Mysterious Flu-Like Illness Continues to Spread

The illness may have originated in China’s southern Guangdong province where 305 people became ill and five died.

The illness, which is being called “severe acute respiratory syndrome,” or SARS, has an incubation period of some three to seven days. It often begins with a high fever and other flu-like symptoms, such as headache and sore throat.

Victims typically develop coughs, pneumonia, shortness of breath and other breathing difficulties. Death results from respiratory failure.

In the United States, the Centers for Disease Control and Prevention is looking into four possible cases of SARS. The CDC has ruled out 10 other suspicious cases. Dr. Julie Gerberding, head of the CDC, said that while the agency is unsure whether the cases currently under investigation involve SARS, it would not be surprising if the disease eventually cropped up in the U.S.

“It certainly reminds us that we do live in a global village and emerging problems in one part of the world will soon be emerging problems for all of us,” she said Wednesday.

The illness may have originated in China’s southern Guangdong province where 305 people became ill and five died.

While the WHO does not know what causes the disease, initial clues suggest that a virus may be culprit. Patients with SARS do not respond well to standard antibiotics, which kill only bacteria. The white blood cell counts of those with SARS drop — a symptom of viral infections, but not bacterial ones. However, experts stress that they still cannot confirm the cause of the disease.

“Something is making these people sick. We can identify some of the symptoms they have but we cannot identify the cause at the moment,” Iain Simpson, a WHO communications officer, told Reuters.

The WHO did not recommend that travelers avoid visiting affected areas, but it did issue an emergency travel advisory on March 15 detailing the disease’s symptoms and issuing instructions for airlines.

“People should continue to travel. This is not a disease that people will get by walking through a marketplace or by sitting in a public place. What we understand is that there has to be close contact,” Dr. David Heymann, the WHO’s communicable diseases chief, told Reuters.

Gerberding issued a firmer warning to U.S. travelers on March 15, saying that “we are advising persons planning nonessential or elective travel to affected areas that they may wish to postpone their trip until further notice.”

Late Sunday, Chinese health authorities sent the WHO an initial report on its handling of the initial outbreak.

The WHO is asking China for more information on the treatments. It was also not known how many of the 305 people that China said fell ill had already recovered after the disease peaked there in early February.

“We are now working closely with the Chinese authorities,” Heymann told Reuters, although it was still not proven that all the various suspected cases in different countries were the same disease.

SARS is proving unreceptive to traditional pneumonia treatments, although the Chinese authorities had clearly had some success with other approaches, Heymann explained.

“The Chinese have indicated that they have tried antibiotics but that these have not been effective… But they have been able to support [patients] with respirators where necessary and other interventions which seem to have worked,” Heymann told Reuters.

The Chinese said seven percent of patients there required breathing tubes, but most eventually got better, especially if they were not also stricken with a bacterial infection. In addition, the disease seemed to weaken as it passed from person to person.

That’s encouraging, WHO officials say, adding that some of the patients in the latest outbreak seem to be recovering.

Heymann added that in Hanoi, Vietnam where one nurse has died and around 50 people have been affected, some patients appeared to be getting better although they had not been discharged from hospital. Nearly 100 are ill in Hong Kong.

SARS was first recognized on Feb. 26 in Hanoi. As of March 17, the WHO reported cases of the illness in Canada, Germany, Hong Kong, Singapore, Switzerland, Thailand, and Vietnam. The WHO officials said they were also investigating possible cases of SARS in England, France, Israel, Slovenia and Australia.

The U.S. Centers for Disease Control and Prevention activated its emergency operations center on March 14 in response to the increasing number of SARS cases. On March 15, Dr. Gerberding said that while the pattern of transmission is consistent with a flu-like virus, the CDC “will be keeping an open mind” when assessing whether the disease could be the result of bioterrorism.