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Mystery masks the virus
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The WHO's clean chit may have come as a relief, but with the recent reports on the rising number of SARS victims in India, the scare is not yet over. PRINCE FREDERICK and SANGEETH KURIAN find out how safe Chennai is.
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SARS HAS created one of the biggest domino effects in a long time. China sneezed and a red alert seemed to be declared across the globe. With the virus twisting the knife in China's (and South-East Asian nations') wound every day, there were enough straws in the wind to suggest that India was also in for a deadly attack. But if the recent pronouncement by the World Health Organisation (WHO) is any indication, India has probably landed on its feet. The WHO has said the cases identified in India are not in lockstep with conditions that betray the presence of the virus. Earlier, the WHO named India among "SARS-reporting" countries (and not SARS-affected countries). Now, it has given India a clean bill of health; it has been wiped off the list of SARS-reporting countries.
This piece of news has taken a lot of anxiety off our chest; the fact, however, remains that we are yet to ride out the storm. Understandably, health-related and allied agencies are not letting their guard down. The `stitch-in-time-saves-nine' policy continues.
"The stringent screening for SARS at the Chennai seaport and airport which began on March 18, continues," says Dr. J. Kadhirvelu, seaport and airport health officer, Chennai.
The passengers alighting from international flights are run over with a fine-toothed comb.
"Immediately after arrival, they have to queue up for a screening at the four health counters manned by a team of ten doctors," says Dr. Kadhirvelu.
Medicos who are supposed to keep a check on any outbreak of SARS in the city say they are prepared to meet any emergency. Listen to Dr. B. Janarthanan, director, Communicable Diseases Hospital, Tondiarpet. "We have formed a SARS Management and Emergency Team and created a 30-bed ward to exclusively attend to SARS cases. If any case is reported from any part of the city, our doctors and supplementary staff will reach the spot, at the earliest."
The Government General Hospital has an exclusive five-bed ward for treating SARS patients. Although the precautionary measures seem impressive, it has to be conceded that they have not been put to the test. The push has not come to the shove; in point of fact, we have not even been pushed too far. What will be the acid test that will conclusively prove their efficacy, one wonders.
"If the virus enters any of the slum areas, then we will have a job on our hands. Squalid and crowded conditions are a mutant microbe's dream. If a slum-dweller gets infected, the impact will be devastating," says Dr. Janarthanan.
The problem is further compounded by the fact that what we know about the virus can be written on the back of a postage stamp. In point of fact, debate still rages on what actually caused the virus. What with conflicting opinions pouring in, the plot thickens every day.
"There are a lot of grey areas in our understanding of the SARS virus," says Dr. P. Thangaraju, Dean, Madras Veterinary College. "There is, so far, no strong empirical support to the theory that the virus is transmitted by livestock. If that is the case, then the animal is probably a reservoir host; it (the animal) may be harbouring the virus but will not be affected by it. And the virus develops a destructive sting only when human beings contract it. Even this can be known for a certainty only if we are able to prove that the genome of the SARS virus matches that of a virus found in an animal. If livestock really transmit the virus, then India should be among the hotbeds of the disease."
It is said that the Indian summer has proved too hot for the SARS virus. "Based on the effect high temperature has on viruses, they can be divided into three categories - thermo-duric, thermo-stable and thermo-labile. The SARS virus is probably thermo-labile; in other words, high temperatures have the ability to take the edge off its virulence," he says.
Dr. Janarthanan begs to differ. "That is not true; it is not tenable in the wake of Pune (which registers high temperatures) recording the most number of "SARS-positive" cases in the country."
But in Pune, as also in other parts of the country, those who were declared SARS-positive have lived to tell the tale. More often than not, subsequent diagnoses have cleared these "patients" of SARS.
"The spread of the virus depends on several factors such as atmosphere, the receiver's immunity level and the stage (of illness) the victim is in," Dr. P. Vijayalakshmi, Dean, Government General Hospital. "SARS spreads through droplets of saliva (of the infected person)."
Recently, the Chennai-based Respiratory Research Foundation of India (RRFI) organised a panel discussion that went into the dynamics of SARS. Panellists, including some medicos from the city, said the disease "had a low mortality rate and was self-limiting as its virulence waned from the first to the fourth generation victims". With adequate precautions, the virus could be kept at bay, they added.
For more information on SARS, call 24335075 (extension 245). This is a 24-hour helpline providing information on the disease, as also the resources available in the city for its treatment and prevention. This helpline has been set up by the Tamil Nadu Health Department at the Directorate of Public Health.
Did you know?
ALTHOUGH SARS has been making news, awareness about the illness is lacking in Chennai. While there is no need to panic and buy a year's supply of surgical masks, there do seem to be quite a few misconceptions about the disease — proved by statements such as "SARS spreads from cockroaches" and "It's some kind of cold that makes you stay indoors". Here are a couple of answers to commonly asked questions:
What is SARS?
Severe Acute Respiratory Syndrome (SARS) is a respiratory illness that was first reported this year. The World Health Organisation puts it as "an atypical pneumonia of unknown aetiology, recognised at the end of February 2003." It was first reported in the Guangdong Province (China), Hanoi (Vietnam) and then spread to Hong Kong and parts North America, mainly through travellers.
What are the symptoms?
The illness usually begins with a temperature greater than 100.4 degrees Fahrenheit (38 degrees centigrade). Other symptoms may include headache, an overall feeling of discomfort, and body ache. Some people also experience mild respiratory symptoms. After two to seven days, SARS patients may develop a dry cough and have trouble breathing.
How does SARS spread?
The primary way that SARS appears to spread is by person-to-person contact. Potential ways in which SARS can also spread are by touching objects that are contaminated with infectious droplets and then touching eyes, nose, or mouth.
What causes SARS?
Scientists have detected a previously unrecognised coronavirus in patients with SARS. Coronaviruses are a group of viruses that have a crown-like (corona) appearance when viewed under a microscope. These viruses are a common cause of mild to moderate upper-respiratory illness in humans.
What precautions can one take while travelling to a country with SARS?
As with most infectious illnesses, careful hand hygiene is essential. So wash with soap and water as often as necessary. To minimise the possibility of infection, you may wish to avoid close contact with large numbers of people as much as possible.
Why is everyone so worried about this infection?
It's important to keep the risk in proportion. Not all people suffering from SARS have developed pneumonia, but those who have, the risk of dying is about 1 in 30 or five per cent.
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