31-03-2003 15:11									#31
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Bugger it! Two people in the office have gone home with a fever. I might be quarrantined. And I just moved so I don't have Internet access!

	31-03-2003 15:20									#32
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Hong Kong health officials have ordered the residents of an apartment building to be quarantined for 10 days in an effort to control a deadly new virus.

With the number of cases in the territory reported to be at least 622 on Monday, 213 have been linked to the Amoy Gardens housing estate in urban Kowloon where the block is situated.

Policemen and dozens of health workers in surgical masks, caps and coats are in the estate where current residents of Block E - said to number 700 - have been ordered to stay at home until midnight (1600 GMT) on 9 April.

The virus, known as Severe Acute Respiratory Syndrome (SARS), has infected more than 1,550 people and killed at least 54 worldwide since first surfacing in southern China in November.


ouch

from http://news.bbc.co.uk/1/hi/world/as...fic/2901607.stm

	31-03-2003 17:18									#33
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When I worked on my PhD on immune response to viruses, the influenza (yes I know this is probably not quite influenza) expert said we were long overdue a pandemic. Because of the long period between the pandemics we are more susceptible to reorganised flu genomes.

The Hong Kong chicken flu from a few years ago was a warning. This looks as though it might become as serious as the 1918 Flu Pandemic, although treatment with Ribavirin and other antivirals seems to work if it is caught early. This makes the 4% casualty rate even scarier...

	31-03-2003 18:11									#34
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quote: Originally posted by Frogger I'm pretty sure we've got a handle on it now. Ontario Public Health has gone schizoid and has quarantined a couple of thousand people for 10 days...

I thought the quarantine in Toronto was only volountary at the moment. (which makes it pretty useless)

There's been cases of it in New Brunswick and BC aswell.

	31-03-2003 18:59									#35
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quote: Originally posted by lightblue When I worked on my PhD on immune response to viruses, the influenza (yes I know this is probably not quite influenza) expert said we were long overdue a pandemic. Because of the long period between the pandemics we are more susceptible to reorganised flu genomes. The Hong Kong chicken flu from a few years ago was a warning. This looks as though it might become as serious as the 1918 Flu Pandemic, although treatment with Ribavirin and other antivirals seems to work if it is caught early. This makes the 4% casualty rate even scarier...

Its unlikely that the mainland chinese have been using Ribavirin to any great degree. From what I've seen with their handling of HIV and blood products, they seem to take the attitude that "yeah a million died, but we've got lots more where they came from"

I've been very concerned about this virus (combination ?or has that been debunked yet). People worry about ebola etc, but this could cause a real pandemic since it is virulent and more contagious than expected.

At least Canada has taken the right approach early on -quarantine!

What virus infections did you work on? I work on immune responses to bug (and now parasite) mucosal infections.

	31-03-2003 19:51									#36
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quote: Originally posted by Starchild So this thing is more deadly than the Spanish flu. loooooovely.

But it is a lot less infectious than a normal flu. So stop panicking.

	31-03-2003 19:53									#37
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quote: Originally posted by DanS Luckily, the CDC likely will have an antibody detector to isolate real cases of the disease.

Aren't they a bit slow? We already have two tests in place, one based on DNA, the other on antibody.

	31-03-2003 19:55									#38
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I worked on Varicella Zoster and Kaposi's Sarcoma Associated Herpesviruses. They are radically different from the kind of RNA virus that this is, and as such I can't judge the immune responses too well.

As far as I have been able to make out they do not yet know what this virus actually is. This suggests to me that it is not a influenza variant, as even with drastic recombination there should be enough of a similarity to rapidly identify if it was influenza by PCR or something similar. My personal, and mostly uneducated guess as I haven't seen too many details, is that it is a virus that has jumped across species. But why in Hong Kong? Lifestock should not be the species these things originate from, they usually come from isolated animal populations that have seen little to no human contact (which is how Ebola and HIV probably originated).

