A mysterious, flulike illness that has stricken scores of hospital workers in Southeast Asia has stumped a battery of tests for known bacteria and viruses and most likely represents a new human disease of unknown origin, federal health authorities said Monday. At least fourteen cases bearing some resemblance to the illness are being evaluated in the United States, including that of an unidentified patient, recently arrived from travel to Asia, who turned up in a Los Angeles County emergency room with a high fever and difficulty breathing.
Patients with the disease come down with a particularly dangerous case of pneumonia fluid filling their lungs and many of those sickened in Southeast Asia have had to be placed on ventilators. World Health Organization epidemiologists have already given the disease a name SARS, or severe acute respiratory syndrome and have confirmed four deaths and hundred and sixty seven cases worldwide.
Under prodding by the United Nations' health agency, China has disclosed an outbreak of three hundred and five cases from November through February that appear similar to SARS. There were five deaths in China, but none of the cases are included yet in the official WHO count. Centers for Disease Control and Prevention Director Dr. Julie Gerberding told reporters that 10 of the fourteen suspected cases in the United States were "almost certainly not" SARS, but that "it would not be surprising" to find the illness soon in the United States. Cases have been confirmed in Canada, where two members of a Toronto family have died after returning from China. One member of that family subsequently visited Atlanta. Cases are also suspected in Switzerland, Germany and the United Kingdom. Gerberding said she was confident that laboratories in the United States or in eight other nations testing for the disease would pinpoint its cause. But the disease detectives are now fairly sure it is a bug they haven't encountered before. "We are not suspicious this is a common microorganism, or we would have found it by now," she said. It was unlikely to be some form of influenza, because Hong Kong hospitals are skilled in identifying even exotic strains of that deadly diseases. While ruling nothing out including bioterrorism Gerberding indicated that the epidemic was behaving like that of a viral illness spread by "close contact" with infected patients in the home or hospital. SARS appears to be highly contagious but requires contact with droplets of infected body fluids through cough or sneezing.
Consequently, doctors and nurses who observe common infection control practices isolating patients and using face shields, gowns and gloves should keep the microbe from spreading. Nearly all the cases worldwide have involved travelers from China and Southeast Asia, or the health care workers in hospitals that have treated them. The first case outside of the Chinese outbreak was that of an American businessman who was admitted to a Hanoi hospital after travel in China. He was transferred to a Hong Kong hospital, where he died Thursday. Meanwhile, forty two Vietnamese workers from the Hanoi hospital, and one child of a worker, have come down with the disease. Two Vietnamese patients have died. Subsequently, ninty five cases in the Hong Kong region have been reported, including at least twenty Hong Kong hospital workers. Suspected cases have since been reported in Singapore, Thailand, the Philippines and Indonesia. A Singapore doctor, who visited a medical conference in New York, was hospitalized after he became ill on a flight from New York to Frankfurt. In San Francisco, the three flights that arrive daily nonstop from Hong Kong are being greeted by a Centers for Disease Control and Prevention quarantine officer, who warns passengers to be alert for the symptoms of SARS and, if they become ill, to tell doctors that they've been to Asia. The incubation period of the illness is believed to be less than seven days. Dr. Susan Fernyak, director of epidemiology and disease control for the San Francisco Department of Public Health, said physicians throughout the city were being faxed a description of the disease and being asked to be especially vigilant. Hospitals will treat suspected cases using special precautions to isolate contagious diseases, including isolating patients in a specially ventilated room.
"We don't know what kind of infection control procedures were used in Hong Kong and Vietnam," Fernyak said at a press conference. "It's very unusual to have a disease spread from patients to health care providers."
