CHINA CONFIRMS CASES AND DEATHS (SARS) - HONG KONG SITUATION DETERIORATING - 22 CASES IN US

Washington Post ^ | 03-22-03

[Mother Abigail]

Mysterious Illness Kills 2 In Beijing in Sign of Spread

Saturday, March 22, 2003; Page A03

BEIJING, March 21 -- Chinese doctors today reported two deaths in Beijing and 20 people stricken in Shanghai by a disease with symptoms similar to severe acute respiratory syndrome.

The doctors' statements cast doubt on Chinese government pronouncements that the spread of the disease, also known as SARS, had been limited to Guangdong province, in southern China, where it is believed to have originated. State-controlled media have been banned from reporting about the disease since mid-February.

Full Article

[Mother Abigail]

From Listserve For Emergency Medical Practioners: [EMED-L]

http://www.ucsf.edu/its/listserv/emed-l/11411.html

Update from Dr. Buckley in HK.

-------- Original Message -------- Subject: Re: SARS

Date: Fri, 21 Mar 2003 06:07:15 +0800 From: Tom Buckley To:

-snip of recipient's address- We are using routine community acquired antibiotics but all our cases who have had contact with ward have not responded. We are now only admitting cases to our hospital who have had contact with our original case. We are now seeing the second wave - relatives of primary contacts.

So far no staff have been infected once isolation procedures were put in place. No one is wearing ordinary surgical masks. There have been some close calls with some nurses being reported as having atypical pneumonia after precautions have been taken but in all cases our contact tracing team has established that there was an earlier contact. Everyone has been wearing N95 masks and while I think (though don't know for sure) that N95 is satisfactory staff have not been wearing them properly or they do not fit.

We are switching to the N100 masks not because they are ~ 5% more efficient but because the nurses have found them more comfortable to breath through (less resistance) and they fit more comfortably on the face. The N95 masks, despite a variety of brands and sizes have been uncomfortable and difficult to breath through. There is also the psychological aspect as well.

We are going to try BIPAP. I do not expect it to work (hypoxic respiratory failure only) but because of the higher flow rates (along the lines of the nebulized ventolin in the Index Case) and potential for environmental spread I want it to be as safe as possible. So besides all our "usual" precautions we are going to do this in one of our isolation rooms - increased ventilation flow rates and personal HEPA units. If the staff can tolerate them we will distribute to all staff. Many problems with these but I cannot afford to lose one nurse. Mind you haven't made a final decision about the BiPAP. Last night senior nurse rang me to say she was resigning. She is petrified. HK Government is down playing the whole thing presumably because of the economic implications but own hospital has been taken over completely by this infection. We currently have 24 cases of atypical pneumonia in ICU - now is that impressive or what.

It also appears to be out in the community. GPs are being admitted.

All of our patients in ICU are either on 100% O2 or they are ventilated (some prone).

Pulse steroids have been given by the physicians to patients on the general ward. They initially improve but are now septic and being referred to ICU. They claim some patients are better on the ward but I think these patients would have improved anyway. While I was able to dissuade them from using pulse steroids in ICU patients I had no control over the general wards.

[EggsAckley]

Nowhere in the text does it support the title: "22 in US.""

[Mother Abigail]

WASHINGTON, March 21 (UPI) -- Centers for Disease Control and Prevention officials said Friday they increased the number of suspected cases of the mysterious severe acute respiratory syndrome outbreak they are investigating to 22.

Officials said the agency also is investigating two cases in which Americans who contracted the pneumonia-like illness while traveling abroad might have transmitted it to others when they returned to the United States, CDC Director Dr. Julie Gerberding said during a teleconference.

[mewzilla]

That's 22 suspected cases, right? Any confirmed?

[Black Agnes]

Add me to a bump list if you have one.

[Black Agnes]

ping.

[Black Agnes]

ping.

[Mamzelle]

bump

[battlecry]

Washington Post this morning said three in VA.

[Mother Abigail]

I will check this morning

[BartMan1]

ping...

[Mother Abigail]

---

A CHRONOLOGICAL COMPILATION OF THE "SARS" OUTBREAK AS REPORTED ON FREE REPUBLIC

---

1. Precognition

2. Hong Kong Health Secretary calls for calm as SARS cases double, (83 up from 42 on Sunday)

3. LATEST SARS UPDATE - DETAILED MEDICAL INFORMATION

4. BREAKING BIG: POSSIBLE PATHOGEN DETECTED IN SARS CASE

5. Killer Virus (SARS) Identified

6. Seven victims of mystery pneumonia stayed on same floor of Hong Kong hotel

7. Guangdong doctor linked to SARS outbreak

8. President of the American Society of Microbiology on SARS - "Everything says it is airborne."   

9. CDC increases SARS cases to 22 in U.S.

Sorry I am running a little slow this morning, been a long night...

[IncPen]

Courtesy ping

[Mother Abigail]

Done

[riri]

Please add me too, if you would be so kind.

[Mother Abigail]

Test for Mystery Illness Being Developed

By EMMA ROSS, AP Medical Writer

GENEVA - Scientists may have a test for diagnosing the mysterious flu-like illness that has sickened hundreds in Asia, and authorities said they could have it available to key laboratories within a few days if it is proved to be reliable.

 The World Health Organization (news - web sites) said Friday that the test requires further experimentation; but if successful, it would be an important tool for slowing the disease's global spread.

"We're all very pleased. It is crucial and it's another step on the way, but there's a lot that still has to be done," said Dr. David Heymann, WHO's communicable diseases chief.

A diagnostic test would make it possible for doctors to quickly isolate patients with the new disease, called severe acute respiratory syndrome, or SARS. It has sickened more than 350 people around the world and killed 10 people in the past three weeks, according to WHO figures.

In the United States, authorities believe 22 people have fallen ill with SARS, said Dr. Julie Gerberding, director of the Centers of Disease Control and Prevention

[Mother Abigail]

Of course

[EggsAckley]

Thanks. Good work. Today I am going to the funeral of my best friend, who passed away from "severe bronchitis and respiratory arrest." Makes me wonder if there are any cases in California.

[Mother Abigail]

Six, as of last night

[Centurion2000]

Bump for captain tripps