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."
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.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.
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.
Oh-oh. Well, we can
cauterize Canada now.
Asia will take work...
And I am NOT going to read "The Stand" ever again.
Nor does 'Valley Fever,' -- fungal pneumonia. Ketakonozol [sp?] may help if treatment started early enough. I think the Germans came up with this medicine years ago. People are still dying of Valley Fever in this country because of wrong diagnosis. Treating with antivirals or antibiotics exacerbates lung fungus. Biopsies needed for diagnosis. Just a possiblity, and I'm sure this new sickness may not be fungal-based, but who knows?