UH, state partner in SARS readiness
By Robbie Dingeman
Advertiser Health Writer
If a confirmed case of SARS turns up here, researchers at the University of Hawai'i are ready to test samples from patients, which could lead to quicker results and advance knowledge about the respiratory illness.
This effort would be led by Dr. Richard Yanagihara, director of the Research Centers in Minority Institutions at UH and professor at the John A. Burns School of Medicine.
Yanagihara said researchers based at Leahi Hospital and affiliated with the Retrovirology Research Laboratory are prepared to investigate the severe acute respiratory syndrome as part of their continuing analysis of emerging diseases. Smoothing the way is a close partnership forged with the state Department of Health through bioterrorism preparedness, he said.
Better tests, Yanagihara said, could give quicker results and allow researchers here to develop expertise in isolating new viruses. Eventually, that could lead to vaccines for SARS and other diseases.
State epidemiologist Dr. Paul Effler is excited about the link with UH researchers. Hawai'i has had no confirmed cases of SARS, but has had five suspected cases in which all of the women experienced relatively mild illnesses and recovered completely.
Effler said the state is fortunate to have the UH expertise available locally. At Leahi Hospital, Yanagihara said that UH has the only highly specialized laboratory in the state that allows scientists to work safely with highly contagious agents in a sealed room with its own ventilation system.
Yanagihara said the lab also has been involved in searching for traces of West Nile virus. He said the community got a wake-up call with the earlier dengue fever outbreak. "We can more or less expect that there will be SARS-like illnesses in the future."
He said the researchers would use cell culture, the same kind of process used to pinpoint SARS as a new coronavirus, a family of viruses that includes the common cold.
Doing the test here could bring much quicker results than sending samples to the Centers for Disease Control and Prevention in Atlanta. Because of the volume of work, that lab might not immediately work on the samples. In addition to speed, local testing would allow samples to be cultured without freezing them for shipment.
Researchers worldwide are working to develop better, more rapid tests as well as a vaccine against SARS and other illnesses "so that you can clearly diagnose suspect cases and then take action," he said. Yanagihara credits Dr. Vivek Nerurkar, director of the Retrovirology Research Laboratory, as a key player in the SARS readiness effort.
"Hawai'i is in a very vulnerable area, geographically isolated from much of the rest of the world," Yanagihara said. "We need more capacity here so that we're not always totally dependent on other laboratories.
He said an entire floor of the new UH medical school will be devoted to infectious disease research.
"Many of us share the vision that Hawai'i should in fact be a regional center of excellence for diagnosis, training and also research for infectious diseases."
Yanagihara was born and raised in Honolulu, attended medical school on the Mainland and worked on a variety of emerging diseases during a 20-year association with the National Institutes of Health in Maryland.
Effler is urging people in the community to learn what steps can be taken to prevent or slow the spread of the disease.
Effler encouraged people to monitor their own health, especially if they have traveled to Asia or Canada, or been in close contact with someone who has. He said people can help to appropriately assess their risk by considering the following factors: travel history within the past 10 days, fever and respiratory troubles such as cough or difficulty breathing
He said one simple precaution — such as calling a doctor instead of showing up in a crowded emergency room — could help to prevent the spread of the disease here. "This is something that everybody can do," Effler said. "Don't just show up at the ER."
People who suspect they may have been exposed to SARS should call the doctor or clinic before showing up so they can be seen after office hours or use a separate entrance, he said.
In addition, most medical facilities have isolation rooms to prevent people from spending time waiting in the lobby and risking transmission of the disease.
What else can people do? Don't panic, Effler said.
For people who have the symptoms but not the recent travel history or the close personal contact with travelers, "the chance that you have SARS is basically zero," he said.
Locally, emergency medical services crews in Honolulu have studied procedures for dealing with possible SARS cases, according to Donnie Gates, assistant chief of EMS operations for the city.
Gates said emergency crews know to put on an N95 respirator, which is designed to prevent airborne transmission "where we suspect that it's SARS or a flulike syndrome."
Gates said crews also will put masks on patients and crews may put on disposable protective suits. The emergency workers wear latex gloves as part of their work.
"Very rarely do you know the seriousness of what you're getting into until you're there," he said.
Gates said the precautions are the common ones for any very contagious disease.
The news has the crews more conscious than ever about fever, coughing, and travel to Asia and Canada. "We're really aware of it and doing everything we can to protect our people and the public."
The CDC is continuing to issue health alert cards to travelers who have been in China (including Hong Kong) as well as Hanoi, Vietnam; Singapore; and Toronto.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
