Barbara Carroll, NewsMax.com
Wednesday, April 9, 2003

James Salisbury, 52, was brought from the border city of Shenzhen to Hong Kong and pronounced dead at North District Hospital, according to Peter Cheng, a hospital spokesman.

In a shocking event in the Chinese police state, a senior Chinese physician today accused the regime of covering up details about the spread of SARS in Beijing.

Dr. Jiang Yanyong, retired chief of surgery for a Beijing military hospital, said the outbreak in the Chinese capital might be five times greater than officially admitted.

Jiang said the dictatorship had not contacted him yet but added, "I don't know what will happen later."

Chinese health officials are giving daily press conferences, with one report Monday claiming that SARS was “slowing down.” Yet new cases and deaths occur in China regularly.

This shows that China is still guarded in sharing information. The death of Salisbury and the recent death of a Finnish citizen raise further questions of the accuracy of information coming from the Chinese government.

The Finnish case is puzzling health officials. He was a staff member of International Labor Organization, in Beijing to attend an international conference. It is unknown how he might have contracted the disease because he arrived via Thailand, where he had little or no contact before flying to Beijing.

Shanghai, which has reported its first SARS case, has requested a visit from the World Health Organizatin's team to discuss SARS and be advised on how best to deal with the disease.

Case Updates

New updates come in regularly as severe acute respiratory syndrome continues to claim victims.

As of this morning, 2,671 SARS cases with 103 deaths have been reported.

One new death was reported in Canada, two in Hong Kong, and two in Singapore. One additional case was reported in Canada, 11 in China, 45 in Hong Kong, one in France, seven in Singapore, and seven in the United States. Taiwan removed two cases from the list.

Making Sense of Statistics

A country may show suspected cases of SARS but still not be a “local chain of transmission,” which means that the disease did not spread in that country.

This is why we see different statistics for cases in different countries. For example, Australia had a suspected case of SARS, but no one else has yet presented any symptoms, so that country is listed as having one case with no chain of transmission. A list of affected countries includes only countries that have tranmission of the disease.

Also, when looking at lists of cases, keep in mind that these are suspected cases. This is important to remember so that the numbers of countries and cases are kept in perspective.

And this is one reason why a reliable diagnostic test is so crucial.

Diagnostic Tests for SARS

So far, there are three tests for this deadly illness. The polymerase chain reaction molecular test works in early stages of SARS but has too many false negatives, which can leave SARS undetected in some people who are actually ill.

Other tests rely on the presence of antibodies. One test, the immunofluorescence assay, calls for the culture of the virus in a lab, something that is difficult to do, and the IFA is reliable only after about day 10 because antibodies take time to appear.

The ELISA test is easier to do, but is reliable only after 20 days. Until more is known of this virus, a reliable vaccine is not going to be available.

Genetic analysis is part of the lab work done to determine the classification of a virus. Dr. Mailik Peiris of the University of Hong Kong maintains that SARS is not one of the two known human coronaviruses, nor is it exactly like any of the known animal coronaviruses.

Ann Falsey and Edward Walsh of the University of Rochester in New York reported that SARS is a new strain of coronavirus. However, there is dissent as to whether this is a coronavirus at all.

An article about the SARS virus classification in The Lancet medical journal states: “A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression.”

Cockroaches and Rats

In studying the cluster outbreak of SARS in Hong Kong at the Amoy Gardens, where more than 240 residents were quarantined last week, officials are suspecting that insect or rodent feces caused the rapid spread of the pneumonia-type disease in the apartment complex. Cockroaches, drinking water and rats are being collected for laboratory inspection.

Insects and rodents are not the cause of the disease but their feces can spread the disease, especially as they dry and become airborne particles that people breathe in or touch.

The Front Line in the SARS Wars

Health workers are on the front line of defense against SARS. The first medical worker in the U.S. has contracted the disease. Dr. Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention, disclosed the case in a speech Tuesday at the University of California, Berkeley.

Testifying before a Senate committee, Gerberding said fewer than half the identified patients in the United States have pneumonia. That suggests these patients do not have SARS, and helps explain why there have been no deaths in this country yet.

Gerberding further stated, "We don't want to alarm people unnecessarily, but we do want to express the fact that this is the beginning of a problem."

She stated earlier: "We're learning as we go. It has the potential to spread very quickly, and we've seen that. And it has the potential to spread globally - we've seen that."

Read more on this subject in related Hot Topics:
China/Taiwan
Health Issues
SARS Epidemic
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