Details given on deadly ailment

Pneumonia strain broke out in Guangdong, then tapered off, China says


Chinese health officials gave the World Health Organization the first sketchy details yesterday about a mysterious respiratory ailment that is believed to have first broken out in Guangdong province in November and that Chinese officials say has tapered off in recent weeks.

It was the first official communication from China about the outbreak, and it provides a longer-term view to the WHO of how the illness, cases of which are now being reported throughout East Asia and in Canada, has behaved since the first cases were detected. Although the new information hints that the outbreak may be tapering off for unknown reasons in Guangdong, WHO officials say they need more information to be certain.

"If it has burned out, it certainly will give us optimism over its control" elsewhere, Dr. David L. Heymann, a WHO official, said in an interview. "That is why we need more information to know what the natural history of the illness has been since November."

On Saturday, the WHO, an agency of the United Nations, declared the ailment "a worldwide health threat." The agency calls the ailment severe acute respiratory syndrome, or SARS, and says it has caused at least nine deaths in Canada and five other countries in recent weeks. The spread of the ailment, a form of atypical pneumonia, has been aided by international travel. New cases, including many hospital workers, are being reported daily in affected countries, said a WHO official.

Laboratories in at least five countries have failed to detect any known infectious agent as a cause of the illness. The illness generally starts with the sudden onset of a fever of 101.4 degrees or higher, muscle aches, a headache, a sore throat, a dry cough and shortness of breath. X-rays show pneumonia or respiratory distress syndrome. Laboratory tests show low numbers of white blood cells and platelets, which help blood clot.

There have been no reports of the illness in the United States. But a 32-year-old doctor from Singapore and his 62-year-old mother-in-law were being treated for pneumonia in isolation in a German hospital after having attended a medical conference in New York. Officials believe the doctor may have contracted the illness in treating the first two cases in Singapore, where there are now 20 reported cases.

The doctor had a fever and a slight cough, and the mother-in-law had a high fever, doctors at the Johann Wolfgang Goethe University Hospital in Frankfurt said at a news conference yesterday. They said the doctor's 30-year-old wife, who is pregnant, has shown no symptoms of the ailment.

New York City health officials said it was highly unlikely that the doctor or his family had given the illness to anyone in the city.

When asked about the issue at a St. Patrick's Day parade yesterday, Mayor Michael R. Bloomberg said he had spoken with the health commissioner, Thomas R. Frieden, and said, "Let me stress that the commissioner is reasonably confident that this guy did not infect anybody" in New York.

Health officials say they believe it takes direct and sustained contact to transmit the illness. But health officials have asked doctors to be alert to patients with flu-like symptoms who have recently traveled to Asia.

Coincidentally, infectious diseases were the subject of the meeting that the Singapore doctor attended, and news of the respiratory ailment was a hot topic in the hallways. The doctor attended the conference for two hours, said Dr. Marcelle Layton, New York City's assistant health commissioner for communicable diseases.

Layton said the Singapore doctor reported that he did not sit near other participants in the meeting and that he had minimal contact with anyone else during his stay in New York City. Layton said she had interviewed the doctor by telephone from his hospital room in Germany.

"He was very cooperative and helpful," Layton said in an interview.

The doctor, whose name has not been released, had treated the two initial cases of the syndrome in Singapore. One patient was a doctor who had traveled to Singapore from Hanoi, Vietnam, where the outbreak has affected 46 people.

Before the Singapore doctor left home for the United States on March 11, he developed a fever, severe muscle aches and a rash, which disappeared within two to three days.

Dr. Barry M. Rosenthal, a physician at Lenox Hill Hospital in New York City, said in an interview that late Thursday night he had received a call from the Singapore doctor, who said he had a rash and fever and wanted to know where he could get a blood test because he suspected he had dengue fever, a mosquito-borne viral infection.

Rosenthal referred the doctor to another physician. New York City health officials said that X-rays showed pneumonia in one lobe of the doctor's left lung and that he was treated with oral antibiotics but not hospitalized.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.