<a href=www.canada.com>The Canadian Press Canadian Press Tuesday, April 01, 2003

(AP) - The disease called severe acute respiratory syndrome, or SARS, continues to make headlines. Here are answers to some concerns about it.

Q. What are the symptoms?

A. It usually begins with a fever of more than 38 C, sometimes with chills and headache and body aches. After two to seven days, patients may develop a cough. Other symptoms can include shortness of breath, difficulty in breathing and pneumonia.

Q. Who's most at risk of getting SARS?

A. Travellers to or residents of certain parts of Asia, and people who've had direct close contact with an infected person, like health care workers and those sharing a household with a SARS patient.

Q. What should I do if I think I have SARS?

A. If you have a fever of more than 38 C and develop a cough or difficulty breathing, contact a health care provider. Explain any recent travel to regions where SARS has been reported and whether you were in close contact with someone who had these symptoms.

Q. How does SARS spread?

A. The germ apparently travels on the tiny droplets of fluid that an infected person spews out when coughing or sneezing. Experts say they're concerned about the possibility that it might also travel more broadly through the air.

Q. What can I do to avoid SARS?

A. Health Canada says people should defer travel to China, including Hong Kong; Singapore; Taiwan; and Hanoi.

Q. Can I catch the germ from an infected passenger in an airplane?

A. There have been a few reports suggesting that. The World Health Organization says that doesn't necessarily mean the germ spreads through recirculated air, however. To reduce the international spread of SARS, WHO is urging officials to screen international airline passengers departing from Toronto, Singapore, Hanoi and several Chinese cities for possible SARS and ask those who appear sick to delay their trip until they feel better.

Q. Is there a cure?

A. None has been identified yet.

Q. What caused those clusters of cases in the Hong Kong hotel and apartment building?

A. It's not yet clear how the germ was transmitted in those cases. Scientists believe SARS is caused by a type of coronavirus, the virus family that causes the common cold. Other coronaviruses can survive up to three hours outside the body. So it's possible that if an infected person coughed droplets onto a door handle or some other object that a second person later touched, that second person might become infected.

On the Web: Health Canada: www.hc-sc.gc.ca/english/index.html WHO information: www.who.int/csr/sars/en CDC information: www.cdc.gov/ncidod/SARS

All Africa South African Press Association (Johannesburg) April 1, 2003 Posted to the web April 1, 2003

Nelspruit

A man is in isolation in the Nelspruit Medi-Clinic with symptoms of malaria or possibly the feared Severe Acute Respiratory Syndrome.

The man, who looked to be in his 40s, was transported from Maputo, Mozambique, by ambulance to the clinic on Monday night, clinic spokeswoman Robyn Freathy said on Tuesday.

He had recently travelled to Hong Kong. She said the man could also be a malaria patient.

"After receiving a call yesterday from the Medical Director of SOS International requesting permission to receive a patient who was seen by a doctor in Maputo with possible symptoms of SARS, Nelspruit Medi-Clinic has taken all necessary precautionary measures in its isolation and hospitalisation process of the patient," Freathy said in a statement.

The man would remain in isolation until the outcome of tests already conducted was known.

"In the interim, the admission of this isolated patient has been reported by Nelspruit Medi-Clinic to the Department of Health."

SARS is a type of atypical pneumonia caused by a new virus from the family of coronaviruses, which also causes the common cold.

The United States Centers for Disease Control and Prevention have said evidence was mounting that the virus was the primary causative agent, but experts say much laboratory work still needed to be done to pinpoint its exact characteristics.

Development of a vaccine will take years.

According to the World Health Organisation the disease originated in China's southern province of Guangdong before spreading to Hong Kong, from where it was then carried to Vietnam, Singapore, and Canada.

Cases later surfaced in other places including the United States, France, Britain, Taiwan and Germany.

Hong Kong and WHO scientists believe the strain likely originated from animals although it does not appear anything like any known human or animal viruses.

Health experts in Hong Kong have ruled out any association with influenza A and B viruses, and also the H5N1 bird-flu virus which jumped the species barrier and killed six people in the territory in 1997, and a man in February.

The WHO says the main symptoms are high fever, a dry cough, shortness of breath or breathing difficulties. Changes in chest X-rays, which are indicative of pneumonia, also occur.

Other symptoms include chills, headaches, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhoea.

Health experts say the disease has an incubation period of between two and seven days. The mortality rate appears to be between three and five percent.

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La pneumonie atypique en provenance de Chine serait causée par deux virus et non un seul. Ce qui en ferait une infection totalement nouvelle. 

01/04/2003 - La pneumonie atypique en provenance de Chine serait causé par deux virus et non pas un seul. C'est l'hypothèse la plus sérieuse envisagée par les biologistes de l'OMS chargés de l'enquête. Le premier virus serait issu d'une famille parfaitement banale, celle des coronaviridae. Ces virus sont notamment responsables de deux tiers des rhumes. Le deuxième, déjà identifié il y a deux semaines, est un paramyxovirus. Cette famille est impliquée dans différentes maladies respiratoires.

