SRAS : Syndrome respiratoire aigu sévère : prévention et élimination

Updated chapter PDF March 2020  in a new book in process on SARS

 From Mike: The year 2003 (16 YEARS BEFORE COVID 19)

I believe SARS is real. Whether natural or not it probably gets handled the same way. Here are two contradictory examples/opinions and my suggestions for prevention.

SARS Is NOT Naturally-Occuring

From Patricia Doyle, PhD
dr_p_doyle@hotmail.com
3-27-3

-Hello Jeff...

According to the latest report, it does appear that coronavirus, as well as some paramyxovirus, is involved in SARS. As to whether or not it is the infecting agent, well, that is yet not determined. Some scientists believe that the coronavirus may be the etiologic agent causing the disease.

According to the article, some scientists believe that both pathogens are part of the pathogenisis. I believe that, if this is the case, we have a recombinent virus - that should not occur naturally. We have a coronavirus/paramyxovirus joining to form a disease. My best guess is that, a mycoplasma may also be in the mix.

My belief is that the illness has an etiologic agent that has been genetically-altered. Do I believe this is intentional release or terrorism? No. I think that the Chinese had been researching and altering the viruses and it simply got loose from a Guongdong Province lab. This could be the reason that it was first identified in doctors from the province.

I will keep you updated. The following does have some very cogent statements and we need to read the articles very closely.

So, do I think SARS is naturally occurring? NO.

Patricia Doyle

Excerpt:

''The coronavirus is the primary cause of the disease,'' said Malik Peiris, a professor of microbiology, adding that another virus, of the family that causes mumps, may also be involved and increase the severity of the disease. Peiris said the new strain had characteristics unlike any other he had ever seen.

''This is unlike any other human or animal virus ever described before,'' he said, adding that humans may not necessarily develop immunity to such a virus after recovering from an infection.

''If we find they behave like a cold, you can get the same cold again and again,'' Peiris said, warning that transmission of such a virus occurs through droplets and can take place in many common public areas. ''Railings, lift buttons and just about anything touched by a person with an infection can pass on the virus,'' he said.

Date: 27 Mar 2003 06:42 From: ProMED-mail Source: AFX News - Asia [edited]

HK Researchers Announce Diagnostic Test For SARS And Confirm Virus Source

HONG KONG (AFX) - University of Hong Kong reseachers announced that they have developed a diagnostic test to rapidly identify victims of an atypical pneumonia which has killed some 50 people around the world.

In a statement, the Department of Microbiology of the Faculty of Medicine of the University of Hong Kong also said it has confirmed previous findings that the global outbreak of atypical pneumonia was caused by the Coronavirus.

The US Centers for Disease Control and Prevention (CDC) said earlier this week that the virus causing the global outbreak of atypical pneumonia, or Severe Acute Respiratory Syndrome (SARS), was from the Coronavirus group.

In their statement, the University of Hong Kong researchers said they have "confirmed that the recent outbreak of pneumonia is caused by the virus known as Coronavirus.

"The discovery of the agent is an important international research breakthrough," they said, adding that the disease should be referred to as Coronavirus Pneumonia, or CVP.

They said the diagnostic test they have developed "will enable early and reliable diagnosies of CVP and hence early treatment of the disease.

"The early phase diagnostic test helps infection control by identifying which contacts have or have not acquired CVP and ensure discharged patients will not infect the community," they added.

The diagnostic test will be available at hospitals here starting tomorrow, the researchers told at a press conference.

Yuen Kwok-yung, head of microbiology at the faculty of medicine, said the virus is mainly transmitted by contact.

"Your hands are the greatest enemy," Yuen said, adding that the virus can only survive in the air for some three hours.

There have been more than 50 deaths and more than 1300 reported cases of SARS worldwide with the majority of the fatalities occurring in China. The disease has claimed 10 lives in Hong Kong, 4 in Vietnam and 3 in Canada.

