*EPF315 03/19/2003
Health Officials Find Clues to Asian Mystery Illness
(Cases increase as researchers make possible identification of virus) (600)

By Charlene Porter
Washington File Staff Writer

Washington -- The number of reported or suspected cases of a previously unknown illness has climbed to 264, according to a daily accounting issued by the World Health Organization (WHO) March 19. The disease, dubbed Severe Acute Respiratory Syndrome or SARS, has appeared in 10 nations and caused nine deaths.

Researchers in Germany and Hong Kong contributing to the international effort to learn more about the condition say they have identified the disease-causing virus as part of the paramyxoviridae family, or a paramyxovirus, according to published reports. Common diseases such as measles and mumps are also caused by this family of viruses.

In response to that development, Director of the U.S. Centers of Disease Control and Prevention Julie Gerberding said March 19 the findings come from good laboratories. "We put a lot of credibility in their report. . .but we don't know yet what it means." In a briefing held at CDC's Atlanta, Georgia headquarters, Gerberding said the new research has revealed the presence of the paramyxovirus in the patients, but they've not been able to determine whether it is directly implicated as the cause of the test subjects' illness. More research is needed, she said, calling the report an "epidemiological clue."

The CDC director said analysis of the disease will move into a more rapid phase now that tissue samples from infected patients are being distributed to disease detectives at international laboratories. Gerberding expressed hope that "we can get to the bottom of this as quickly as we can."

The illness first appears with a high fever and respiratory symptoms, such as a cough or breathing difficulties. While it seems like a flu-like condition, SARS will quickly escalate into a form of life-threatening pneumonia, and that's one of the patterns that has caused international health officials to launch a wide-scale effort to investigate the syndrome. SARS also spreads quite rapidly from patients to health care workers, and that too has given health officials cause for serious concern that this may be an illness with the capability to spread rapidly and approach epidemic proportions.

The initial symptoms are like those caused by other common illnesses, so at this stage patients are identified as likely SARS cases only if they've visited one of the affected areas within the two-to-seven day incubation period, according to CDC criteria for case identification. Gerberding said there are 11 suspect cases in the United States as of March 19, and the number will likely fluctuate as health officials around the country examine patients reporting the suspect symptoms and their recent travel history.

The latest accounting from WHO documents suspected or reported cases in Canada, Germany, Hong Kong Special Administrative Region of China, Singapore, Slovenia, Spain, Taiwan, China, Thailand, United Kingdom, United States and Viet Nam.

An outbreak of a similar condition was reported in the Guangdong province of China from November to February, but officials have not yet determined whether the currently emerging illness is caused by the same pathogen.

In an earlier briefing this week, Gerberding said the pattern of transmission among the cases identified so far indicates that close face-to-face contact is necessary for one person to be infected by another. The CDC director said further evidence supporting that conclusion has now emerged from Hong Kong where authorities have tracked several patients to the same hotel. No one on the hotel staff has been infected, and the suspected incubation period has passed, Gerberding told the March 19 briefing.

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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