SA put on alert for deadly pneumonia virus
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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
Travelers Warned About SARS
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.
Building is sealed off due to mystery flu
By DIRK BEVERIDGE
Associated Press
4/1/2003
Wearing masks and other medical apparel, Hong Kong police prepare to go inside the Amoy Gardens apartment building, where an outbreak of suspected SARS has caused all 240 residents to be quarantined.
HONG KONG - Health officials sealed off an apartment building and quarantined all 240 residents Monday after reporting an alarming jump in new cases of a mysterious flulike disease.
More than 600 people in this city are believed to have the dangerous respiratory infection, and almost half of those live in the Amoy Gardens apartment complex. Officials reported 92 new cases in the complex Monday.
Severe acute respiratory syndrome, or SARS, has prompted officials in Asian countries to enforce little-used quarantine laws, close schools and impose new health screenings on travelers.
The disease, which has no proven treatment, also continued spreading in other affected "hot spots," such as Singapore and Toronto.
Doctors and nurses in Singapore donned special respirator suits designed for handling germ warfare attacks so they could get close to patients infected with SARS.
In Canada, where a health emergency has been declared in Ontario province, Toronto authorities reported that at least two children had been hospitalized with the disease, and three others were showing symptoms of it. But they would not give details.
Worldwide, about 60 people have died from the disease, at least 15 of those in Hong Kong. Government officials are pondering whether to set up quarantine centers if the disease cannot be contained.
The World Health Organization said Monday that experts hope to pinpoint the cause soon, and signs continue to point to the coronavirus.
In Hong Kong, the 240 residents under the apartment quarantine have been ordered to stay inside until midnight April 9. They will get regular medical exams and three free meals a day.
Hong Kong's health secretary, Dr. Yeoh Eng-kiong, appeared emotional and had trouble speaking as he said "a very exceptional circumstance" had forced the drastic response.
"We haven't done it before and we hope we won't do it again," he told a news conference.
More SARS
Nation Multimedia
Apr 04, 2003
WHO: Thailand still on risk list
Thailand remains on the risk list for countries hit with by outbreaks of Severe Acute Respiratory Syndrome, or SARS, the World Health Organisa-tion’s (WHO) Bangkok office said yesterday.
This contradicted media reports last month that Thailand had been removed from the list after convincing the WHO’s head office in Geneva that it was safe.
“You probably can minimise it, but you can never eliminate it,” said Dr Bjorn Melgaard, the WHO’s representative in Thailand.
Despite still being on the list, Melgaard said Thailand had done a good job with its control and prevention measures against SARS.
Meanwhile, the Hong Kong Health Department was tracing all air crew and passengers from a Thai Airways International flight from Bangkok to Hong Kong on Saturday, after one passenger was confirmed with SARS.
The department called on passengers who had travelled on flight TG 606, which arrived in Hong Kong at 7.45pm, to contact its hotline on 2961 8968 for health advice.
The appeal was made after an investigation found that a 30-year-old man who had taken the flight developed symptoms of SARS during his stay in Bangkok between March 25 and 29.
The man, admitted to Hong Kong's Princess Margaret Hospital on March 29, is in a stable condition.
The department has asked THAI to disinfect the plane.
In southern China, WHO doctors investigating the origin of SARS said yesterday initial government figures showed that fewer people in hard-hit Guangdong province were getting sick.
The WHO assessment came as the national government insisted China was a safe place to live – and, just as importantly, to visit.
“The number of cases is going down,” WHO team spokesman Chris Powell said. “There are still new cases – which is very sad – but the number of cases from what we’ve seen is going down.”
The Nation, Associated Press
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CURBING THE SPREAD: Foreigners face isolation
12-hour quarantine may apply for arrivals from high-infection countries
Foreigners arriving from countries with outbreaks of Severe Acute Respiratory Syndrome (SARS) may be quarantined for 12 hours to curb the spread of the virus to Thailand.
Public Health Minister Sudarat Keyuraphan declined to say when the drastic measures would be introduced for foreigners arriving from China, Hong Kong, Singapore, Taiwan and Vietnam.
