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US Hospitals Brace For
SARS As Cases Inch Up
By Kim Dixon
4-11-3

CHICAGO (Reuters) - U.S. hospitals are bracing to treat more patients with the baffling respiratory disease SARS, as the number of suspected cases in the United States inches up.
 
SARS, or Severe Acute Respiratory Syndrome, "has the potential to be a significant problem here if it were to get out of control, considering what happened in Toronto," said Stephen Sokalski, director of infectious diseases at Advocate Christ Hospital in Chicago. "That could happen here."
 
The disease has sent thousands into quarantine in Canada, putting a dire strain on the country's health care system.
 
The roughly 5,000 hospitals in the United States are preparing special isolation rooms, retooling emergency rooms and stocking up on face masks to be ready for SARS, which has killed 114 people worldwide, though none yet in the United States. It has infected more than 3,000 worldwide.
 
And although the flu-like illness originated in southern China, it swiftly made its way to North America and killed 10 in Canada, where some hospitals closed due to the outbreak.
 
Canada is the only country outside Asia where people have died of SARS, which is spreading around the globe via air travel.
 
Wal-Mart Stores Inc. this week banned staff travel to Toronto on SARS worries, and other companies are cutting back on travel.
 
The illness, marked by dry cough, shortness of breath, and a high fever, is striking health workers particularly hard, despite stringent precautions in emergency rooms.
 
On Thursday, Florida health officials said the 47-year-old colleague of a suspected SARS patient also had a respiratory illness that could be SARS. It would be the first time SARS had spread to someone in the United States who was not caring for a SARS patient.
 
The rapid spread of the virus has fueled demand for respiratory masks produced by U.S. companies -- so-called N95 masks, which block 95 percent of solid and liquid particles that do not contain oil.
 
Minnesota-based 3M Corp. for example, has factories running round the clock to keep up with demand, which it predicts is mostly coming from hospital and other health care companies.
 
CONTAINMENT
 
The U.S. Centers for Disease Control counts 166 suspected cases in the United States of SARS in 30 states, as of Thursday.
 
"When we see an unexplained case popping up in a school or an unexplained case of SARS popping up in a workplace, then that's when we become concerned that our containment efforts have failed," said CDC director Julie Gerberding. "We are not seeing that in Florida or the U.S. at this time."
 
Still, some officials cite the Spanish flu pandemic of 1918, which killed at least 40 million mostly young, healthy adults, as reason to be vigilant.
 
"Infectious outbreaks tend to occur in one area and then spread beyond that area," Sokalski said.
 
Doctors believe the coronavirus, believed to be a potential culprit in SARS, spreads in droplets, perhaps coughed by a patient or spread on surfaces such as elevator buttons.
 
The U.S. definition of SARS is intentionally broad to encapsulate even borderline cases.
 
Anyone with a temperature above 100.4 degrees Fahrenheit, at least one respiratory illness symptom like a dry cough or shortness of breath, and who has traveled within 10 days of onset of symptoms to an affected country, is under suspicion.
 
That CDC definition also includes close contact with someone who meets all those criteria.
 
HOSPITALS ON OWN
 
HCA Inc., the biggest for-profit hospital chain, says members are on their own to ready themselves for SARS.
 
"We serve only as a conduit of information from the CDC," said spokesman Jeff Prescott. "It is not telling them how to manage clinical practice."
 
Prescott said only three physicians hold offices at HCA's corporate headquarters in Nashville.
 
For now, the CDC parameters are all health workers have to go on. The CDC has developed three experimental tests for coronavirus infection but says none are ready for wide use. The test will need licensing by the U.S Food and Drug Administration.
 
"I'm hoping that within the next couple weeks, we'll have a more specific test," said Shmuel Shoham, an infectious disease expert at the Washington Hospital Center in Washington, D.C. "Right now we're using the tool of symptoms plus exposure." (with reporting by Maggie Fox in Washington)
 
 
 
Copyright © 2003 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

 

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