Hong Kong would make sense for influenza variants due to the density of pigs and chickens/ducks.

	31-03-2003 19:58									#39
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It's a corona virus, if that means anything to you.

	31-03-2003 20:03									#40
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Yep did some more reading (must read befor post...). Corona viruses are one of many families of viruses that cause the common cold. Small RNA virus, highly mutable, has a number of RNA pseudoknots in it. But that's about it

	31-03-2003 20:10									#41
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And I just moved so I don't have Internet access!

Dewd. You're screwed. Now you're just going to be talking with friends and family.

	31-03-2003 20:20									#42
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They pinpointed the source for the local outbreak as a visiting professor from the PRC. He went to Hong Kong on 04/02 and died on the 6th. In the hotel he lived a number of people contracted the disease (including a couple of people who went back to Toronto). One of the people there got sick and was sent to the Prince of Wales hospital, which turned out to be the first "epicentre," so to speak.

	31-03-2003 20:22									#43
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Thanks for the recap.

	31-03-2003 20:48									#44
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quote: Originally posted by Urban Ranger But it is a lot less infectious than a normal flu. So stop panicking.

How would you know that? Given that the Chinese are probably hiding the extent of the disease (as they definitely do for HIV).

I agree there is no need to panic, but I havent seen any data to support any estimates of infectivity compared to human coronaviruses (which cause the cold not the flu).

quote: Aren't they a bit slow? We already have two tests in place, one based on DNA, the other on antibody.

Two tests for what, human coronavirus? The etiological agent of SARS has not been positively identified. What about the metapneumo (paramyxovirus) virus that the Canadians have identified with SARS patients? In any case, a DNA-based or ELISA-based test that detects human virus may not necessarily detect a similar virus that has jumped from animals to humans.

	31-03-2003 20:52									#45
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Regarding infectivity, can anything interesting be said, based on the belief that it is similar to viruses causing the common cold?

	31-03-2003 20:58									#46
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quote: Originally posted by SpencerH How would you know that? Given that the Chinese are probably hiding the extent of the disease (as they definitely do for HIV).

That was judging from the number of cases in Hong Kong. With quarantine not really in place for the first two weeks or so, there are a total of 600 cases since 14/02.

quote: Originally posted by SpencerH Two tests for what, human coronavirus? The etiological agent of SARS has not been positively identified. What about the metapneumo (paramyxovirus) virus that the Canadians have identified with SARS patients? In any case, a DNA-based or ELISA-based test that detects human virus may not necessarily detect a similar virus that has jumped from animals to humans.

quote: University of Hong Kong researchers have identified the virus that has caused the recent outbreak of atypical pneumonia. Known as a coronavirus, it is spread through droplets and can also survive for up to a few hours outside the human body.

Link

WHO update

	31-03-2003 21:07									#47
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Sorry, but that aint proof of that a coronavirus is the cause of SARS (not by a long shot).

EDIT: some other links to alternate possibilities

Last edited by SpencerH on 31-03-2003 at 21:31

	31-03-2003 21:47									#48
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quote: Originally posted by DanS Regarding infectivity, can anything interesting be said, based on the belief that it is similar to viruses causing the common cold?

Its hard to say since its still very early. Whatever the agent, or combination of agents, the route of infection is likely to be similar to more common coronavirus/paramyxovirus infections ie direct contact with infected mucosal secretions. What may be one factor affecting infectivity is whether this virus survives longer outside the host (which would increase its potential for transmission).

The most interesting possibility is that it really requires a combination of viruses to cause SARS. I'm not familiar with any evidence with viruses but there is ample data of virus-bug and bug-bug interactions that can potentiate the occurance of disease and its severity.

	31-03-2003 21:50									#49
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I note that the Spanish flu had at least two variants. I don't know whether one supported the other.

