- As with Avian Influenza, SARS outbreak tends to have
a lot of contradictory information released. We hear that SARS is mutating
more virulent, yet, we only have 4 cases and they had successful outcomes
with patients released from hospital and at home.
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- Here again, with SARS as demonstrated by this 4th case
we have infection acquired while working in hospital. The first case this
year was in a SARS researcher who became infected during his work in the
lab on SARS.
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- World Health Organization
1-30-4
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- A new case of laboratory-confirmed infection with the
SARS coronavirus (SARS-CoV) has been reported today by the Ministry of
Health in China. This is the 4th case (3 confirmed and one probable) detected
in China since 16 Dec 2003.
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- The new case is a 40-year-old director of a hospital
and practicing physician from Guangzhou, Guangdong Province who developed
symptoms of SARS on 7 Jan 2004. He was admitted to a hospital in Guangdong
with pneumonia on 16 Jan and placed in respiratory isolation on the suspicion
of SARS. He has made a full recovery and was discharged home on 30 Jan
2004.
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- In accordance with WHO recommendations for SARS-CoV testing
in the inter- epidemic period the results of SARS-CoV testing performed
at the national reference laboratory in Beijing were verified by a WHO
SARS International Reference and Verification Network laboratory in Hong
Kong.
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- http://www.who.int/csr/sars/guidelines/en/WHOSARSReferenceLab.pdf
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- At present, the source of infection in this most recent
SARS case is unknown. The Ministry of Health is conducting an epidemiological
investigation into possible sources of transmission and has carried out
contact tracing and other public health measures. To date, none of the
contacts so far identified has developed symptoms of SARS. The Ministry
is also collaborating with WHO China Country Office to further investigate
this and the other recent SARS cases in Guangdong province. See Review
of probable and laboratory-confirmed SARS cases in southern China <http://www.who.int/csr/don/2004_01_27/en/>.
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- WHO will continue to closely monitor the situation in
Guangdong.
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- _____
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- ProMED-mail
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- [This is now the 4th case of SARS reported in China (i.e.
3 laboratory confirmed, one probable case -- see references below). Of
note, this case is in a health care worker, which may suggest that this
individual was infected in the health care environment. In the outbreak
in Guangdong reported in February 2003, the proportion of SARS cases in
health care workers was approximately 30 percent. In the final analysis
of the global outbreak, approximately 21 percent of SARS cases reported
in 2003 were in health care workers, with a high of 43 percent reported
in Canada -- see The Consensus Document on the Epidemiology of SARS. http://www.who.int/csr/sars/en/WHOconsensus.pdf
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- From a seasonal perspective, the outbreak of SARS in
2003 became apparent with reports of 305 cases in Guangdong in early Feb
2003 (see ProMED-mail posting from 10 Feb 2003 Pneumonia - China (Guangdong):
RFI 20030210.0357). Investigation of that outbreak identified the probable
1st case of SARS with a date of onset of illness on 16 Nov 2002. Looking
at the epidemic curve of the 2003 outbreak (Fig. 2, page 18 of the above-referenced
Consensus Document), there were apparently "sporadic" cases of
SARS with dates of onset in the period November/December 2002 followed
by increases in numbers of cases in January 2003, when there were several
cases a day followed by an increase in cases reported in the last week
in January and the first week in February 2003.
-
- This "season" there have been 3 apparently
sporadic cases reported during the period December 2003/January 2004, all
associated with rapid implementation of appropriate infection control procedures.
We await information on the epidemiologic investigation of this 4th case
to see whether the case is associated with possible transmission in the
health care environment, signalling that possible additional cases may
not have come to the attention of the formal health sector reporting units.
While the numbers in 2004 are still very small, they bear an intriguing
similarity to 2004's pattern.
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- All 4 of these reported cases to date have been associated
with a mild illness and full recovery. This is a small number of cases
from which to draw any real conclusions, but all 4 were in individuals
less than 50 years of age. According to the final analyses presented in
the above-mentioned Consensus Document (Table 3 page 14), the age-specific
case fatality rates reported in China were 0.9 percent for those 20-29
years of age, 3.0 percent for 30-39 years, and 5.0 percent for 40-49 years.
-- Mod.MPP]
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- Patricia A. Doyle, PhD Please visit my "Emerging
Diseases" message board at: http://www.clickitnews.com/ubbthreads/postlist.php?Cat=&Board=emergingdiseases
Zhan le Devlesa tai sastimasa Go with God and in Good Health
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