<a href=iol.co.za>IOL April 01 2003 at 06:19PM

South Africa's National Institute for Communicable Diseases put the country on the alert on Tuesday for signs of the deadly pneumonia virus that has already killed more than 60 people worldwide.

The institute said that it had sent step-by-step instructions to the health department and private and state medical laboratories detailing what to do should doctors suspect Severe Acute Respiratory Syndrome (SARS) in a patient.

"Doctors should be on the lookout for high temperatures, they should look for respiratory illness such as coughing or shortness of breath, but most importantly they should get the patient's travel and contact history," the institute's director, Professor Barry Schoub, explained.

According to the guidelines, patients suspected of having SARS must be isolated and "barrier-nursed" with mask, gown and glove precautions.

'There is an alert for the disease'Specimens such as clotted blood and nasopharyngeal swabs should be sent to the institute for analysis.

Schoub said there had been no confirmed deaths of SARS in the country.

He said the first step would be to develop a good diagnostic test for the disease, which at the moment was being subjected to the more expensive molecular testing.

"There is an alert for the disease, but it is not major. HIV/Aids is a much bigger problem in South Africa," said Schoub.

The epicentre of the disease is in Asia where the majority of the deaths have occurred. Scientists fear the disease may be spread by close human contact such as that experienced inside passenger planes.

Meanwhile, doctors at the Nelspruit Medi-Clinic said on Tuesday that a man who was admitted to the hospital on Monday night with some of the symptoms of SARS - and who had recently travelled to Mozambique and Hong Kong - did not appear to be suffering from the disease.

"The patient will be treated for malaria. The patient is stable and doing well, and will be removed from isolation to another ward," the hospital said in a statement.

The man was transported from Maputo by ambulance to the clinic on Monday night.

In parliament on Tuesday, the African Christian Democratic Party questioned South Africa's readiness to respond to a global outbreak of SARS.

"The question arises as to whether the South African government is taking sufficient preventative steps to prevent the outbreak of SARS in South Africa," said MP Steve Swart. - Sapa

WASHINGTON, April 1, 2003 (CBS/AP)

"Men may not even recognize that depression is the problem or that much can be done to help them." Dr. Thomas Insel

(CBS) In a society that emphasizes men being rugged and strong, it's tough for a guy to admit to being depressed, but the National Institute of Mental Health wants that to change.

The agency, one of the National Institutes of Health, launched a campaign Tuesday to raise awareness that men, too, suffer from depression and that they need to seek help.

About 6 million men have clinical depression, but research shows they are less likely to seek treatment than do women. One result is that men are suicide victims about four times more often than women.

"For generations men have been told that they have to act tough," U.S. Surgeon General Richard Carmona said in a statement. "Today we're saying to men, it's OK to talk to someone about what you're thinking, or how you're feeling, or if you're hurting."

The new public health campaign, said Carmona, is "attacking the stigma that tough guys can't seek help. They can and they should."

Called "Real Men, Real Depression," the campaign will include a series of television, print and radio public service announcements featuring people telling their personal stories about how they confronted their own depression. The campaign will not use actors, but ordinary people who had problems, the agency said.

Studies show that depression affects women about twice as often as men, but the two genders respond differently to the serious health problem. Women tend to talk about the symptoms and seek treatment, while men do not, the NIMH said.

Men tend not to recognize that some health symptoms may be caused by depression. Signs of depression include irritability, poor sleep, loss of interest in work or hobbies, and withdrawal. Depression is often a major factor in suicides.

"Men may not even recognize that depression is the problem or that much can be done to help them," Dr. Thomas Insel, head of NIMH, said in a statement. "Effective treatments are available and the success rate is very high — more than 80 percent — for people who seek help."

When depression strikes, men are more likely to seek relief with drugs or alcohol, or to become frustrated and angry. Some respond with compulsive work or attention to hobbies. Others may engage in reckless behavior.

"We need to understand how men respond to stress and symptoms associated with depression and how to alert physicians to better recognize and treat depressive disorders in men," Dr. Dennis Charney, chief of the NIMH mood and anxiety disorders program, said in a statement.