	01-04-2003 01:34									#50
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quote: Originally posted by Osweld I thought the quarantine in Toronto was only volountary at the moment. (which makes it pretty useless)

I have no firsthand knowledge, but the reports suggest otherwise. They're making enforcement phone calls to those quarantined (twice a day).

The quarantine list includes a few hundred health care workers and some hundreds of hospital visitors etc. with a relatively small number of outside contacts of known cases.

	01-04-2003 01:38									#51
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quote: Originally posted by SpencerH How would you know that? Given that the Chinese are probably hiding the extent of the disease (as they definitely do for HIV). I agree there is no need to panic, but I havent seen any data to support any estimates of infectivity compared to human coronaviruses (which cause the cold not the flu).

Well, in metro Toronto from an original nucleus of 4 cases (a family that had come back from Hong Kong) there have only been 60(?) or so reported cases to this point (a month after they returned). This is with absolutely no knowledge of the disease/quarantine efforts until two weeks ago.

Given the amount of contacts the average person has in a day, it seems to be relatively hard to pass on.

	01-04-2003 01:39									#52
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Oh, and all of the cases thus far were either passed on in hospital or in household, IIRC. None have been passed to general public.

	01-04-2003 03:45									#53
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quote: Originally posted by Frogger Oh, and all of the cases thus far were either passed on in hospital or in household, IIRC. None have been passed to general public.

That pattern suggests that it's not an airborne pathogen and requires close contact (as do human corona and paramyxo viruses). There simply is not enough cases yet to determine how communicable this is. On the one hand if its an animal virus we might guess that it should have a lower incidence than a similar human tropic virus. But there have been statements suggesting that it might live longer in the environment which may balance the effects of the host animal vs human question. One thing is clear though, whatever virus (or combination) it is much more lethal than the human virus and at least nearly as communicable. That's a worrying combination if it spreads.

	01-04-2003 03:50									#54
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well if it spreads and has 4% mortality rate than buhuuuu... scary.. very very scary...

a hundred million dead?

	01-04-2003 04:31									#55
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If we dont contain it now and we assume that it is as communicable as the human-tropic virus and maintains a 4% mortality then the death toll world-wide could be very high.

Once we positively ID the organism(s) then we could make a quick vaccine that would have some efficacy, the question is whether we could make enough vaccine. Given that the flu vaccine for the US is started the previous year and there is never enough to vaccinate everyone it may be a problem.

The 3rd world would be hit very hard. Luckily China would be hit hard too and they know it. Thats why they are now using soldiers to enforce quarantine.

	01-04-2003 08:06									#56
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The quarantine is not being enforced very well here. There were 200 cases in one housing estate starting on the March 26. The government quarantined the estate five days later, but by that time hundreds of people had left to live with their relatives.

Latest gossip is that one person in our office is in hospital for observation while a relative of another employee has the virus.

Not much work being done today.

	01-04-2003 09:42									#57
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quote: Originally posted by SpencerH That pattern suggests that it's not an airborne pathogen and requires close contact (as do human corona and paramyxo viruses). There simply is not enough cases yet to determine how communicable this is.

Sure it is. An airborne virus is a lot more communicable, because it spreads easily.

	01-04-2003 09:45									#58
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quote: Originally posted by SpencerH Sorry, but that aint proof of that a coronavirus is the cause of SARS (not by a long shot).

Have you looked at the WHO website as well? If they think it's a strong candidate, it's probably it.

	01-04-2003 09:57									#59
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Interesting. Last month there were 5 cases of unexpected deaths of young children in Eastern Virginia. All presented with respiratory symptoms, then unexpectedly progreesed to respiratory failure. AFAIK the agent has't beemn reported yet.

My understanding about the Hong Kong cases is that the virus was identified as a new strain of Corona virus. Are you guys saying that the virus in Canada is different from the one in Hong Kong?

	01-04-2003 10:00									#60
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I once consulted a doctor who told me he never gets sick.

Bastard.