| At least 80 percent of people stricken by a mysterious new lung infection spreading around the globe appear to recover, but the rest become critically ill and about half of them die, health officials said yesterday.
Victims who are older than 40 and have other health problems, such as heart or liver disease, are most likely to move to the life-threatening phase of the infection, officials said.
New details about the disease, dubbed severe acute respiratory syndrome (SARS), emerged yesterday when about 80 doctors treating patients in 13 countries participated in an unprecedented electronic meeting organized by the World Health Organization. The "electronic grand rounds" enabled doctors trying to save patients worldwide to exchange information over the telephone and Internet about how best to diagnose and treat the disease.
"For the first time, we brought all the clinicians together," Mark Salter, who is coordinating WHO's clinical response to the new disease, said in a telephone interview. "The WHO has never brought together this many clinicians with such rapidity. It's groundbreaking."
SARS, which emerged in southern China in November, has spread to at least 13 countries in Asia, Europe and North America, sickening more than 1,300 people and killing at least 49. U.S. health officials are investigating 45 possible cases in 20 states, including three in Virginia.
A distinctive pattern of symptoms has become clear, Salter said. Two to seven days after being exposed, patients suddenly develop a high fever -- 104 degrees Fahrenheit or higher -- start shaking and experience chills, shortness of breath and a dry cough. Some also experience headache, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhea.
Laboratory tests show that white blood cell and platelet counts drop in some patients. Chest X-rays usually reveal a distinctive pattern in which a cloudy area appears in one part of a lung and then spreads across both lungs.
After about six or seven days, about 80 percent to 90 percent of patients begin to improve. The remaining 10 percent to 20 percent deteriorate and require intensive care, with many needing a mechanical ventilator to help them breathe.
About 40 percent to 50 percent of those patients die, making the overall mortality rate for the disease about 4 percent. Salter said that mortality rate is similar to that of the mosquito-borne West Nile virus, which first appeared in the United States in 1999.
No antibiotics appear to work against SARS. The antiviral drug ribavirin has been used by a number of doctors, but its effectiveness remains unclear. During yesterday's meeting, doctors agreed to quickly organize a study to determine ribavirin's usefulness.
Treatment has been complicated, because many of the victims have been doctors and nurses who were infected by some of the first patients. That left hospitals, particularly in Hanoi and Hong Kong, short-staffed.
"Clinicians around the globe are stretched to the limit," Salter said. "Everybody is working very hard to try to not only identify the agent that's causing this, but to find methods that might be effective in treating it."
The disease appears to be spread by tiny droplets that become airborne when a sick person coughs, or through contact with other body fluids, such as blood.
Scientists from at least 11 laboratories are racing to identify the cause. Researchers have found two previously unknown viruses in patients and are trying to determine whether either one, alone or in combination, causes the disease. One is a previously unknown strain of a virus that usually causes the common cold. Both also cause illnesses in animals.
"Hypotheses include a virus known to cause disease in an animal that has jumped the species barrier to infect humans, or a known human virus that has mutated to acquire properties that are causing much more severe disease in humans," WHO's statement said. "It is increasingly certain, however, that SARS is a serious new disease caused by a newly recognized pathogen."
Source: Washintgon Post | |
