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U.S. narrowly avoided big outbreak

Nobody at the suburban Virginia hospital knew a disease that would be named SARS even existed on the snowy February day an ambulance brought a wheezing woman to the emergency room.
/ Source: The Associated Press

Nobody at the suburban Virginia hospital knew a disease that would be named SARS even existed on the snowy February day an ambulance brought a wheezing woman to the emergency room. Doctors quickly diagnosed pneumonia, but weren’t unduly worried until her nephew called two hours later to say the woman, who spoke no English, had just returned from China’s Guangdong province — where relatives had reported a strange type of pneumonia was killing people.

It was the nation’s first suspected case of severe acute respiratory syndrome, a full month before the World Health Organization would warn the globe about the contagious new disease.

Luckily, the woman landed at a hospital that had beefed up infection control so much after the 2001 terrorist attacks that it could swing into action and prevent the virus’ spread.

“This event could have had a very different outcome,” Karin Kerby, the Loudoun Hospital Center nurse who sounded the alarm, told Congress Wednesday.

Because the patient needed oxygen, she had been placed in a room that routinely vents part of its air outside instead of circulating it through the Leesburg, Va., hospital.

AN UNKNOWN DISEASE

When Kerby ended the phone call with the nephew, she immediately alerted co-workers that they might be facing a new disease — she’d recently read a newspaper article about a Chinese illness that matched his description.

Doctors donned masks and switched vents in the patient’s room to circulate all the air outside, while Kerby called state health officials who in turn alerted the Centers for Disease Control and Prevention.

Although even CDC wasn’t sure what the woman had, a Loudoun doctor and another nurse were voluntarily quarantined for a few days after developing sniffles. The woman recovered, weeks before the SARS epidemic became official.

SARS STILL A THREAT TO U.S.

WHO has since counted close to 7,000 probable cases of SARS in 27 countries, and more than 450 deaths. In the hardest-hit areas, health care workers have caught and spread the disease.

The United States so far has been lucky, with only 63 probable infections, no deaths and no hospital outbreaks.

But, “until this disease is contained everywhere in the world, it remains a threat to all of us,” said CDC Director Julie Gerberding, cautioning doctors to remain on the lookout.

The CDC’s prime strategy is to meet every plane and ship arriving from a SARS-hit country, checking for openly sick passengers.

Thousands of customs and immigrations inspectors and other federal homeland security workers are being trained to spot symptoms of SARS, and they have orders to detain people with symptoms.

The CDC is also giving travelers yellow cards instructing them to telephone a doctor if they develop the telltale fever, cough and other flulike symptoms.

Telephoning ahead is crucial — coughing inside an emergency room could spread the virus. Doctors are supposed to meet possibly infected people outside the hospital, mask them and whisk them straight to an isolation ward.

Kerby lamented that travelers aren’t reading CDC’s yellow warning cards — they still come straight inside the ER without calling.

The government has spent about $1 billion so far beefing up the nation’s public health system to prepare for possible bioterrorism, and those improvements that help tackle natural infectious diseases. Health specialists told a congressional subcommittee Wednesday that those steps, plus heightened awareness to watch for new diseases, have helped limit SARS’ U.S. spread.