-- ProMED-mail

****** [2] Date: 27 Mar 2003 From: ProMED-mail Source: International Herald Tribune 27 Mar 2003 [edited]

HONG KONG The government imposed quarantine measures Thursday to impede the spread of an epidemic of deadly pneumonia as scientists announced a breakthrough in testing patients for the mysterious virus. Hong Kong, the transportation hub from which the disease apparently spread worldwide, announced the immediate quarantine of more than 1000 residents suspected of infection and shut down schools for 1 million students. ''Hong Kong faces an epidemic that the world has never seen before,'' said Tung Chee-hwa, the territory's chief executive. ''This is a very, very serious issue.''

Hong Kong has been battling a wildfire and the rapid spread of the disease for 2 weeks. The quarantine announced Friday applies to 1080 people who had close contact with those infected by the disease. Nearly 1000 other people who had social contact with infected patients will undergo surveillance. Penalties for breaking domestic quarantine include a fine of 5000 Hong Kong dollars (about USD 640) , obligatory confinement and 6 months in prison. The Hong Kong measures came a day after Singapore undertook similar moves. Singapore, by contrast, canceled all schools and instituted draconian quarantine measures shortly after the first sign of infection appeared.

''We are favor of any measure within the law that will contain a disease outbreak,'' said Peter Cordingley, a spokesman for the World Health Organization. ''We don't have any problem with Singapore's approach.''

The most secretive least forthcoming country, however, has been China, which on Wednesday acknowledged the presence of the atypical pneumonia for the first time, announcing the highest number of infected patients and fatalities in the world. The Chinese authorities also said the situation was ''basically under control,'' hoping to avert the panic that took place several months ago over an outbreak of pneumonia now thought to be linked to the current crisis.

Popular worries were evident throughout Hong Kong on Thursday as a growing proportion of the public put on face masks while walking in public areas.

Researchers at the University of Hong Kong announced successful DNA sequencing of a virus that they say causes the disease. The finding, if confirmed by the U.S. Centers for Disease Control and Prevention, could allow creation of a rapid diagnostic test and reduce death rates by allowing doctors to identify affected patients sooner.

The illness, severe acute respiratory syndrome, or SARS, has killed at least 53 people, mostly in Asia, and infected 1300 in more than a dozen countries. The group of microbiologists from the University of Hong Kong identified the virus as a new strain from the family of coronaviruses, highly contagious viruses that are the second leading cause of colds in humans.

''The coronavirus is the primary cause of the disease,'' said Malik Peiris, a professor of microbiology, adding that another virus, of the family that causes mumps, may also be involved and increase the severity of the disease. Peiris said the new strain had characteristics unlike any other he had ever seen.

''This is unlike any other human or animal virus ever described before,'' he said, adding that humans may not necessarily develop immunity to such a virus after recovering from an infection.

''If we find they behave like a cold, you can get the same cold again and again,'' Peiris said, warning that transmission of such a virus occurs through droplets and can take place in many common public areas. ''Railings, lift buttons and just about anything touched by a person with an infection can pass on the virus,'' he said.

To avoid infection, he warned people to wash their hands frequently, avoid touching the eyes, mouth or nose and wipe down with rubbing alcohol. ''The virus is easily killed with rubbing alcohol,'' Peiris said. ''Wear a mask if you want, but make sure not to touch your face with your hands when adjusting it.''

Peiris said his findings supported the multiple drug treatment with ribavirin and steroids currently administered to patients. The ribavirin suppresses growth of the virus, while the steroids mitigate damage caused by the body's own immune reaction.

[byline: Thomas Crampton]

-- ProMED-mail

****** [3] Date: 27 Mar 2003 From: ProMED-mail promed@promedmail.org Source: Reuters 27 Mar 2003 10:50 EST [edited] 

BERLIN (Reuters) - Microbiologist Bernhard Fleischer, head of Hamburg's Bernhard Nocht Institute for Tropical Medicine (BNI), said his institute had probably identified the virus causing severe acute respiratory syndrome (SARS).

"I don't assume that there will be a worldwide epidemic which will spread among the population," Fleischer told Reuters in an interview. "We are lucky that this disease is not as contagious and does not spread as easily as first assumed."