But she said the compulsory 12-hour quarantine would only be enforced if tourists from designated countries refused to undergo a medical check-up at the airport, or declined to wear a surgical mask while staying in Thailand.
Prime Minister Thaksin Shinawatra yesterday said he had given the green light for Sudarat to proceed with the 12-hour quarantine.
"They may have to spend some 12 hours at the airport but they would be allowed to go if there were no symptoms," Thaksin said.
The prime minister said the ministry had decided on the quarantine following complaints that Thais arriving from affected countries had to stay home for 14 days, but foreigners were free to go.
Sudarat said foreigners found to have suspicious symptoms would be immediately deported, while the rest would have to wear masks while in the country.
"We may have to quarantine people arriving from these five risk countries at the airport for 12 hours, although they may not show any sign of SARS. But we will use this measure only if current measures are not effective," Sudarat said.
She said the ministry had increased the number of health quarantine officials at Bangkok International Airport from about 10 to 40 per shift to handle the arrival of some 76 flights a day from the five countries.
She said her ministry had asked Airports of Thailand to provide separate arrival facilities for these flights, so that doctors can check the passengers on board. She said if doctors found any passenger with SARS-like symptoms, all passengers would be taken for examination at a special checkpoint.
Sudarat said if no one with SARS-like symptoms was found on board, the passengers would go through the medical check-up at the arrival terminal. She said their temperatures would be taken.
"If a Thai is found to have a symptom, he or she will be admitted to a hospital for monitoring immediately. If the person is a foreigner, he or she will be deported immediately," Sudarat said.
She said foreign passengers on the same plane as a person with suspected symptoms would be quarantined at the nearby military airport.
Sudarat said she had also asked all government agencies to cancel all events involving arrivals from the five countries.
She said the Women's Asian Football Championship, initially planned for April 19, had been postponed indefinitely.
Meanwhile, Communicable Disease Control Department director-general Jaral Trinwutthipong said he had replaced a quarantine chief at Don Muang airport with an official from the ministry in order to increase efficiency.
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Masks ‘inappropriate’
Executives of Hong Kong-based Dow Jones Co Inc postponed a meeting with Prime Minister Thaksin Shinawatra scheduled for yesterday due to Severe Acute Respiratory Syndrome (SARS) precautions.
According to a source, the Dow Jones executives felt that meeting Thaksin in face masks would be inappropriate.
The government requires that visitors from SARS-hit countries, including Hong Kong, wear face masks while they are in Thailand. The four other countries are Singapore, Taiwan, China and Vietnam.
The executives scheduled to meet the premier were from Hong Kong and Australia.
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200 contacts must undergo check-ups
Some 200 people who are known to have come into contact with seven Severe Acute Respiratory Syndrome (SARS) victims, including two who died, will undergo medical check-ups, Public Health Minister Sudarat Keyuraphan said yesterday.
The announcement came as seven new cases of possible SARS were reported in Surin, Nakhon Phanom and Songkhla.
The two deaths were Italian doctor Urbani Carlo, who contracted the disease in Vietnam while working for the World Health Organisation, and Hong Kong citizen Lam Ying Cheung, who came to visit Thai relatives during the Chinese Qing Ming festival.
Of the other five, only an insurance employee remains hospitalised for treatment, while four - including a Thai Airways International cabin-crew attendant, a Laotian and a Westerner - have already been discharged, Sudarat said.
In Surin, a contract worker who recently returned from Singapore had come down with flu-like symptoms and was being kept at the provincial hospital under observation for two weeks, hospital director Pramote Suchinphrom said. The man's two children are also under quarantine, even though they did not display any symptoms after coming into contact with him, Pramote said.
A husband and wife who recently visited Singapore have also undergone a health check-up, but they had no telltale symptoms and were asked to stay home for two weeks to be on the safe side, Pramote said.
In Nakhon Phanom, a medical team is monitoring a Thai-Vietnamese woman who fell ill with flu-like symptoms after meeting a group of 40 Vietnamese students from Vinh. The woman is being treated in an isolation room at the provincial hospital.
Songkhla Nakharin Hospital director Sutham Pincharoen said a 20-year-old pregnant woman from Hat Yai had been admitted with flu-like symptoms. She is being monitored for SARS but a diagnosis has yet to be made, he said.
