THE STRATEGY AGAINST SARS AS THE MYSTERIOUS ILLNESS HITS U.S. SHORES, L.A. COUNTY HEALTH OFFICIALS WORK TO STRENGTHEN SAFEGUARDS AND STOP RUMORS.Byline: Mariko Thompson Staff Writer Around 8 a.m. Saturday, March 15, Jonathan Fielding caught a TV news report on a World Health Organization global alert warning of a new and dangerous virus originating in Asia. Los Angeles County's director of public health immediately picked up the phone and rousted a half-dozen senior staff members. From home, one began drafting an alert for local hospitals. Another called the Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. in Atlanta for more information on the pneumonia-like disease. Around noon, the group held a conference call to address the looming threat of SARS - severe acute respiratory syndrome Severe Acute Respiratory Syndrome (SARS) Definition Severe acute respiratory syndrome (SARS) is the first emergent and highly transmissible viral disease to appear during the twenty-first century. . When the meeting ended, the team sent an alert by fax and through the EMS radio system to hospital emergency rooms and doctors of infectious disease Infectious disease A pathological condition spread among biological species. Infectious diseases, although varied in their effects, are always associated with viruses, bacteria, fungi, protozoa, multicellular parasites and aberrant proteins known as prions. throughout the county. ``Los Angeles is a major gateway from Asia to the U.S.,'' Fielding said. ``This is a new, emerging infection and we want to do everything we can.'' From local to international levels, public health officials say technology both in communications and in the laboratory allowed them to respond to the SARS virus with unprecedented speed. Since the terrorist attacks of Sept. 11, 2001, public health agencies and hospitals have geared for major catastrophes stemming from bioterrorism, preparations they say aided in the response time to SARS. While the county agency was quick to respond to the most recent concern, a report released last week by the Little Hoover Commission, an independent state oversight agency, found that California, as a whole, is ill-prepared to respond to environmental hazards, bioterrorism and emerging infectious disease An emerging infectious disease (EID) is an infectious disease whose incidence has increased in the past 20 years and threatens to increase in the near future. EIDs include diseases caused by a newly identified microorganism or newly identified strain of a known microorganism (e.g. . The commission called for the fragmented system to be consolidated under a California surgeon general The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease . Fielding agreed that the preparedness levels probably vary from county to county. ``We have more capacity than any other county department to deal with these issues,'' he said. ``We are not smug about it. We have to continue to work on preparedness every day.'' Even with the most sophisticated technology, containing infectious disease in an age of air travel is a Herculean task. ``The increased density of the world combined with increased travel means things can spread a lot faster,'' Fielding said. ``There's no substitute for vigilance. Earlier is always better.'' Chinese beginnings The origin of SARS has been traced to Guangdong Province in southern China, where the illness first struck in November. Since then, SARS has hit at least 19 countries, including Vietnam, Singapore, Canada, Australia, Germany and the United States. Worldwide, there have been more than 2,700 reported cases and at least 111 deaths. So far, there have been more than 150 suspected cases in the United States and no deaths. Of the suspected cases in the United States, the majority have occurred in California - 36 as of April 10. One California man who had traveled to Hong Kong tested positive for the virus and has since recovered. Hospitals such as UCLA Medical Center UCLA Medical Center is a hospital located on the campus of the University of California, Los Angeles in Los Angeles, California. It is rated as one of the top three hospitals in the United States and is the top hospital on the West Coast according to US News & World Report. and Cedars-Sinai Medical Center Cedars-Sinai Medical Center is a world-renowned hospital located in Los Angeles, California. History Cedars-Sinai is the result of a merger in 1961 between two major Los Angeles hospitals, Cedars of Lebanon and Mount Sinai Home for the Incurables, with Steve Broidy as have adopted protocols to handle SARS and prevent infection of health workers and other patients. At Cedars-Sinai, patients who arrive in the emergency room complaining of SARS symptoms are given surgical masks. Doctors and nurses don protective goggles goggles, n the protective eyewear worn by dental personnel and patients during dental procedures. goggles see periocular leukotrichia. , masks and gowns and have been reminded to wash their hands between seeing patients. Anyone suspected of having SARS would be isolated and treated in a negative pressure room to keep the germs from spreading in the air. Such a room, which is used for contagious diseases such as tuberculosis, pulls air inside but doesn't allow it to recirculate. ER workers at Cedars-Sinai continue to examine patients complaining of symptoms consistent with SARS but so far no cases have been confirmed. At Los Angeles International Airport “LAX” redirects here. For other