Scientists from the BNI, Germany's top tropical diseases institute, worked on identifying the virus by analyzing tissue samples taken from a doctor from Singapore who was being treated in Frankfurt after showing symptoms of SARS. Fleischer said his institute had developed a test with which experts could detect within one or two hours whether a patient had caught the virus.

A group of microbiologists from the University of Hong Kong said on Thursday they had also identified a virus and believe it is a new strain from the family of coronaviruses, the second-leading cause of colds in humans. The finding is consistent with tests conducted by the U.S. Centers for Disease Control and Prevention.

Coronaviruses, so named because they have a crown-like appearance when seen under a microscope, are often responsible for upper respiratory infections in premature infants.

Fleischer said he believed it is spread through droplets by sneezing and coughing and therefore can only be caught through very close contact with an infected person. "I expect it to abate in the next few weeks," he added. Fleischer also said he believed the disease was not very contagious before a patient started to show symptoms, such as high fever and shortness of breath. Other viruses are highly contagious from the moment of infection.

Developing a serum against SARS could take years, Fleischer said, but he added that a new vaccination may not be necessary as known medications against viruses could help to combat it. "It first needs to be examined whether known and existing medication can help," he said. The Hong Kong research team said patients were responding well to a cocktail of anti-viral drugs and steroids.

Fleischer said his institute and U.S. scientists had independently found that the cause of SARS was probably a coronavirus. It had probably been transmitted from animals to human beings, he said. However, other labs that analyzed samples from patients had said they found what looked like a new kind of paramyxovirus, which causes measles and respiratory disease in babies.

[byline: Kerstin Gehmlich]

-- ProMED-mail

[Hong Kong is the third location with documented local transmission of SARS to implement quarantine measures for known contacts of SARS cases (Singapore and Ontario Canada have implemented similar quarantines). In addition, Hong Kong and Singapore have closed schools in an attempt to reduce situations of close contact that might enhance transmission.

The multiple press releases related to the identification of a coronavirus continue to be promising, (especially if there has been genetic sequencing of the virus), yet again caution needs to be exerted until further confirmation that this agent is in fact the etiologic agent of SARS. (Remembering that last week 3 independent laboratories identified a paramyxovirus from specimens taken from SARS patients). It is also premature to conclude that infection with this agent does not lead to the production of protective antibodies as is suggested in one of the newswires above. There are many questions that remain to be answered before definitive conclusions can be drawn and more detailed specific recommendations can be made. - Mod.MPP]

[Two of the laboratories that originally suggested that SARS was associated with infection by an unspecified paramyxovirus have now come into line with the CDC verdict that the etiologic agent has the characteristics of a member of the genus _Coronavirus_ of the family _Coronaviridae_. A consensus seems to be appearing. Until the full details of the scientific evidence become available, however, the final verdict will remain in doubt in view of the earlier contrary reports from Canada that the recently characterized human metapneumovirus may be the etiologic agent. Some of the information in these press reports, such as the statement that: "The new strain had characteristics unlike any other he (Professor Peiris) had ever seen", are not interpretable at this stage. - Mod.CP]

Patricia A. Doyle, PhD 
Zhan le Devlesa tai sastimasa 
Go with God and in Good Health

From Mike:

Well, you read that now you'd better read this one to see what YOU think after you have heard BOTH sides. Is China manipulating as well or is SARS real.  I think it is real but quite manageable. First  From The Christian Science Monitor

Here is another. This one from a travel agency source.

HI, all,

I received several calls about SARS-concerns. I have communicated with 3 MDs who were/are in China. They agree that it is nothing other  than bad cases of flu or average cases of pneumonia. They insist that the people dying are mostly people who are treated with medication, causing an allergic effect that is fatal. Below is more evidence to validate the above conclusions.

I suggest that no one on the diet be concerned about SARS. If you planned to travel to Asia, enjoy the trip and focus on having fun.

   SARS BUBBLE IMPLODES AS THE SEWAGE HITS THE FAN !

   by Fintan Dunne, SarsTravel.com- April 18, 2003 07:00 GMT

   THE END FOR SARS

   "A large number of suspect SARS cases turn out, on further investigation, to have other, common causes."

