6/11/03: Toronto troubled anew by SARS

[NRSKarenRN, BSN, RN]

Posted on Wed, Jun. 11, 2003 Phila. Inquirer

Fifteen more people were showing possible signs. And a U.S. man became ill after visiting the area.

By Tom Cohen

Associated Press

http://www.philly.com/mld/inquirer/living/health/6059098.htm

TORONTO - Health authorities in Canada's biggest city scrambled yesterday to explain possible new SARS cases at one hospital and how a recent visitor from the United States came down with the illness after returning home.

The 15 patients showing symptoms of severe acute respiratory syndrome at a hospital outside Toronto, and the U.S. man with SARS under quarantine at his home near Raleigh, N.C., renewed fears that the World Health Organization could impose another travel warning for the city.

At a WHO meeting in Geneva, Switzerland, public-health specialists discussed a Toronto travel warning, among other topics, but declined to impose one, agency spokesman Iain Simpson said.

Toronto has been the epicenter of the biggest SARS outbreak outside of Asia, with 33 deaths reported.

Health authorities closed Lakeridge Health Center in Whitby, Ontario, 40 miles east of Toronto, to new patients Monday because of a possible fresh cluster of cases. Officials said 12 patients showed pneumonialike symptoms of the disease, but the diagnosis has yet to be confirmed.

"We have to assume they may be SARS," said James Young, the Ontario commissioner of public safety.

Authorities ordered anyone who came into contact with the patients to be quarantined at home for 10 days.

Donald Low, a Toronto microbiologist and key figure in the city's SARS containment team, said the nature of the new cluster made SARS the likely cause.

"This is very typical of a SARS outbreak, seeing a large number of pneumonia cases appear in a very short period of time," Low said. "Our experience would be that we could expect to see another 20 or 30 cases over the next week."

In North Carolina, health authorities confirmed Monday that a man developed SARS after returning from a visit last month to Toronto. He is under quarantine with members of his family, none of whom have shown symptoms, in Orange County, outside Raleigh.

The man visited a Toronto hospital patient sharing a room with people who later came down with SARS, officials said. His diagnosis raised the possibility of SARS spreading from people carrying the virus but not showing any symptoms. Until now, health authorities have assumed that only symptomatic patients spread the illness.

Eleven of the U.S. probable cases, or about 16 percent, have been linked to Toronto, said Llelwyn Grant, a spokesman for the U.S. Centers for Disease Control and Prevention.

SARS appeared in Toronto in early March, and the initial cluster was thought to be contained by early May. Then a second cluster emerged involving an undiagnosed case at North York General Hospital that led to a further spread among patients, their relatives and health-care workers.

Health-care workers have complained that authorities dropped their vigilance in May in a rush to proclaim Toronto safe after the initial outbreak of SARS.

Ontario Premier Ernie Eves announced yesterday that a former judge would conduct an independent investigation of how the province and city handled SARS.

[fergus51]

They are assuming SARS until proven otherwise in the Whitby area only because of PR problems related to the fact that they were too slow to recognize it at York, which is what started this second outbreak. The fact that none of them have any epidemiological link to SARS makes the diagnosis of SARS unlikely, but they are playing it safe.

[oramar]

http://www.post-gazette.com/healthscience/20030615toronto0615p1.asp

[fergus51]

They have now ruled out SARS in most of the Whitby cases.