- The Washington Times - Friday, April 18, 2003

The number of SARS cases in the United States dropped sharply yesterday as federal officials began applying guidelines consistent with international standards for identifying the deadly disease.
The Centers for Disease Control and Prevention (CDC) said 35 out of 208 reported are "probable" cases of severe acute respiratory syndrome and the remaining are "suspected" cases.
The case definition set by the World Health Organization (WHO) requires the presence of pneumonia or acute respiratory distress syndrome to determine a person has SARS. The suspected cases had fevers and milder respiratory symptoms.
Of the 35 individuals considered probable SAR cases, 33 had traveled to mainland China, Hong Kong, Singapore, or Hanoi; one was a health care worker who provided care to a patient with SARS, the remaining one was a household contact of a SARS patient.
As of yesterday, 3,389 cases had been reported in 22 countries, and with 165 deaths, the death rate is about 5 percent. However, WHO officials say the number of infected cases in military hospitals has been underreported by the Chinese government and may be as many as 200 more than the 37 reported; an additional 1,000 may be under observation in Beijing.
"This is a clear problem," said Wolfgang Preiser, a WHO team member investigating reports in China. "The military seems to have its own reporting system."
The largest outbreak outside of Asia has occurred in Canada, where 303 cases, including 13 deaths, have been reported. The illness spread in Canada after an infected patient attended a Catholic Mass there.
"In the United States, local transmission of suspected SARS has been limited to [health care workers] and close contacts of suspected SARS patients who were travelers," the CDC said in a statement yesterday.
Of the probable cases in the United States, 23 were hospitalized and 11 were not. The main age group affected is the 18-to-64 one, with 25 cases. Asians reported 14 cases, and Caucasians reported 13 cases; 16 females and 18 males are infected.
Meanwhile, a simple test has been developed to detect the virus within a few hours through a nasal swab or throat culture. Microbiologists at the University of Hong Kong created the noninvasive diagnostic test, which is described in an online article today in Clinical Chemistry (www.clinchem.org) and will appear in the July print issue.
The testing of hundreds of suspected SARS cases may be needed daily during the outbreak, and it is expected that the quick method to identify this pathogen will help control the disease and lead to prompt treatment.
Health officials this week confirmed that the virus is a type of coronavirus that comes from animals but had never before affected humans. Experiments on monkeys in the Netherlands confirmed the link, but scientists don't know how SARS first spread to humans.
Another outbreak in Koway Court, a Hong Kong apartment complex, was reported yesterday, with nine illnesses linked to a fast-food worker near Amoy Gardens, where more than 300 people were infected.
The disease mostly has spread from face-to-face contact, but Hong Kong officials suspect the disease has mutated and is being spread through a sewage pipe and carried by rats or roaches.
"Attention has focused on possible transmission via the sewage system. Among several unusual features, the Amoy cluster includes a high proportion of cases presenting with diarrhea, estimated at about 60 percent. In most other clusters of cases, diarrhea has typically been seen in only 2 percent to 7 percent of cases," the WHO said in a statement yesterday.



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