   Last line in WHO Update 32 for 17 April 2003

   PART I

   POP GOES SARS IN THE USA

   Unlike other countries, the US has never identified the 'probable' SARS cases within the large 'suspected' group.

 Now we know why.

The CDC revealed yesterday that of 208 'suspects' only 35 cases were 'probable' SARS. So now you know. When do severe respiratory symptoms not fulfill the criteria for SARS? When they are not severe at all. Or never were. The other 173 suspected U.S. cases involved only fever or milder respiratory symptoms, according to Dr. Julie Gerberding, of the US Centers for Disease Control. "Probable cases are more likely to have the condition," she added.

Thanks for that stunning insight. So, the US CDC has been padding out their SARS statistics with influenza-type conditions for weeks. Thanks a bunch. Well, how many of the remaining 35 probable cases are actual SARS? For example, how many have recovered? This statistic is now listed by the WHO. As of Thursday, 17th April global recoveries stood at 1,597 of the 3,389 cases. But no statistics are expected to be available anytime soon from the United States, according to CDC press officer Rhonda Smith. "We're still working to define what SARS is, which makes it difficult to define someone as recovered," she said.

I nearly burst a gut laughing when I read that. OK then, at least tell us how these 35 --possibly recovered, possibly still SARS cases-- are distributed around the USA. Officials are not saying where the probable cases are.Right, let's try and figure this out despite the tightlipped CDC stance. The CDC had previously reported that 5 of these 35 patients, all of whom were travelers, had laboratory evidence of recent infection with a novel coronavirus.

 Let's make an educated guess that these are the 5 persons with a semblance of something like SARS in the entire USA. Let's make another guess that the reason the US CDC is so coy about the recovery issue is that they already reported those 5 had recovered. And therefore the mortality from this "deadly" SARS epidemic in the USA out of the existing caseload is likely to be zero. Big, fat Zero.Just like SARS itself. One national public health authority SARS bubble just burst. Imagine that repeating in other countries. Meanwhile, in Hong Kong, the sewage just hit the fan.

PART II

SARS: Sewage Acquired Respiratory Syndrome.

"...the Amoy cluster includes a high proportion of cases presenting with diarrhoea, estimated at about 60%. In most other clusters of cases, diarrhoea has typically been seen in only 2% to 7% of cases.”- WHO Update 32 - 17 April 2003

In Hong Kong also on 17th April, Health Secretary Dr.Yeoh Eng-kiong said the mass outbreak at the Amoy Gardens apartment complex began after a SARS-infected man who also had diarrhea visited his brother there between March 14 and March 19. Most of the 321 infected residents in the Amoy Gardens complex probably picked up the virus in their bathrooms, according to the Secretary for Health. Large amounts of human waste carrying the virus went into the sewage system and leaked into apartments connected by toilet pipes. A report prepared by Hongkong health authorities said that under-floor U-traps such as those in bathroom floors were dry in most cases. This would have allowed air from decomposing fecal matter to waft into bathrooms.The moist conditions there allowed water droplets containing the virus to form, the report said. Bathroom extractor fans then spread the virus into the apartments. Most of the SARS cases were in vertically linked flats in a single building, Block E. Media reports have described Amoy Gardens as a lower middle class housing estate. But the sanitation system rendered it effectively a slum with conditions which rivaled those in the Middle Ages. In other words, the first headline-grabbing high-profile mass-infection so-called SARS incident arose from the oldest disease source known to mankind: exposed human excrement. Now it gets really interesting. According to the WHO, two-thirds of the building's residents reported diarrhea as one of their initial symptoms of SARS. In most other clusters of SARS cases, diarrhea was typically only 2% to 7% of cases. Most significantly, the Amoy Gardens residents have been sicker than other SARS patients. Doctors have reported these cases are not responding as well to the anti-viral drugs and steroids that have been effective in around 80 percent of patients.