uses, see LAX (disambiguation). “KLAX” redirects here. For other uses, see KLAX (disambiguation). Los Angeles International Airport (IATA: LAX, ICAO: KLAX, FAA LID: LAX , city officials recently announced flights arriving directly or indirectly from Asia are being screened for SARS cases and that all passengers will receive notices describing symptoms of the disease. About 25 flights per day arrive directly from Asia. Another 25 stop in other cities en route from Asia before landing at LAX. The CDC See Control Data, century date change and Back Orifice. CDC - Control Data Corporation has assigned a quarantine team to the airport, Fielding said. While WHO and CDC investigators are uncovering more information about the SARS virus and its spread, public health officials have been scrambling to counter misinformation mis·in·form tr.v. mis·in·formed, mis·in·form·ing, mis·in·forms To provide with incorrect information. mis and quell panic. ``There's been a lot of concern about transmission,'' Fielding said. ``In the Asian community, it's rumored to be spread in Chinese food. I'm working hard to debunk de·bunk tr.v. de·bunked, de·bunk·ing, de·bunks To expose or ridicule the falseness, sham, or exaggerated claims of: debunk a supposed miracle drug. the myths.'' Fielding said county public health workers have reported a ``substantial increase'' in phone calls from residents concerned about SARS, though he had no figures readily available. The CDC has logged more calls on SARS than it received at the height of the anthrax scare in 2001. The number of people worldwide who have contracted SARS pales compared to the millions who come down with the flu every year. And many other diseases now considered commonplace have taken far more lives. An estimated 36,000 Americans die from flu-related complications each year. In 2000, HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome took 14,478 lives while lung cancer lung cancer, cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell. claimed 156,900. ``It's the things we don't know Don't know (DK, DKed) "Don't know the trade." A Street expression used whenever one party lacks knowledge of a trade or receives conflicting instructions from the other party. about that make us nervous,'' said Dr. Ralph Frerichs, professor of epidemiology at the UCLA School of Public Health The UCLA School of Public Health is the graduate school of public health affiliated with UCLA, and is located within the Center for Health Sciences building on the UCLA campus. UCLA is located in the Westwood neighborhood of Los Angeles, California. . ``Once we know about something, we're no longer afraid of it.'' Unknown makeup So far, researchers have linked SARS to an unknown form of coronavirus coronavirus /co·ro·na·vi·rus/ (ko-ro´nah-vi?rus) any virus belonging to the family Coronaviridae. Coronavirus /Co·ro·na·vi·rus/ (ko-ro´nah-vi?rus , which can cause the common cold in humans. SARS symptoms resemble the flu and include fever, chills, headache, body ache, shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. and dry cough dry cough n. A cough not accompanied by expectoration; a nonproductive cough. . ``How the SARS virus arose - whether it was two or more different coronaviruses combining or a new one - isn't known,'' said Dr. David Pegues, an infectious disease specialist and hospital epidemiologist at UCLA Medical Center. Right now, the most critical piece of information doctors are pursuing is the patient's travel history, whether he or she has been to infected areas of Asia within the last 10 days or had contact with someone who has, Pegues said. Doctors also look for signs of pneumonia with chest X-rays and white blood cell counts. CDC officials say they have no way of predicting the eventual scope of SARS. The worst pandemic pandemic /pan·dem·ic/ (pan-dem´ik) 1. a widespread epidemic of a disease. 2. widely epidemic. pan·dem·ic adj. Epidemic over a wide geographic area. n. in U.S. history, the influenza of 1918, killed more than 600,000 Americans and 20 million people worldwide. In 85 years, the ability to combat infectious disease has improved exponentially. Today's weapons include powerful antibiotics, laboratory analysis of microbes, creation and distribution of mass amounts of vaccines, and instantaneous communication. But in the war against disease, there are no guarantees, Fielding said. ``We have better tools today to reduce and control the spread,'' Fielding said. ``I'd never speculate on what is possible.'' While public health workers must be prepared for emergency outbreaks, agencies can't neglect their battles on other fronts. Rising obesity rates threaten to overwhelm the health system with chronic conditions including type 2 diabetes type 2 diabetes n. See diabetes mellitus. , hypertension and heart disease. Too many children in Los Angeles still don't get immunized for preventable diseases such as polio, tetanus and diphtheria diphtheria (dĭfthēr`ēə), acute contagious disease caused by Corynebacterium diphtheriae (Klebs-Loffler bacillus) bacteria that have been infected by a bacteriophage. It begins as a soreness of the throat with fever. , Fielding said. ``We have to keep a reasonable balance,'' he said. ``Most of our morbidity and mortality Morbidity and Mortality can refer to:
