| The Centers for Disease Control and Prevention on Thursday revealed the locations of 14 suspected cases of atypical pneumonia in the United States. The CDC said there were three patients in California, two in North Carolina and one each in Hawaii, Maine, Massachusetts, New Jersey, New Mexico, Tennessee, Virginia and Wisconsin. The report follows Colorado’s earlier announcement of a possible case of the mysterious illness in Denver.
NEW YORK health officials said two cases, not reported by the CDC, were also under watch.
“The 67-year-old man is receiving medical care, is hospitalized and in isolation; the 27-year-old woman visited an emergency department and is now home. Both are in good condition,” the New York City Department of Health and Mental Hygiene said in a statement.
The CDC said it was using a broad definition in deciding who has a suspected case of severe acute respiratory syndrome, or SARS, and many sickened individuals may turn out to have other infections.
There are now 306 people worldwide who are sick with the disease, according to the World Health Organization. About half of those cases are in Hong Kong, but these figures excluded a large outbreak in China that started last November and may have been the source of the infection.
In addition to confirmed cases in Southeast Asia and Canada, investigators are looking into possible instances of the illness in Britain, France, Israel, Slovenia, Australia, Spain, Belgium, Finland, Japan and Romania.
The Associated Press reported that at least 14 people have died from the disease.
HOSPITAL WORKERS SENT HOME
In New Mexico, a patient from Albuquerque, who recently returned from Hong Kong, was in a hospital’s respiratory isolation unit, state health officials said Wednesday. The case has not yet been confirmed as SARS, the state Health Department said.
As many as 15 workers at Albuquerque’s Presbyterian Hospital, where the patient was receiving treatment, have been given two days off work to avoid the possible spread of the respiratory disease, officials said Thursday. The workers, mainly in the hospital’s emergency and radiology departments, had contact with the patient before they suspected he had SARS.
The patient remained in fair condition Thursday, said spokesman Todd Sandman. Sandman said the local hospital workers are not under a formal quarantine but have been asked “to remain at home and report any symptoms. It’s a move of extreme caution because we don’t have a specific diagnosis on the patient.”
Aside from the patient, he said no symptoms of SARS have appeared among anyone at the hospital.
Dr. Ron Voorhees, deputy state epidemiologist, said the Department of Health recommended sending the hospital workers home because of uncertainty over how the disease is spread.
SUSPECTED CASES ACROSS U.S.
Meanwhile, Los Angeles County’s public health officer said a man with the symptoms of SARS was recovering after being hospitalized Saturday. He fell ill on March 11 after returning from a visit to Vietnam, Hong Kong and China. Specimens from the man have been sent to the Centers for Disease Control and Prevention for testing.
“Respiratory illnesses are very common in Los Angeles County at this time of the year,” said Dr. Jonathan Fielding, director of public health for the county, in a statement. “For many of these, a specific diagnosis is never obtained. Therefore, the mere presence of these symptoms should not be a cause of heightened concern.”
In Massachusetts, a health official said a man there who traveled to Hong Kong and Singapore last week, has shown possible symptoms of SARS but has never been ill enough to be admitted to the hospital.
The New Jersey case involves a 36-year-old woman who began complaining of fever and a cough more than a week before she traveled to Asia, state health officials said. She returned to the United States on March 2 and was hospitalized after her condition worsened. She was released Monday.
Family members who traveled with the woman to Asia and hospital staff members who treated her in New Jersey have shown no signs of the illness, according to the New Jersey Department of Health and Senior Services. No other suspected cases have been reported in the state.
Another case under investigation is that of a 32-year-old California man, who is hospitalized in Denver with flu-like symptoms and who recently returned from a month-long trip to Hong Kong and Indonesia, the Colorado Department of Public Health and Environment reported Tuesday.
A statement by the department said the man, who was not identified, was listed in fair condition.
A NEW STRAIN OF A KNOWN VIRUS?
As more suspected cases of the illness were reported in the United States, scientists continued to examine patient samples in an effort to identify the cause of the disease. In particular, researchers were looking for signs of paramyxovirus — a family of microbes that causes measles, mumps and canine distemper — after German and Hong Kong health officials on Wednesday reported they had identified the virus in several specimens.
The World Health Organization said its laboratories will study other samples to see if the same virus is present.
“There is now a clue about what might be causing this,” said Dr. David Heymann, WHO communicable diseases chief. “This clue will make it easier to diagnose patients.”
