First SARS case reported in Georgia
The Atlanta Journal-Constitution By M.A.J. McKENNA / Cox News Service
ATLANTA - Georgia reported its first case of severe acute respiratory syndrome on Monday, an elderly Atlanta woman who is recovering in a hospital, as governments in Asia took drastic action to limit spread of the fast-moving disease.
Health authorities in Hong Kong, where 610 people have been hospitalized and 15 have died, sealed residents inside an apartment complex where 213 people already have become sick. Officials said they will set up quarantine camps if cases continue to rise.
The World Health Organization said Monday 1,563 cases of SARS have been identified outside the United States, including 58 deaths. But those numbers were acknowledged to be incomplete: There have been no updates from mainland China, where the outbreak began and is believed to be spreading rapidly.
There were 72 cases of SARS in the United States, a jump of 10 since Saturday, according to the federal Centers for Disease Control and Prevention in Atlanta. There have been no U.S. deaths.
Georgia has been on alert since the outbreak began: A Canadian victim visited Atlanta in early March, but did not pass the disease to anyone here. On Monday, health authorities discovered the first Georgia case.
The Georgia Division of Public Health said the patient, whom they declined to identify by name, is an 83-year-old woman who lives in an Atlanta suburb. She recently traveled with a tour group that visited several locations in China, said Dr. Susan Lance-Parker, an epidemiologist. The woman began experiencing mild symptoms Wednesday, the day she returned, and was hospitalized Friday.
Despite her age, she did not become ill enough to need a respirator and is recovering, Lance-Parker said. A member of her household who also went on the tour became mildly ill, but was not sick enough to be considered a SARS case by the CDC. Another household member, who did not go on the trip, remained well.
The CDC is tracking down passengers on the flight and members of the tour, which was not operated by an Atlanta company. "We don't know of any other patients from that flight," Lance-Parker said.
The woman had no known contact with any SARS patients who have been identified, health officials said. Her case reinforces the likelihood that the disease can no longer be tracked on clear paths from patient to patient, but is spreading through communities in a pattern that could be impossible to trace.
Fear of community outbreaks prompted severe actions Monday in Asia and Canada.
In Hong Kong, authorities placed one block of the Amoy Gardens apartment complex under strict quarantine for 10 days, with orders that residents must disinfect their apartments before they will be allowed outside again.
The complex is a set of 11 33-story towers, designated A through K, that perch on a shared lobby. Each tower holds 240 families. At least 107 patients, of the 213 from the complex, have come from tower block E, which was sealed Monday.
The Hong Kong Health Department said it had identified the person who brought the disease to the apartments: a SARS patient who now is in a hospital but who had visited his brother in Block E three to four times.
"We have reason to believe ... that this is the source of infection. And the other residents in other blocks have been affected as a spillover from this infected block," Dr. Yeoh Eng-kiong, Hong Kong's health secretary, said.
WHO epidemiologists said they were concerned that cases in the tower were occurring vertically, with victims living in apartments directly above or below each other. That is in sharp contrast to the cluster of cases traced to Hong Kong's Metropole Hotel, where the disease spread horizontally: A doctor who had treated patients in mainland China apparently gave the disease to at least nine and possibly 14 guests sharing the same floor.
Both instances have increased concern that the virus can spread through the air, as well as through building systems such as ventilation ducts.
Amid fear that the Amoy Garden quarantine had been ordered after many residents had already fled the building, the Hong Kong government said it might consider isolating SARS patients in four campgrounds.
"With a large number of people infected, the unpredictability becomes larger, so we are planning for all different types of scenarios," Yeoh said.
In Canada, where visitors from Hong Kong brought the infection to Toronto, thousands of health care workers, hospital patients and their families are under quarantine. Authorities announced additional measures Monday: In Toronto, where officials have declared a health emergency, every hospital staff member has been ordered to wear gloves, gown, mask and protective eyewear.
Ontario, which has 81 of Canada's 98 suspected SARS patients, put severe restrictions on its hospitals. The province's Health Ministry has already closed two hospitals and has limited visitor traffic in three others.
On Monday, the Health Ministry broadened the restrictions to all hospitals, nursing homes, prisons and long-term care facilities in the Toronto metro area and suburbs. The order prevents people from entering facilities unless they are relatives of a critically ill patient or a sick child.
Ontario officials announced that at least two children, and possibly five, may have come down with SARS. They are hospitalized in Toronto's Hospital for Sick Children. The hospital has not been put under quarantine.
Hospital doors have been locked, with security guards or police posted in front of them. Visitors are interviewed before being allowed to pass. Once inside, visitors must don masks and dip their hands in disinfectant before being allowed onto the floors where patients are.
Because hundreds of health care workers are among the thousands under quarantine in Ontario, many nonemergency services -- including elective surgeries and outpatient care -- have been canceled.
Canada and the United States have asked residents not to travel to Hong Kong, mainland China, Singapore or Hanoi -- the epidemic's hot spots -- if it can be avoided. In the United States, the CDC is meeting any flights that originated in those areas or passed through them and handing out health alert cards to arriving passengers.
The cards list SARS symptoms and tell passengers to report to a doctor if they become sick within 10 days of arriving.
More than 160,000 cards have been handed out so far -- a sizable portion of them at Atlanta's Hartsfield International Airport, where the CDC maintains one of eight permanent stations that monitor the health of international travelers.
M.A.J. McKenna writes for The Atlanta Journal-Constitution.