The 1 st New Disease of the 21 st Century. by Otto Sanchez MD MSc PhD Faculty of Health Sciences University of Ontario Institute of Technology June 2004. Who am I? Story teller, note taker, and someone desperately needing your ideas about the health problem I must deal with. Who are you?
by Otto Sanchez MD MSc PhD
Faculty of Health Sciences
University of Ontario Institute of Technology
Who are you?
Throughout the story you will be asked four questions. You should answer each question individually on your card, then briefly discuss them with your group to reach consensus or prioritize. Be prepared to announce your answer/idea to the other groups when prompted.
Foshan City is situated in the mid-southern part of Guangdong, the central region
of the Pearl River Delta, which has fertile land and a mild, wet subtropical monsoon
climate with plenty of rainfall, 1600-2000 mm, and four distinct seasons. The annual
average temperature is 80 °F.
Zhou LX et al. report the first case in the Intensive Care Unit of The First People's Hospital of Foshan City, Guangdong Province, Foshan, China…
…in which they describe an individual with the following features:
1. high fever, followed by dry cough, rapid progression to respiratory failure, followed by radiographic evidence of bilateral lung damage
2. spread to four family members who had direct contact with the patient
3. the patient was treated without significant improvement
4. history of contact with wild cats and with eating their meat
Outbreaks in Guangdong Province, People's Republic of China. The geographic
distribution of the outbreak in Guangdong from Nov. 16, 2002 to Feb. 9, 2003. Number of cases are shown in parentheses. Approximate dates of the onset of the outbreaks for each city were: Foshan, Nov 16, 2002; Heyuan, Dec 17, 2002; Zhongshan, Dec 26, 2003; Guangzhou, Jan 31, 2003; Jiangmen, Jan 10, 2003; and Shenzhen, Jan 15, 2003.
Question 1You make a phone call to the Officer of Health in Guangdong Province (Poor communication allows you to only ask 1-2 questions)What would you like to knowfrom them?
A 65-year-old medical doctor from Guangdong Province, who had treated patients in his hometown, checked in to the 9th floor of a four-star hotel in Hong Kong. He had treated patients with atypical pneumonia prior to his departure from Guangdong Province and was symptomatic upon arrival in Hong Kong.
A 48-year-old Chinese-American businessman is admitted to the French Hospital in Hanoi, Vietnam, with a three-day history of respiratory symptoms. He had previously been in Hong Kong, where he visited an acquaintance staying on the 9th floor of the hotel where the Guangdong physician was a guest.
March 1, 2003
A 26-year-old former flight attendant is admitted to a hospital in Singapore with respiratory symptoms. During a recent visit to Hong Kong, she had been a guest on the 9th floor of the same Hong Kong hotel as the medical doctor and Chinese-American businessman.
March 5, 2003
An elderly Toronto woman, who had been a guest on the 9th floor of the Hong Kong hotel dies at Toronto’s Scarborough Grace Hospital. Five members of her family are found to be infected and are admitted to the hospital.
The World Health Organization terms the new disease Severe Acute Respiratory Syndrome or “SARS” and declares it a “worldwide health threat.”
The mortality rate of SARS fluctuated across countries and reporting organizations.
In early May 2003, the World Health Organization (WHO)
and the U.S. Centers for Disease Control (CDC) quoted
the SARS mortality at 7%.
Others spoke in favor of a 15% figure, saying it reflected
the real situation more accurately.
As the outbreak progressed, both mortality measures
The WHO laboratory network announced conclusive identification of the SARS causative agent: a new coronavirus, unlike any other human or animal member of the coronavirus family.
SARS-CoV courtesy of Centers for Disease Control and Prevention: http://www.cdc.gov/ncidod/sars/lab/images.htm
Question 4The Chinese government has invited you to attend the First Annual SARS Conference in Foshan City on the 2nd anniversary of the first case.Would you attend? Why? Why not?
for your ideas!