Conclusion: Amoy Gardens is to the rest of the SARS "epidemic" as chalk is to cheese. Much of SARS is arguably atypical pneumonia. Amoy Gardens was just atypical filth. But it sure kickstarted the SARS scare, didn't it? Even though health authorities lumped all the pneumonia into one grand syndrome, there is more than one type of SARS. Next stop Canada.

PART III

SLOPPY SCIENCE OF SARS

Dr. Frank Plummer, the head of the Canadian WHO lab investigating SARS was puzzled. He found so few copies of the coronavirus in so many cases that he doubted it was the cause of SARS. Worse still he could only find the alleged causal coronavirus in half of the so-called SARS cases. So what were the rest of the cases? SARS or not?

Here's what I wrote two days ago:

"The virus is not the same as the syndrome. A syndrome is a collection of symptoms. It's a concept. Whereas the coronavirus is a thing. So, to describe the virus, call it "SARS associated virus." That's not being pedantic --that's being scientific. Sloppy words lead to sloppy thinking and result in sloppy science."

Next, see the flaw in the WHO case definition of the syndrome: High fever AND cough or breathing difficulty AND either:

a) close contact with a case of SARS;

b) travel to an affected area;

c) residing in an affected area.

A rather loose definition, said Frank Plummer. But let's take it at face value. Cough and fever is SARS if you are anywhere near another SARS case. And... how do we know the SARS case you were near was a SARS case? Same thing. Cough and fever anywhere near a SARS case. No wonder the SARS thing mushroomed! It classified bad influenza or regular pneumonia as SARS cases. No wonder hospitals began to bulge at the seams. Have people been dying? Sure they have. People die of pneumonia all the time in their millions. But if you stand the Amoy Gardens incident on it's own. And if you strip out the 50% of cases with no coronavirus. As 3,000 people die each year in Hong Kong from "regular" pneumonia. You are left with the natural background incidence of pneumonia, and a possible fecal matter derived pathogen. We may still have a health problem. And we need to review the cases more prudently this time. But unless you live in a slum. Or fail to wash your hands after the bathroom. SARS is not a problem for you.

Best case: Standby for the announcements from health authorities that their hysterical overreaction has saved us all from the deadly SARS epidemic.

Worst: More of the hype machine and further global economic damage, over a spurious syndrome which is a drop in the disease ocean.

 * * *

The mass media is a monstrosity --this website is a small voice.

Copyright © SarsTravel.com, 2003

Meanwhile I have researched and discovered that SARS is probably VERY preventable. Below are my recommendations for strengthening the body so as one does not get SARS or gets rid of it quicker..



• The affected person’s immune system is probably disrupted to the point where they are unable to defeat the virus.
   
• Poor food quality, inadequate digestion excessive exposure to toxic chemicals and a high-speed lifestyle in combination with poor adaptation to high stress levels puts all of us at greater risk for disease. Holism is the answer. The quick fix silver bullet approach is a thing of the past. 
   
• Vitamin C  in large quantities is likely to be quite effective. 6-10,000 units daily to bowel tolerance. more about
   
• Coral Calcium - Strengthens lungs function cofactors - more about
   
• KingBio Lungs and Bronchial Relief.
   
• Excluding refined sugars, starches and relevant grains, as detailed in Doug Graham's booklet Grain Damage 
   
• Internal cleansing using Oxy-Cleanseadds another important ingredient.   
   
• Enough sleepand exercise and having an important tool to address the emotional traumas in your life will be particularly helpful. 
   
• How did you do on our Free Breathing Test?  Did emotions get selected?  Our Self Esteem Exerciseis one profoundly simple, inexpensive and effective tool to address the underlying emotional traumas that can help devastate the immune system.

NOTE: If you depend upon the public system to protect you from SARS you may be asking for a heap of trouble such as vaccines and or silly excesses like washing your toilet seven times daily. Just witnessed a man in my gym practically hosing down his stationary bike with some kind of germ killer. Wonder how much toxicity is in that bottle of spray disinfectant and how much damage the excessive usage will do to his immune system.

