Chinese authorities on alert as SARS breaks out again
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《英国医生杂志》
China is on high alert following a fresh outbreak of severe acute respiratory syndrome (SARS). The index case is a 26 year old female laboratory researcher from Anhui province who worked for two weeks at the Chinese National Institute of Virology in Beijing, which is known to be investigating the SARS coronavirus.
The researcher, who developed symptoms of SARS on 25 March, subsequently infected her mother, who died, and a 20 year old nurse in a Beijing hospital where she was being treated. In turn the nurse is suspected of having infected her mother, father, aunt, and a fellow patient. A 31 year old laboratory researcher who also worked at the virology research laboratory is also suspected of having been infected. Almost 1000 people are in quarantine or under close medical supervision.
The World Health Organization has questioned why the index case was not immediately isolated when she developed a fever and why she was allowed to travel several times on trains while showing symptoms of SARS. It has criticised Chinese authorities for what seems to be a serious breach of both national and WHO laboratory bio-safety guidelines.
Julie Hall, the leader of the SARS team at WHO's Beijing office, said that China's health ministry had requested help in investigating how the outbreak occurred and said that WHO had sent a team of bio-safety experts to go to the laboratory, which is currently closed. Until specimens from patients have been tested by a WHO network laboratory outside China, WHO considers that the cases that Beijing has labelled "confirmed" are "probable."
Although this is not the first laboratory related outbreak of SARS—there has been one outbreak in Singapore and one in Taiwan—this is the first where there is evidence of transmission. Hundreds of contacts of the suspected cases are under medical surveillance, at least five of whom have developed fevers. All those suspected of having been infected were in close contact with either the index patient or the nurse who cared for her.
"We are still saying at this point that we do not see a significant public health threat because what we have seen so far is limited transmission," said Bob Dietz, WHO's spokesman in Beijing. "If we start seeing people who travelled on the train with the researcher or from the hospital where she was treated , then we would have to revisit that," he said.
After working at the virology laboratory for two weeks in March, the index case returned to her home in Anhui on 22 March. On 25 March she developed symptoms of SARS, and on 27 March she took the train back to Beijing, where she was admitted to Jiangong Hospital. On 29 March she was diagnosed with viral pneumonia, and on 2 April she returned by train to Anhui for further treatment. From the end of March her mother provided continuous nursing care until she (the mother) developed pneumonia on 8 April. The mother died on 19 April and was retrospectively diagnosed as a suspected SARS case.
Mass screening of air and rail passengers has been introduced in China, ahead of the "golden week" May day holiday celebrations, traditionally a time when there is a huge surge in the number of travellers. The Hong Kong, Taiwan, South Korean, and Australian authorities have all announced the stepping up of screening measures for incoming visitors from China.
The UK Health Protection Agency has issued guidance for identifying possible SARS and avian influenza cases and has urged health professionals to remain vigilant.(Hong Kong Jane Parry)
The researcher, who developed symptoms of SARS on 25 March, subsequently infected her mother, who died, and a 20 year old nurse in a Beijing hospital where she was being treated. In turn the nurse is suspected of having infected her mother, father, aunt, and a fellow patient. A 31 year old laboratory researcher who also worked at the virology research laboratory is also suspected of having been infected. Almost 1000 people are in quarantine or under close medical supervision.
The World Health Organization has questioned why the index case was not immediately isolated when she developed a fever and why she was allowed to travel several times on trains while showing symptoms of SARS. It has criticised Chinese authorities for what seems to be a serious breach of both national and WHO laboratory bio-safety guidelines.
Julie Hall, the leader of the SARS team at WHO's Beijing office, said that China's health ministry had requested help in investigating how the outbreak occurred and said that WHO had sent a team of bio-safety experts to go to the laboratory, which is currently closed. Until specimens from patients have been tested by a WHO network laboratory outside China, WHO considers that the cases that Beijing has labelled "confirmed" are "probable."
Although this is not the first laboratory related outbreak of SARS—there has been one outbreak in Singapore and one in Taiwan—this is the first where there is evidence of transmission. Hundreds of contacts of the suspected cases are under medical surveillance, at least five of whom have developed fevers. All those suspected of having been infected were in close contact with either the index patient or the nurse who cared for her.
"We are still saying at this point that we do not see a significant public health threat because what we have seen so far is limited transmission," said Bob Dietz, WHO's spokesman in Beijing. "If we start seeing people who travelled on the train with the researcher or from the hospital where she was treated , then we would have to revisit that," he said.
After working at the virology laboratory for two weeks in March, the index case returned to her home in Anhui on 22 March. On 25 March she developed symptoms of SARS, and on 27 March she took the train back to Beijing, where she was admitted to Jiangong Hospital. On 29 March she was diagnosed with viral pneumonia, and on 2 April she returned by train to Anhui for further treatment. From the end of March her mother provided continuous nursing care until she (the mother) developed pneumonia on 8 April. The mother died on 19 April and was retrospectively diagnosed as a suspected SARS case.
Mass screening of air and rail passengers has been introduced in China, ahead of the "golden week" May day holiday celebrations, traditionally a time when there is a huge surge in the number of travellers. The Hong Kong, Taiwan, South Korean, and Australian authorities have all announced the stepping up of screening measures for incoming visitors from China.
The UK Health Protection Agency has issued guidance for identifying possible SARS and avian influenza cases and has urged health professionals to remain vigilant.(Hong Kong Jane Parry)