NEW YORK, April 4, 2003 Medical Correspondent Dr. Emily Senay and Julie Chen. (CBS/The Early Show) (CBS/The Early Show) Dr. Jim Hughes, Dir. of the National Center for Infectious Diseases (CBS/The Early Show)

(CBS) The state department is advising some American workers at the embassy in China to return home because of the risks to them from the SARS outbreak in areas of China.

The Early Show medical correspondent Dr. Emily Senay reports the workers are not being ordered to leave, but the government is recommending that nonessential diplomats and their family members leave Beijing until the outbreak of SARS, or Severe Acute Respiratory Syndrome, is under control.

It is one of many advisories being issued by such groups as the Centers for Disease Control and the World Health Organization.

If you're thinking of traveling to Asia, you should probably postpone the trip unless it's absolutely essential, especially if the destination is China, Hong Kong, Singapore and the Vietnamese capital of Hanoi.

There are no confirmed cases in the United Sates but more than 80 cases are suspected. California has the most cases in the country, 19, and state health officials say they are investigating 12 more. Of those 31 suspected cases, at least 17 traveled to Southeast Asia in recent weeks, and three others share homes with travelers to Asia. No health care workers have been infected so far, state health officials said Wednesday.

On Tuesday, five suspected SARS patients were removed from an American Airlines flight from Tokyo that was quarantined on a San Jose, Calif., tarmac. Later health officials cleared the passengers of the mystery illness.

According to the World Health Organization, at least 78 people worldwide have died from SARS. And the group estimates that about 2300 people are infected with the illness. The highest concentration of the illness is in mainland China, where more than 45 people have died. There have also been deaths in Hong Kong, Singapore and, closer to home, in Canada.

Senay says the average American is not at great risk. Most cases have been in China, she says, and people at highest risk are health care workers caring for SARS patients and family members who may have come in contact with respiratory secretions. If you have recently traveled to an affected country, look out for symptoms to appear seven to 10 days after you return. If you become sick, Dr. Senay recommends you see your doctor at once.

Evidence suggests the disease spreads by close contact, says Dr. Jim Hughes, director of the National Center for Infectious Diseases in Atlanta. He told The Early Show co-anchor Hannah Storm on Monday that it is still too early to tell how close that contact has to be for the disease to spread.

According to the Centers For Disease Control, examples of close contact include “having cared for, lived with, or had direct contact with respiratory secretions and body fluids of people with SARS.”

While some SARS cases have been reported in Canada, there's no sign of widespread community spread, so CDC isn't advising against travel to or from there.

Here are some symptoms of SARS:

• Fever of 100.4 degrees F
• Cough
• Shortness of Breath
• Muscular Stiffness
• Confusion
• Travel to Affected Areas
• Contact With Traveler to Affected Area

You'll notice many of these symptoms are something that you would feel if you had a cold or the flu. The big difference with SARS, says Dr. Senay, is that you would either have traveled to Asia, where the illness is believed to have started, or come in contact with someone who traveled to Asia.

Health alert notices are being given to those traveling to and from Hong Kong and parts of China and Vietnam. Travelers are being told that they may have been exposed to SARS, and what symptoms to look for if they start feeling sick within a week of their trip.

Because the cause of SARS has yet to be confirmed, there is no set treatment for the illness. So what patients are getting is known as supportive care, such as antibiotics or fluids.

Dr. Senay says SARS patients should limit their activities to the home.

She says they should not go to work, school or any public place for at least 10 days. In addition, if they're coughing or sneezing, they should use common-sense precautions, such as covering their mouth with a tissue, and, if possible, they should wear a surgical mask to reduce the possibility of droplet transmission.

In addition, says Dr. Senay, they should use wash hands frequently with soap and water or an alcohol-based hand rub.

CBS

(CBS) When soldiers are wounded how they are treated on the battlefield can mean the difference between life and death.

The Early Show medical correspondent Dr. Emily Senay took a look at the latest medical devices being used on the front lines.

Dr. Senay says since the first Gulf War, the military has invested a lot of money in creating new medical devices so doctors in the field are better equipped than they have ever been. Many of the advances we've seen are in devices that treat hemorrhaging, which is perhaps the largest preventable cause of death among soldiers.

