Health

Update

ACUTE RESPIRATORY SYNDROME IN HONG KONG AND VIETNAM – DISEASE OUTBREAK REPORTED

PRESS RELEASE ISSUED BY WHO — CASES OF SEVERE RESPIRATORY ILLNESS MAY SPREAD TO HOSPITAL STAFF

12 March 2003 | GENEVA — Since mid February, WHO has been actively working to confirm reports of outbreaks of a severe form of pneumonia

in Viet Nam, Hong Kong Special Administrative Region (SAR), China, and Guangdong province in China.

In Viet Nam the outbreak began with a single initial case who was hospitalized for treatment of severe, acute respiratory syndrome of

unknown origin. He felt unwell during his journey and fell ill shortly after arrival in Hanoi from Shanghai and Hong Kong SAR, China.

Following his admission to the hospital, approximately 20 hospital staff became sick with similar symptoms.

The signs and symptoms of the disease in Hanoi include initial flu-like illness (rapid onset of high fever followed by muscle aches,

headache and sore throat). These are the most common symptoms. Early laboratory findings may include thrombocytopenia (low platelet

count) and leucopenia (low white blood cell count). In some, but not all cases, this is followed by bilateral pneumonia, in some cases

progressing to acute respiratory distress requiring assisted breathing on a respirator. Some patients are recovering but some patients

remain critically ill.

Today, the Department of Health Hong Kong SAR has reported on an outbreak of respiratory illness in one of its public hospitals. As of

midnight 11 March, 50 health care workers had been screened and 23 of them were found to have febrile illness. They were admitted to the

hospital for observation as a precautionary measure. In this group, eight have developed early chest x-ray signs of pneumonia. Their

conditions are stable. Three other health care workers self-presented to hospitals with febrile illness and two of them have chest x-ray

signs of pneumonia.

Investigation by Hong Kong SAR public health authorities is on-going. The Hospital Authority has increased infection control measures to

prevent the spread of the disease in the hospital. So far, no link has been found between these cases and the outbreak in Hanoi.

In mid February, the Government of China reported that 305 cases of atypical pneumonia, with five deaths, had occurred in Guangdong

province. In two cases that died, chlamydia infection was found. Further investigations of the cause of the outbreak is ongoing. Overall

the outbreaks in Hanoi and Hong Kong SAR appear to be confined to the hospital environment. Those at highest risk appear to be staff

caring for the patients.

No link has so far been made between these outbreaks of acute respiratory illness in Hanoi and Hong Kong and the outbreak of `bird flu,`

A(H5N1) in Hong Kong SAR reported on 19 February. Further investigations continue and laboratory tests on specimens from Viet Nam and

Hong Kong SAR are being studied by WHO collaborating centers in Japan and the United States.

Until more is known about the cause of these outbreaks, WHO recommends patients with atypical pneumonia who may be related to these

outbreaks be isolated with barrier nursing techniques. At the same time, WHO recommends that any suspect cases be reported to national

health authorities.

WHO is in close contact with relevant national authorities and has also offered epidemiological, laboratory and clinical support. WHO is

working with national authorities to ensure appropriate investigation, reporting and containment of these outbreaks.

For more information contact:

Dick Thompson – Communication Officer

Communicable Disease Prevention, Control and Eradication WHO, Geneva

Telephone: (+41 22) 791 26 84

Email:thompsond@who.int

http://www.who.int/csr/don/2003_03_12/en/print.html

NOTE: CDC is working with WHO to investigate this outbreak. This information also will be posted to Epi-X.