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SARS Now "Many Different Outbreaks"

Spread of Mysterious Disease in Hong Kong Shows New Level of Danger

From the WebMD Archives

March 31, 2003 - Health officials are now taking unprecedented steps to control the spread of the mysterious illness known as SARS (severe acute respiratory syndrome) as the death toll continues to rise.

Hundreds of people living in a Hong Kong apartment complex have been ordered not to leave their homes for 10 days. The isolation order came after officials discovered that more than 213 of the complex's residents have been hospitalized with SARS since the outbreak began in Hong Kong on March 12.

And in an attempt to prevent further spread of severe acute respiratory syndrome in Canada, health officials have asked thousands of people who may have come in contact with SARS patients in Toronto to stay home and voluntarily isolate themselves for 10 days. Toronto has a large Asian immigrant population and at least 44 SARS cases and four deaths have been reported in Canada since the outbreak began.

According to the World Health Organization (WHO), more than 1,600 people have been affected by SARS, including 58 deaths. The CDC is currently investigating 69 suspected SARS cases in the U.S., but no deaths have been reported in this country.

WHO officials lost one of their own this weekend when infectious disease expert Carlo Urbani, MD, died of severe acute respiratory syndrome on Saturday at the age of 46. Urbani was the first WHO officer to identify the outbreak of the new disease in an American businessman in Hanoi.

"Carlo was the one who very quickly saw that this was something very strange. When people became very concerned in the hospital, he was there every day, collecting samples, talking to the staff, and strengthening infection control procedures," says Pascale Brudon, the WHO representative in Vietnam, in a news release.

How SARS Spreads

Based on the investigation so far, researchers believe that SARS is primarily transmitted when an infected person sneezes or coughs, and the droplets are spread to a nearby contact. But officials say they are also concerned about the possibility that the disease may be transmitted through the air or via contact with a contaminated object.

"Coronaviruses can survive in the environment for up to two or three hours, and so it's possible that a contaminated object could serve as a vehicle for transfer to someone else," said CDC director Julie Gerberding, MD, in a briefing on Saturday.

A previously unknown form of a coronavirus is thought to be responsible for severe acute respiratory syndrome. Other coronaviruses are known to cause respiratory illnesses such as the common cold.

Gerberding says people with SARS seem to be most contagious when their symptoms first begin. Early symptoms of SARS may include the following:

  • Fatigue
  • Headache
  • Fever (over 100.4 degrees)
  • Respiratory symptoms, such as cough, difficulty breathing and shortness of breath

Gerberding says people with a history of travel to the affected areas in Asia or contacts with SARS patients should contact a medical provider immediately if they develop any symptoms of an illness.

The CDC also expanded its travel advisory to include all of mainland China, Hanoi, Vietnam, and Singapore. People planning non-essential travel to these areas are advised to postpone their trips until further notice.

In addition, CDC officials extended the monitoring period for incoming passengers from these areas from seven to 10 days. The agency is currently meeting flights and ships arriving from these areas at 20 U.S. ports of entry and distributing health alert notices advising passengers to be alert for possible SARS symptoms.

At this point, neither CDC nor WHO has issued travel restrictions to the areas hardest hit by the outbreak.

How to Protect Yourself from SARS

To control the spread of the disease among close contacts and healthcare workers of recovering SARS patients, the CDC now recommends the following safety precautions for at least 10 days after respiratory symptoms and fever are gone:

  • SARS patients should limit interactions outside the home and should not go to work, school, out-of-home day care, or other public areas.
  • During this 10-day period, all members of the household with a SARS patient should carefully follow recommendations for hand hygiene, such as frequent hand washing or the use of alcohol-based rubs.
  • Each patient with SARS should cover his or her mouth and nose with a tissue before sneezing or coughing. If possible, a person recovering from SARS should wear a surgical mask during close contact with uninfected people. If the patient is unable to wear a surgical mask, others in the home should wear masks when in close contact with the patient.
  • Disposable gloves should be considered for any contact with body fluids from a SARS patient. However, immediately after activities involving contact with body fluids, gloves should be removed and discarded and hands should be washed. Gloves should not be reused, and are not intended to replace proper hand hygiene.
  • SARS patients should avoid sharing eating utensils, towels, and bedding with other members of the household, although these items can be used by others after routine cleaning such as washing or laundering with soap and hot water.
  • Other members of the household need not restrict their outside activities unless they develop symptoms of SARS such as a fever or respiratory illness.
WebMD Health News

Sources

SOURCES: CDC briefing, March 29, 2003. News release, World Health Organization. News release, CDC.

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