New York State health workers take measures to curb spread of SARS
( 2003-05-16 15:40 ) (8)

Health authorities in Suffolk County, New York State, have taken extreme precaution to guard against the spread of severe acute respiratory syndrome (SARS) since the epidemic found its way into the state in February, local media reported Thursday.

Dr. Darin Wiggins, chairman of the department of emergency medicine of Southampton Hospital, was quoted as saying that they have a daily average of four or five people who walked into the emergency room and complained they had SARS, but all turned out tobe suffering from other diseases.

A man who had just returned from Cambodia had a high fever and suffered from flu-like symptoms.

The patient was given a mask and immediately led into a respiratory isolation room where the air does not flow through therest of the facility. The hospital staff, after consulting the county health department, asked the man to subject himself to 10-day home confinement.

The man agreed, sending his family members away, consigning himself to solitude and delivered meals, informing the health officials of his temperature twice daily.

Yet, the man, whom authorities declined to identify, is not considered even a "suspect" case of SARS by the standards set by the national Centers for Disease Control and Prevention (CDC).

Dr. Patricia Dillon, director of epidemiology and disease control for the Suffolk County Department of Health acknowledged that the county health authorities might be overcautious, citing the fact that Cambodia is not on the list of countries considered high risk, and respiratory trouble or pneumonia characteristic of SARS did not occur in the patient.

"We're trying to be conservative to protect the public," she said.

Since February, Suffolk has reported only one suspect SARS caseto the CDC, but has monitored about a dozen people for varying periods and to varying degrees, Dillon said.

Some had traveled recently to infected regions and returned with symptoms that raised an alarm, others showed no symptoms but may have been exposed to the disease, such as the two passengers on a Germany-bound plane which had a Canadian SARS patient on board.

These are not "suspect" or "probable" cases, but Dillon said the county is considering them "potential exposures" nevertheless.

"It will be wonderful when they develop an accurate, rapid test," Dillon said. "Because we do not have that, we're using the only tools that are possible, and that is a clinical case definition."

A spokeswoman for the Nassau County Health Department said it has asked only those patients who have been reported to the CDC, or their families, to follow similar measures.

Kristine Smith, a spokeswoman for the state Health Department, called voluntary isolation for individuals with respiratory symptoms "a prudent and practical approach to reduce the risk to the general public."

To many doctors and health officials, the case definitions are guidelines, useful for understanding the disease and its spread, but not necessarily an accurate diagnosis tool for individual patients.

　　Wiggins, of Southampton Hospital, described the situation as "adelicate balance," that involves "a huge amount of responsibility."

"It's kind of that higher medical ethics that we're not really taught in medical school, but it's that responsibility to the public to explain what's going on as best as we can without creating panic or fear," he said.

According to statistics released by the New York State Department of Health as of May 15, 26 suspect and probable SARS cases have been reported statewide. The figure does not include New York city, which has 21 suspect and probable cases. As none ofthe cases were severe, the patients were either not hospitalized or released shortly afterward.