Faculty Bibliography

Hundreds of people in Vietnam, Hong Kong and China have been stricken by a mysterious respiratory illness that has killed at least six people and left the others with severe breathing difficulties from which they have yet to fully recover, the World Health Organization said yesterday. Hong Kong's secretary of health, welfare and food, Dr. Yeoh Eng- kiong, said 43 hospital staff members had been admitted to hospitals with symptoms of the sickness, and 29 had been found to show signs of what is believed to be the atypical pneumonia. An American businessman who lived in Shanghai died of the illness at a Hong Kong hospital Thursday. The businessman had passed through Hong Kong to Hanoi, where he fell ill, entered a hospital and was then evacuated to Hong Kong when his condition deteriorated and the disease began spreading through the hospital staff. Officials in Vietnam said that 30 doctors and other employees had fallen ill at the hospital where the man was treated

Hundreds of people in Vietnam, Hong Kong and China have been stricken by a mysterious respiratory illness that has killed at least six people and left all the others with severe breathing difficulties from which they have yet to fully recover, worried officials of the World Health Organization said yesterday

It is the second World Health Organization team since early February to be denied access to Guangdong Province, just north of Hong Kong. The group arrived on Sunday in Beijing, where its members are reviewing epidemiologic information about the illness known as SARS, for severe acute respiratory syndrome, and have met with officials from Guangdong and Beijing. Dr. [David L. Heymann] said the organization was also ''very concerned'' about the rising number of cases in Hong Kong, because ''we have less information and we are less sure that containment activities are being successful'' there than in other countries. Hong Kong has reported 286 SARS cases, including 10 deaths. Hong Kong officials played down the seriousness of SARS earlier this month. Dr. Yeoh Eng-kiong, Hong Kong's secretary of health, welfare and food, who has managed the SARS outbreak with Dr. William Ho, the chief executive of the Hong Kong Hospital Authority, accused the World Health Organization of being too quick to sound an international alarm

'This is new. We don't know a lot about it, and we have a lot of questions about the overall spread' of SARS and 'the possibility of airborne transmission,' she said. 'We are very concerned about the speed' with which SARS has spread in Hong Kong. There's epidemiologic evidence that, for unknown reasons, some patients can transmit SARS to other people much more efficiently than other SARS patients can. [Julie Gerberding] cited one patient in Hanoi, Vietnam, who spread SARS to 56 percent of the health workers with whom the patient came in contact

In Canada, health officials asked that the thousands of people in Toronto who have been in the Scarborough Grace Hospital since March 16 isolate themselves at home for 10 days from the time of their visit. Two people at the hospital have died from SARS. Premier Ernie Eves of Ontario declared SARS a provincial emergency yesterday. In Hong Kong, top officials yesterday ordered more than 1,000 family members of SARS patients to stay home except for visits to government clinics to check for the disease. Those who violate the quarantine face fines of up to $640 and up to six months in jail. In addition, the government closed all primary and secondary schools for nine days as the number of suspected cases climbed by 51, to 367. Singapore decided on Monday to close all schools and restrict SARS patients to their homes. Based on the spread and course of the illness, health officials have repeatedly said that it takes close contact to transmit the SARS agent, presumably a virus, from an ill person to other people. Individuals most likely to transmit SARS are those who are quite sick and have a fever and cough. Most cases have involved health-care workers who have cared for patients, their family members and friends

The new figures are being released just days after a World Health Organization team arrived in China to help investigate this country's epidemic of the mystery pneumonia, which goes by the name SARS, for severe acute respiratory syndrome. A clearer picture of the course of SARS emerged on Wednesday after 80 doctors who have treated cases in 13 countries held a teleconference moderated by Dr. [Salter]. In a second group, from 10 to 20 percent of patients develop increasing difficulty in breathing. Such patients usually required breathing assistance with a mechanical ventilator, and many have had to stay on ventilators for a long time. Most SARS deaths have involved patients in this group

U.S. health officials say that the mysterious respiratory illness that has sickened hundreds of people around the world might be caused by a different virus from the one first suspected. In recent days the World Health Organization said its team of 11 laboratories worldwide had suggested that the cause of the illness, known as SARS, for severe acute respiratory syndrome, might be a previously unknown member of the paramyxoviridae family of viruses. But Monday, the U.S. Centers for Disease Control and Prevention, a member of the World Health Organization team, announced it had found very strong evidence that 'a previously unrecognized virus from the coronavirus family is the leading hypothesis' for the cause of SARS. Among other illnesses, coronaviruses cause the common cold. 'This virus could be, if not the entire cause of SARS, at least contributing to SARS,' Dr. Julie Gerberding, director of the centers, said at a news conference. But she cautioned that it was 'very premature to assign a cause.' Dr. Klaus Stoehr, a virologist who heads the investigation of SARS for the World Health Organization, said the cause could be a paramyxoviridae virus alone, a coronavirus alone or a co-infection of both. 'There is no clear- cut evidence to rule out either virus, so we cannot drop any hypothesis now,' Stoehr said in an interview. 'The investigation has become relatively complex.' Identifying a specific cause is critical because it would allow health officials to better control outbreaks and possibly find a specific therapy

The seven had clearly defined risk factors for heart disease or had heart problems. But heart problems are not known to put people at greater risk of adverse reactions to smallpox vaccine, said Dr. Julie L. Gerberding, the director of the Centers for Disease Control and Prevention. Tommy G. Thompson, the secretary of health and human services, agreed in a meeting yesterday afternoon with the disease agency's recommendation to defer smallpox vaccinations for people with heart disease, Dr. Gerberding said. The decision was made even though no definitive link between the vaccination and adverse reactions had been made and the cases had not been thoroughly studied. Dr. Gerberding said that in the event of a smallpox outbreak from bioterrorism, health officials would abandon the precaution because in such an event the risk of the disease would outweigh what at this point is only a speculative link between the vaccine and heart problems

The government has also stockpiled antibiotics, treatments for burn and blast victims, and antidotes to chemical weapons and nerve gases. A federal program called the Strategic National Stockpile, part of the Department of Homeland Security, says it has enough medicine to treat 12 million people exposed to anthrax, 100 million exposed to plague and 50 million exposed to tularemia, a bacterial infection. The program says it can deliver the drugs anywhere in the country in 12 hours or less

Since 9-11 the agency has also offered doctors training materials to help recognize anthrax and other unusual infections. Health experts cited other advances as well, including the computer systems used to flag odd patterns of illness or medicine use. In addition, hospitals have retooled their disaster plans. The United States has enough smallpox vaccine to inoculate the population, and, [Tara O'Toole] said, vaccinating military personnel and health workers has helped doctors learn how to conduct immunization programs