focusing on the possibility of a previously unknown infectious agent.

Reported cases have come from Canada and six countries in Asia — Hong Kong and elsewhere in China, Indonesia, the Philippines, Singapore, Thailand and Vietnam, the health organization said.

There have been no reports of the illness in the United States. But today, an ill passenger and two companions who traveled from New York City were removed from a flight after it arrived in Frankfurt and put in isolation in a German hospital.

The passenger is a surgeon from Singapore who treated one of the earliest cases there, and who flew to a medical meeting in New York City, said Dick Thompson, a spokesman for W.H.O. The surgeon may have gone to a hospital in New York — the agency is not certain which one — before flying back to Singapore via Frankfurt with his wife and another doctor. Before boarding the flight, the surgeon called a colleague in Singapore to describe his symptoms, and the colleague notified the World Health Organization.

In an emergency advisory issued today, the World Health Organization, an arm of the United Nations based in Geneva, said that "there is presently no indication to restrict travel to any destination."

But it urged all travelers to be aware of the main symptoms and signs. In addition to the breathing problems, the illness can cause a dry cough and other flulike symptoms that apparently develop about four to five days after exposure. They usually start with a sudden onset of high fever and go on to include muscle aches, headache, sore throat and shortness of breath.

Standard lab tests often show low numbers of white blood cells and platelets, which help blood to clot.

W.H.O. said that any passenger or airline crew member who developed such symptoms should immediately seek medical attention and ensure that information about their recent travel is passed on to the health care staff. "Any traveler who develops these symptoms is advised not to undertake further travel until they have recovered," the agency said.

If a passenger became ill on a flight, the agency asked airlines to alert the airport of destination and to refer any ill passengers to airport health officials.

"There are currently no indications to restrict the onward travel of well passengers, but all passengers and crew should be advised to seek medical attention if they develop" symptoms, the agency said.

In another rare step, the United States Centers for Disease Control and Prevention activated its emergency operations center in Atlanta, including sophisticated communications technology, to enhance its ability to coordinate information from other countries and to investigate any suspect cases in this country.

C.D.C. has used the operations center only twice before, for the mosquito-borne West Nile fever epidemic last year and the anthrax attacks in 2001. The last time it issued a global health alert was in 1993, to enhance measures to control tuberculosis. W.H.O. officials said they could not recall the last time an emergency global travel advisory was issued.

C.D.C. is investigating the travel histories of the passengers who are now in a German hospital as well as one of the eight cases suspected to be the new syndrome in Toronto and Vancouver that Canadian health officials reported on Friday.

W.H.O. officials said they at first thought the surgeon who fell ill was on a flight to London, but learned from a pharmaceutical company that paid for his trip that he was flying to Frankfurt instead. Two hours before landing, W.H.O. notified German health officials, who had the plane moved to a separate runway where the surgeon, his wife and colleague disembarked and were taken to a nearby hospital. German health officials advised the other passengers to monitor their health and gave them a telephone number to call if they developed any symptoms. Officials did not release any information on his condition.

Mr. Thompson said the cases in Toronto involved a family who returned home after flying to Hong Kong. A woman, Kwan Sui-chu, died shortly after her return. Five other family members who had not been to Hong Kong have since become ill; four are still in the hospital while the fifth, Mrs. Kwan's son, Chi Kwai Tse, died on March 13, according to Toronto Public Health officials.

Toronto health officials said they were aware of two other cases in Vancouver, British Columbia, both involving people who had recently traveled to Hong Kong.

C.D.C. officials are aiding in the investigation because Mrs. Kwan's daughter, who is being treated in an intensive care unit in Toronto, had flown to Atlanta recently, Mr. Thompson said.

So far, laboratory scientists have not been able to identify a known or novel infectious agent, said Dr. David L. Heymann, a W.H.O. official.

Japanese officials said their tests showed that the influenza virus was not the cause of the illness. But Dr. Heymann said that samples from more victims need to be tested, because it can take weeks for the immune system to produce influenza antibodies, the proteins that are formed to fight invading microbes.

"We have not ruled out influenza definitively," Dr. Heymann said.

Tests of victims' samples have found no evidence of mycoplasma or similar microbes that are the usual causes of atypical pneumonia. Additional tests have shown no evidence of Ebola or any of the other viruses that cause hemorrhagic fevers, hanta virus and bacteria.

In Hong Kong, an American businessman died on Thursday after passing through Hong Kong and falling ill in Hanoi, where 30 doctors and other medical personnel have fallen ill at the hospital where the businessman was initially treated before being sent back to Hong Kong.

today, Hong Kong's secretary for health and welfare, Dr. Yeoh Eng-kiong, denied that the Chinese territory was experiencing a serious public health problem. Dr. Yeoh said that the outbreak in Hong Kong remained almost entirely confined to hospital workers and had not spread to the general community.

Robert Brazelle report on msnbc. said nobody has recovered once infected-death comes pretty quickly (days).

You TOTALLY misunderstood that.

In any sort of possible panic situation people really need to think carefully if they are reporting accurate information.

What was meant was that no one who has GOTTEN it has made an absolute full, out-of-the-hospital happily running around, no symptoms or problems recovery. Yet.

It was NOT meant that EVERYONE who has gotten it has died; as others have pointed out, far from it.

Sounds like Captain Tripps, doesn't it?

Although some victims remain stable and others seem to get better for two to three days, they eventually relapse, developing acute respiratory distress. Some need to have a tube inserted in their windpipe to help them breathe.

Among the survivors, "no one has gotten well yet," Dr. Heymann said in an interview with the Times. "It is not clear what is going on, and it is not clear what the extent of spread will be," particularly because "these are areas where there is a lot of international travel," he added.

>Lethal "flu" hits Asia, Canada: unknown cause, no cure

Oh-oh. Well, we can
cauterize Canada now.
Asia will take work...

Cap'n Trips.

Before boarding the flight, the surgeon called a colleague in Singapore to describe his symptoms, and the colleague notified the World Health Organization.

Just the thing to do with a contagious disease, get on an international flight.

M-O-O-N, that spells scary.

You know, I'd hate to be the first to say it (but I will, anyway): Saddam's revenge?

LOL

"Plague" alert

I doubt Saddam would have started it in China. I suspect this superflu is a natural mutation.

The problem is that people don't seem to recover from it. Let's hope that most of us are naturally immune, or this could end up being a nightmare.

Thank you for this expanded information

Well, maybe someone in the know could inform us if any of the known biological warfare agents produce similar symptoms, before we make any erroneous assumptions, and then run around like chickens with our heads cut off!