Here are some examples of progressive medical equipment:

Fast-Clotting Bandages: This is one of a new breed of fast-clotting bandages that was recently given approval by the Food and Drug Administration. They are manufactured by a new company called Hemcon, and they are made from chitosan, which is a shrimp-based product. Dr. Senay says it works by using positively charged chitosan molecules that are attached to the bandage. They attracts negatively charged red blood cells, creating a clot. Researchers say the product is very effective at treating all types of battlefield wounds.

Clotting Powder: This is a quick-clotting powder that goes by the name QuikClot. It induces rapid coagulation of wounds. Dr. Senay says it works by rapidly removing liquid from the blood and stops bleeding almost instantly. QuikClot is poured directly into an open wound. And the clot it creates stays in place until the soldier is brought to a medical facility. Another good thing about this product is that wounded soldiers can apply it directly to themselves.

One-Handed Tourniquet: The Tourniquet has been around forever and in order for one to work effectively, it takes two hands. But with this new device, says Dr. Senay, a soldier takes it out of the bag, slips it through the arm and simply pulls. The one-handed tourniquet was developed by Army researchers. More than 20,000 of the tourniquets have been handed out to U.S. soldiers.

Intraosseous Infusion Device: This device is used to stop blood pressure from dropping to dangerously low levels. Dr. Senay says this sometimes happens when a person loses a great deal of blood. It is filled with fluids, including saline. And it works by punching a hole in the sternum so that the fluids quickly enter the blood stream by bone marrow.

After a soldier has been treated on the battlefield, he or she can go back into action with minor injuries, says Dr. Senay. Others will be sent to the hospital at the nearest base. There are also floating hospitals, including the USS Boxer, which is now stationed in the Northern Persian Gulf. It is equipped to deal with biological and chemical attacks.

Il Nuovo

Tra i tanti allarmi che hanno attraversato la Penisola in quest'ultimo periodo, il ministro Sirchia ne individua uno definendolo "molto sospetto". Si tratta di uno steward, ricoverato a Roma.

ROMA - Un caso "molto sospetto". Dopo gli allarmi che hanno investito un pò tutta la Penisola (gli ultimi a Firenze e Imperia) su presunti contagi da Sars, la polmonite atipica che proviene dall'Oriente, e che si sono rivelati quasi tutti normali casi di affezione polmonare, il ministro della Sanità Girolamo Sirchia punta ora il dito su un paziente che potrebbe rappresentare un problema decisamente più serio. E' uno steward, ovvero, per professione, un soggetto che ha contatti con l'estero, l'Asia in genere, e gli eventuali viaggiatori e passeggeri che provengono dall'Oriente.  E' ricoverato da tempo allo Spallanzani di Roma, uno dei due centri italiani (insieme al Sacco di Milano) più preparati per affrontare un'eventuale emergenza, e, secondo il ministro, "sembra essere molto sospetto". "Il paziente - sostengono i medici dell'istituto romano - sta meglio, è senza febbre ma resta in costante osservazione". Proseguono, intanto, gli esami di laboratorio sui virus e batteri prelevati dallo steward. Per ora, non se ne dice di più.

L'uomo, ricoverato a Roma, era arrivato da Hong Kong e stava poco bene già alla partenza del suo volo. Peraltro, sceso nella Capitale, ha fatto tappa in altre città italiane, prima di tornare a farsi ricoverare a Roma. "E' obbligo delle autorità sanitarie ricostruire  tutti i suoi percorsi - dice ora Sirchia -  e le persone con cui è venuto a contatto". Nel frattempo, mentre si ridimensiona il caso di quattro soggetti ricoverati a Firenze (che in un primo tempo sembrava fosse un intero nucleo familiare) ne spunta uno nuovo, sempre nel capoluogo toscano. Un uomo di 39 anni infatti, è stato ricoverato oggi, dopo essere rientrato da un viaggio in Cina. Anche a Imperia si segnala un caso da tenere sotto attenzione: un uomo di 64 anni, reduce da un viaggio in Thailandia, è stato ricoverato questa notte. (1 APRILE 2003, ORE 12.39, aggiornato alle 15.47)