When a Loudoun County woman, who had traveled to Guandong Province, China, became ill with flu-like symptoms after returning to the United States in February, her doctors began treating her with antibiotics. In addition, the physicians began monitoring her family and friends to see if they also became ill.
Not long afterwards, she was released from the hospital to recover at home and is in good condition. More than a month later, the Virginia Department of Health is looking into whether the woman is the first suspected case of severe acute respiratory syndrome (SARS) in the United States.
“We don’t know what the causative organism is yet, but clinicians have been successful in its treatment,” said Jennifer Fricas, a public health nurse in the communicable diseases unit of the Fairfax County Department of Health. “SARS is causing pneumonia-like symptoms and is responding well to general treatments for pneumonia.”
To date, the state health department is investigating three suspected cases of SARS, two of which are in Northern Virginia. A suspected fourth case was determined to be Influenza A.
WHILE THE LATEST figures available on the Centers for Disease Control and Prevention (CDC) Web site show a total of 2,416 reported SARS cases worldwide, it is still relatively nonexistent in the United States. As of April 5, the CDC was reporting 115 suspected cases in the U.S. In all, there have been 89 reported deaths believed to be linked to SARS: seven in Canada, 49 in China, 20 in Hong Kong, one in Malaysia, six in Singapore, two in Thailand and four in Vietnam.
“Thus far, the overall fatality rate from SARS is 4 percent, which is on par with any other pneumonia,” Fricas said.
In general, the respiratory disease starts with a fever greater than 100.4 degrees Fahrenheit or higher. Other symptoms can include headache, an overall feeling of discomfort and body aches, and in some people, mild respiratory symptoms. After two to seven days, the person may develop a dry cough and have trouble breathing.
So far, it is believed SARS is spread through close contact, meaning prolonged contact of within 3 feet, and by coming into contact with secretions from the sick person. SARS is not contagious until the affected person begins showing symptoms.
“We want people to be aware of SARS, but we don’t want people who are from Asia or have traveled to Asia to be treated suspiciously,” Fricas said. “The severity of the illness varies by person. And many of the people in the U.S. suspected of SARS have not needed to be hospitalized.”
One of the problems health-care providers’ face is the newness of the disease, which is believed to be a previously unrecognized coronvirus, therefore there is no test specifically for SARS. Instead, physicians have to diagnose the disease by testing and eliminating other more common illnesses such as pneumonia and influenza.
THE CDC and World Health Organization (WHO), the heath agency for the United Nations, has launched an educational campaign that includes giving informational cards about the illness to international travelers and daily updates on their Web sites.
“We only have two direct flights, one from Seoul and one from Tokyo,” said Tara Hamilton, public affairs manager for the Metropolitan Washington Airports Authority (MWAA), which owns Washington Dulles International and Ronald Reagan Washington National airports. “Passengers coming in from those cities are given cards created by the CDC as they go through customs.”
Hamilton said MWAA has not been told to advise people who work at the airports to take any special precautions. She said the airports officials will comply with any directive issued by the CDC and local health departments.
“We’re all closely working together,” Hamilton said.
As for the general public, the state health department is recommending international travelers wait until they start to show symptoms before visiting their doctors.
“Some people are calling in simply because they’ve traveled,” said Lucy Caldwell, state health department spokesperson. “We’re discouraging that. Only call in if you’ve got a fever.”
In addition, Caldwell said the state agency is recommending people wash their hands frequently since the disease can be spread through secretions.
Information about SARS is being updated daily on the CDC Web site at www.cdc.gov/ncidod/sars or on the WHO Web site at www.who.int/csr/sars/en/.