In Bangkok, National Electronic and Computer Technology Centre director Thaweesak Koanantakool yesterday denied that two of his staff had contracted SARS after participating in a scientific seminar in Shanghai last month, citing medical reports from two public hospitals.
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Face masks are hard to find
Face masks have been flying off of shelves, with the more effective N95 type completely out of stock since the outbreak of Severe Acute Respiratory Syndrome.
3M Thailand, a major distributor of the N95 mask, yesterday said that its parent company in the United States had stepped up its production in a bid to keep pace with the rising demand.
"Our plant there is operating around the clock and has even postponed manufacturing other products to concentrate on the masks," said Thawatchai Chinwiseswong, a product specialist at the company.
He declined, however, to give specific details of the number of masks that had been ordered, saying only that their retail price would remain Bt25-26.
Government Pharmaceutical Organisation (GPO) director Dr Thongchai Thavichachart said the shortage was getting serious and that some hospitals had run out of masks.
"Money cannot buy the face masks because there are none available," he added.
He said two suppliers of the N95 mask had confirmed that their stocks had been depleted. GPO has three suppliers for the masks.
"The other has not yet delivered its products to us," Thongchai added.
Juree Khemathanont, an inventory official at Osot Sala at Chulalongkorn University's pharmacy faculty, said her pharmacy had never sold the N95 face masks before and that it was trying to order some.
"But all of the distributors we contacted said they were out of stock," she said.
She added that Osot Sala was still selling general face masks and that they were going like hot cakes.
"We sold about 1,000 face masks today. Before the SARS outbreak, we sold only two masks a day," Juree said.
A number of people complained that they had been unable to find the masks at convenience stores, which generally have plenty on their shelves, and even at big discount store chains. "We don't have any masks available today because a few customers bought the last lot we had on Wednesday," an official at Carrefour said, adding that the stock would be replenished on Monday.
Saithong Wongkrua-sorn, a customer-service official at Berli Jucker Thailand, said her company had received "many" orders for the N95 masks that it could not deliver because the manufacturer had not yet delivered them.
"We should get the face masks by the middle of next week," she said.
3M's Thawatchai advised wearers to regularly check their masks to ensure their efficiency. He said people should change their masks if they experienced difficulty breathing or if their masks were torn.
"There is no medical equipment that can guarantee 100-per-cent protection from the virus," he said.
A technician at the same company, who spoke on condition of anonymity, said the N95 face mask was the most effective protection against SARS.
Napanisa Kaewmorakot
THE NATION
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SARS: Virus puts business on high alert
Masks and travel bans imposed to prevent disease
Local businesses, banks and government agencies are on high alert against the deadly SARS virus and have introduced preventive measures ranging from handing out surgical masks and cleaning air-conditioning filters to using video-conferencing and giving staff 14 days sick leave.
More than 800 employees at Thailand's National Science and Technology Centre (Nectec), also known as the Science Park, were told to stay home yesterday and the park was closed to allow for a thorough cleaning of all facilities before staff return to work, according to a Nectec security official.
The move came after two staff members developed a fever after attending a meeting in Shanghai. China is one of the five countries on the watch-list for potential contagion from Severe Acute Respiratory Syndrome.
The two sick workers were quarantined to comply with the Public Health Ministry measures, but Thaweesak Anatakul, the Nectec director-general, said yesterday that the employees denied having SARS and claim to be suffering from a normal flu.
Meanwhile, a Bank of Asia spokesman said the bank would buy surgical masks for all of its 2,000 staff to protect them from SARS.
SARS has claimed the lives two people in Thailand and scores of others in Asia.
Bank staff that catch influenza will be allowed to stay home and receive medical treatment for 14 days, the Bank of Asia spokesman said.
The Government Pension Fund office at the Abdulrahim Building is displaying the Health Ministry's warning for all staff to follow. It also requested that staff wear masks if necessary to prevent catching any variety of flu.
An official at Bangkok Bank said the bank has instructed all staff to refrain from travelling overseas. Staff stationed in overseas branches are requested to remain where they are until further