Le coronavirus serait le premier à attaquer, de façon à mobiliser les défenses immunitaires de la victime. Dans un deuxième temps, le paramyxovirus prendrait le relais sur un organisme affaibli. Cette façon de procéder ferait du SARS (Severe acute respiratory syndrome) une infection totalement nouvelle, selon la revue Nature.

L'identité des coupables reste à confirmer mais la nouvelle inquiète les autorités médicales du monde entier. Il n'existe à l'heure actuelle aucun traitement efficace contre les coronavirus, qui sont en général bénins. La recherche médicale sur ces microbes n'a jamais été une priorité. Il s'agirait cette fois d'un mutant exceptionnellement offensif. Le seul traitement fourni aux victimes est la ribavirine, un antiviral courant. Mais son efficacité n'est pas encore démontrée. Le 1er avril, le SARS avait d'ores et déjà contaminé 1804 personnes dans 17 pays et provoqué la mort de 62 d'entre elles, selon l'OMS.

News.com.au 06Apr03

SIX airline passengers have been detained for medical assessment at Australian airports over the last 24 hours under tough new quarantine measures announced in response to the SARS epidemic. In a statement, Chief Commonwealth Medical Officer Richard Smallwood said four of the passengers landed at Perth Airport.

All four were cleared of Severe Acute Respiratory Syndrome (SARS) after being assessed by nurses based at the airport.

The other two were also cleared after a checkup by on-site medical staff at Sydney Airport.

One of them was referred by the airline and the second was stopped by customs officers, Professor Smallwood said.

The latest figures bring to 14 the number of people who have been identified for medical assessment at airports since the new quarantine clearance measures were announced on Friday.

All cases have been cleared.

However, four people remain under investigation for the deadly pneumonia-like illness in Victoria.

The four under investigation include three children from the same family from Canada and a two-year-old girl from Vietnam.

A temporary resident in NSW who has since recovered is believed to have been Australia's only confirmed case of the illness, which has killed 89 people and infected 2,500 worldwide since spreading from southern China.

Meanwhile, the health department's SARS hotline had received more than 10,000 calls since it was established eight days ago, Prof Smallwood said.

This report appears on news.com.au.

News.com.au By Jewel Topsfield 06Apr03

ISABELLE Hogarth, one of four suspected SARS victims in Melbourne, turned four today in an isolation ward at Monash Medical Centre.

"I want to go home," she yelled through the glass walls.

"I want to ride my bike," her six-year-old brother Thomas chimed in.

Isabelle, Thomas, 18-month-old Jack and their parents David and Deb have been in the isolation unit since Thursday night, after all three children developed symptoms of the deadly SARS virus, including high fevers and coughs.

The Australian-born family, who were on holidays from Toronto, Canada, arrived in Melbourne last Sunday.

"The walls are definitely closing in around us," Mr Hogarth said wearily.

"All I'd like to say is that the children are fine, a little bit tired, and the medical staff have been wonderful."

Professor Richard Doherty, the treating doctor at Monash Medical Centre, said he was very pleased with the children's condition.

He was hopeful they would be discharged tomorrow.

"I had the opportunity to talk to the head of respiratory diseases for public health in Canada and one of the senior treating doctors for the SARS cases at the children's hospital in Toronto and we're all pretty comfortable these children would not have been classified as SARS (cases) in Canada," Prof Doherty said.

But he said SARS could not be ruled out unless they had an alternative diagnosis.

"It remains possible in the absence of a firm diagnosis they had mild SARS and are now getting better," Prof Doherty said.

The dilemma facing Monash Medical Centre is that no-one knows whether a SARS victim could potentially spread the virus even though they appeared to have recovered.

"We have to strike a balance between keeping someone in hospital for public health reasons and getting them out of hospital for economic, social, personal and medical reasons," Prof Doherty said.

"I'm really hopeful we will be on solid grounds to be able to discharge tomorrow but I can't promise."

Meanwhile, a two-year-old girl who was rushed to Monash Medical Centre with suspected SARS late yesterday remains in an isolation unit.

The girl, whose name has not been released, arrived in Australia from north Hanoi in Vietnam yesterday.

Prof Doherty said she had responded extremely well to antibiotics and her fever seemed to have disappeared.

However, her case was still considered "fairly serious" because several SARS cases had been reported in Vietnam.

Prof Doherty said communication had been difficult because the mother did not speak fluent English and the child was bewildered.

"She seems well but as you can imagine she is a little girl whose mum doesn't speak good English and she is finding the circumstances fairly terrifying and she's fairly upset," he said.

Prof Doherty said testing was continuing and he was hopeful an alternative diagnosis would be made.

This report appears on news.com.au.