Tracking the disease November 2002: Mystery respiratory illness emerges in Guangdong Province in southern China. Feb. 11, 2003: Chinese Ministry of Health notifies the World Health Organization about 305 cases and five deaths stemming from a strange pneumonia in Guangdong Province. March 5: A Toronto woman, Kwan Sui-chu, dies of the disease after a visit to Hong Kong. March 12: World Health Organization issues a global alert and begins worldwide surveillance for SARS (severe acute respiratory disease). March 13: An American businessman based in Shanghai dies in Hong Kong. He had been treated for the disease in Hanoi, where more than three dozen health workers later became ill. March 14: Centers for Disease Control and Prevention in Atlanta activates emergency operations center The Emergency Operations Center, or EOC, is a central command and control facility responsible for carrying out the principles of emergency preparedness and emergency management, or disaster management functions at a strategic level in an emergency situation, and ensuring . March 15: World Health Organization issues an emergency travel advisory. CDC initiates domestic surveillance. Senior officials at the Los Angeles County Department of Public Health meet to develop a plan and send an alert to local hospitals. March 16: CDC begins advising passengers on direct flights from Hong Kong, Hanoi and Guangdong Province to seek medical attention if they develop symptoms. March 19: CDC officials announce an estimated 11 Americans have the disease. The number of countries reporting SARS cases reaches 11, including China, Vietnam, Singapore, Taiwan and Canada. March 24: CDC announces that an unknown form of coronavirus may be the cause. March 29: Dr. Carlo Urbani, the WHO doctor who first identified SARS, dies in Thailand, where he was treated after becoming infected with the disease in Vietnam. April 1: An American Airlines flight from Tokyo is held on the tarmac at San Jose International Airport For the Costa Rican airport, see . Norman Y. Mineta San Jose International Airport (IATA: SJC, ICAO: KSJC, FAA LID: SJC) is a medium-sized airport in San Jose, California. for several hours when the pilot fears several passengers on board have the virus. Santa Clara County health officials determine that the passengers do not have SARS. April 3: WHO team leaves Beijing and arrives in Guangdong Province to investigate the source of the outbreak. April 4: President Bush signs an executive order giving federal health officials authority to quarantine Americans who have SARS. The order marks the first time in two decades that a disease has been added to the quarantine list. China apologizes for not notifying the WHO of the outbreak sooner. Los Angeles officials announce precautionary measures for travelers arriving at LAX. April 9: A prominent Chinese doctor charges that the mainland government covered up details of the spread of SARS in Beijing. An American living in China dies in Hong Kong. April 10: The CDC issues guidelines to school administrators and health officials on what to do if a student has been exposed to SARS. April 11: A Santa Clara man becomes the first in California to test positive for the virus. He had traveled to Hong Kong. What we know about SARS CAUSE: A form of the coronavirus, which can also cause the common cold. WHO'S AT RISK: Anyone who has traveled to infected areas of Asia or had contact with someone in the past 10 days who has. SYMPTOMS: Fever, chills, headache, body ache, shortness of breath and dry cough. TRANSMISSION: Droplets expelled by coughing and sneezing To verbally tell somebody about a new and interesting Web site. See viral marketing. . Investigators have not ruled out some form of airborne transmission airborne transmission Epidemiology The transmission of pathogens by aerosol, which enter the body by the respiratory tract. See Aerosol. . MORTALITY RATE: 3 to 4 percent. The cause of death is typically lung congestion and an inability to take in enough oxygen. Only a fraction of patients with SARS have required hospitalization or oxygen through a mechanical ventilator. POSSIBLE TREATMENT: Unlike bacterial infections, which are treated with antibiotics, few specific treatments exist for viral diseases. Doctors say most SARS patients recover on their own. The effectiveness of antiviral drugs Antiviral Drugs Definition Antiviral drugs are medicines that cure or control virus infections. Purpose Antivirals are used to treat infections caused by viruses. such as ribovirin are being tested on SARS patients. National Institutes of Health researchers have started working on a SARS vaccine, but it will likely be year or more before one is ready. - M.T. CAPTION(S): 7 photos, 2 boxes Photo: (1 -- cover -- color) FEAR FACTOR Local officials gear up as the deadly respiratory disease SARS spreads worldwide (2) no caption (Man with mask) Photo illustration/Jennifer Blatz (3) Lung tissue sample Erik S. Lesser/Associated Press (4) A flight from Asia sits on the tarmac at San Jose International Airport Patrick Tehan/San Jose Mercury News (5) Canadian health worker Dan Janisse/Windsor Star (6) Zhang Wenkang China's Health Minister Ng Han Guan/Associated Press (7) David L. Heymann David L. Heymann, MD (born 1946 in Pennsylvania, USA) was appointed the Assistant Director-General, Communicable Diseases of the World Health Organization (WHO) in February 2007. He is also the Director-General's Special Representative for Polio eradication. Executive director of WHO Laurent Gillieron/Associated Press Box: (1) Tracking the disease (see text) (2) What we know about SARS (see text) |
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