State monitoring visitor from Shanghai for SARS
By Robbie Dingeman
Advertiser Health Writer
Hawai'i got another possible case of SARS this week when a man visiting from China developed mild symptoms shortly after arriving in Honolulu, but three other suspected cases have been ruled out as the new disease, state health officials said.
State epidemiologist Dr. Paul Effler said the man from Shanghai arrived in Hawai'i on Tuesday to visit relatives and is resting at a private home in Honolulu.
He had conditions consistent with the disease — fever, respiratory illness and exposure to an area of SARS transmission — but only lab tests can determine what he ails from, Effler said.
"This doesn't prove or mean for sure that this person has SARS," Effler said. "They may have another respiratory illness that's going around, but we've isolated this individual to home."
The good news, Effler said, is that he arrived at night and went directly to the home of his extended family, limiting opportunities for transmission. The man was in contact with only half a dozen relatives, who are aware of the disease and how to prevent its spread.
SARS — severe acute respiratory syndrome — is believed to have originated in China, and spread to cause significant outbreaks in Hong Kong, Singapore, Toronto and Hanoi, Vietnam. As of yesterday afternoon, the World Health Organization tallied 4,439 cases of the disease, with 263 deaths.
The disease is a concern worldwide but especially worrisome in areas like Hawai'i that rely on tourism that includes a steady stream of visitors from Asia.
The Centers for Disease Control and Prevention yesterday reported 39 probable cases of 247 suspect cases in the United States, with no fatalities.
Hawai'i has had no confirmed cases of SARS. Of seven suspected cases, four have been ruled out, but two are considered "probable" because the patients had developed pneumonia.
Effler praised the medical response to the man from Shanghai. "They were seen at a clinic that did absolutely the appropriate precaution: isolated the individual, supplied the patient and the staff with masks, and took them to an area where they would not have contact with any other patient," he said.
Effler said he and another staffer on Wednesday collected specimens from the man from Shanghai and got them on a plane to the CDC laboratory in Atlanta. He said he expects preliminary results by the end of next week.
None of the man's relatives have gotten sick and his condition yesterday had not worsened, Effler said.
Meanwhile, the news that a Kaua'i woman did not have SARS drops three people off the list because two of the other potential cases were healthcare workers who came in contact with the traveler.
The three remaining cases are: the man from Shanghai, an O'ahu woman who traveled to China and returned home and a merchant seaman who has not lived here recently but has a Hawai'i mailing address.
Effler said once the testing kits arrive from the CDC, local government laboratories should be able to have test results within four hours of a specimen being gathered. "We're looking at major advances to come into play in our investigation," he said.
Effler encourages anyone with fever, respiratory illness and who has traveled to China (including Hong Kong), Hanoi, Vietnam; and Toronto to take precautions. "They need to self-isolate and then call a physician or report to a physician's office," he said.