But CDC Director Julie Gerberding and other experts cautioned that it’s still too soon to be sure paramyxovirus is the culprit behind the mystery illness.
“The laboratories that have identified this virus are very good laboratories,” Gerberding said. “But we don’t at this point know what it means” because the virus was found in patients’ nasal passages and “it hasn’t yet been identified from any tissues or lung material or other specimens that would directly implicate it as the cause of the infection.”
“My suspicion is it may be a new virus within that family,” said Dr. Larry Anderson, a CDC virus expert.
LINKS TO HONG KONG HOTEL
The global spread of the mysterious flu-like illness that has killed 10 people in the past three weeks appears to have started with a guest in a tourist hotel in Hong Kong.
Hong Kong health officials said Thursday that other guests who caught the disease then carried it to a Hong Kong hospital, Vietnam, Singapore and Canada. Three of the seven people who stayed on the ninth floor of the Metropole Hotel in Kowloon later died from SARS.
Hong Kong health officials have traced the outbreak to a professor from China’s Guangdong province who stayed at the hotel on Feb. 21-22. He died March 4.
His case bolsters the belief that the outbreak stems from one that began last November in the southern part of Guangdong, where 300 people were sickened and five died.
The Metropole, a bland-looking, rectangular building, is a three- or four-star hotel located in a residential district of Hong Kong’s Kowloon peninsula, an area where many tourists stay. It is a short bus ride away from the main tourist area of Tsim Sha Tsui.
During the two days the infected Chinese professor stayed on the ninth floor, three women from Singapore were guests on the same floor. After they returned home, they became ill. Singapore’s Health Ministry said all 34 Singapore SARS patients had been in contact with the three women.
An American businessman from Shanghai also stayed on the ninth floor of the Metropole before flying on to Vietnam and falling ill, officials said.
“His name was Johnny Chen,” said Hoang Thuy Long, director of Vietnam’s National Institute of Hygiene and Epidemics. “When Mr. Johnny Chen came to Vietnam, he was actually in an incubation period.”
Two days after his arrival, he was hospitalized at the Hanoi French Hospital, but asked to be moved to a hospital in Hong Kong where he died.
A third Metropole guest during that time was a 78-year-old woman from Toronto. She returned home where she infected her grown son. Both later died.
In addition, a Hong Kong man visited a friend on the ninth floor while the professor was there, health authorities said.
That man has been identified as the Hong Kong “index patient” who spread the disease to the Prince of Wales Hospital, where dozens of workers have been sickened, said Health Department spokeswoman Sally Kong.
HOW DID DISEASE SPREAD?
It remains unclear how the disease would have spread in the hotel. One expert has speculated it could have spread from the air-conditioning.
“Perhaps they all stood outside the elevator at the same time and someone sneezed or coughed,” said Dr. Margaret Chan, the director of the Hong Kong Health Department.
None of the 200 to 300 workers at the Metropole have become ill, Chan said.
Since the outbreak, hotel spokeswoman Anita Kwan said, guests had been given a letter explaining what had happened. She said none had been scared away.
But a group of tourists from Shanghai emerged wearing surgical masks early Thursday and told reporters they were seeking different accommodation.
“The Health Department has already indicated that the germ doesn’t exist here anymore,” Kwan said Wednesday night. But she added that the ninth floor won’t be reopened until it has been thoroughly checked.
Dr. David Heymann, WHO’s communicable diseases chief, said Thursday the cases at the hotel do not diminish the view that the illness is spread only by close contact because such a scenario has not been ruled out.
“There is no evidence of casual contact,” he said. “Speculation can go from it being a pigeon sitting on a window sill, flapping its wings outside four rooms, to anything under the sun.”
If the illness was spread as easily as passing somebody in a corridor, or through the air conditioning system, cases would likely have shown up elsewhere in the hotel, experts said.
While new cases continue to turn up daily, health officials are encouraged to see that reports of recovery are also on the rise.
“In Vietnam there are 20 patients now out of 56 who are much better, and some are ready for discharge from the hospital,” Heymann said.
A Singapore doctor and his wife and mother-in-law who were on their way home when they were quarantined in Frankfurt, Germany, are also recovering, doctors there said.
It is unclear whether medications are helping them recover or whether they would have got better anyway.
Source: MSNBC | |