Oops! Sure as I rant about the Gov for sure they come up with something maybe workable. See below

Update: Severe Acute Respiratory Syndrome --- United States, May 14, 2003

CDC continues to work with state and local health departments, the World Health Organization (WHO), and other partners to investigate cases of severe acute respiratory syndrome (SARS). This report provides an update on reported SARS cases worldwide and in the United States.

During November 1, 2002--May 14, 2003, a total of 7,628 SARS cases were reported to WHO from 29 countries, including the United States; 587 deaths (case-fatality proportion: 7.7%) have been reported (1). The 345 SARS cases identified in the United States have been reported from 38 states, with 281 (81%) cases classified as suspect SARS and 64 (19%) classified as probable SARS (more severe illnesses characterized by the presence of pneumonia or acute respiratory distress syndrome) (Figure,Table) (2).

Of the 64 probable SARS patients, 44 (69%) were hospitalized, and three (5%) required mechanical ventilation. No SARS-related deaths have been reported in the United States. Of the 64 cases, 62 (97%) were attributed to international travel to areas with documented or suspected community transmission of SARS during the 10 days before illness onset; the remaining two (3%) probable cases occurred in a health-care worker who provided care to a SARS patient and a household contact of a SARS patient. Among the 62 probable SARS cases attributed to travel, 35 (56%) patients reported travel to mainland China; 18 (29%) to Hong Kong Special Administrative Region, China; six (10%) to Singapore; three (5%) to Hanoi, Vietnam; and eight (13%) to Toronto, Canada. Seven (11%) of these 62 probable patients had visited more than one area with SARS during the 10 days before illness onset.

Laboratory testing to evaluate infection with the SARS-associated coronavirus (SARS-CoV) has been completed for 96 cases (23 probable and 73 suspect). Of 20 probable SARS patients with complete test results, six with laboratory-confirmed infection with SARS-CoV have been identified (3,4); this number remains unchanged since the last update (5). None of the 73 suspect SARS patients evaluated has had laboratory-confirmed infection with SARS-CoV. Negative findings (i.e., the absence of antibody to SARS-CoV in convalescent serum obtained >21 days after symptom onset) have been documented for 90 cases (73 suspect and 17 probable).

Since the previous update (5), the epidemiology of SARS in the United States has not changed markedly; secondary spread to contacts such as family members and health-care workers is limited, and most cases continue to be associated with international travel to areas where SARS is being transmitted in the community. CDC has developed interim recommendations for businesses and other organizations with employees returning from areas with community transmission of SARS and for other organizations and institutions (e.g., schools) hosting persons arriving in the United States from such areas (6,7). CDC does not recommend quarantine of persons traveling to the United States from areas with SARS nor the cancellation or postponement of classes, meetings, or other gatherings that would include travelers from areas with SARS. Activities to prevent importation and spread of SARS from inbound travelers (6) include 1) pre-embarkation screening of persons traveling from areas with SARS, 2) assessment by health authorities of ill persons aboard flights arriving from areas with SARS to ensure that ill passengers are isolated and evaluated promptly and that appropriate follow-up of other passengers occurs, 3) distribution of health alert notices to travelers arriving in the United States to notify them of the importance of monitoring their health for 10 days after departure and promptly seeking medical evaluation if they have fever or respiratory symptoms, and 4) the rapid detection and isolation of persons in the United States who have traveled from an area with SARS who have symptoms compatible with early suspect SARS within 10 days of arrival.

Reported by: State and local health departments. SARS Investigative Team, CDC.

References

1. World Health Organization. Cumulative number of reported cases of severe acute respiratory syndrome (SARS). Available at www.who.int/health-topics/severe-acute-respiratory-syndrome#tab=tab_1 
2. CDC. Updated interim U.S. case definition of severe acute respiratory syndrome (SARS). Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5217a5.htm
3. CDC. Severe acute respiratory syndrome (SARS) and coronavirus testing---United States, 2003. MMWR 2003;52:297--302.
4. CDC. Update: Severe acute respiratory syndrome---United States, 2003. MMWR 2003;52:357--60.
5. CDC. Update: Severe acute respiratory syndrome---United States, 2003. MMWR 2003;52:411--3.
6. CDC. Interim guidance for institutions or organizations hosting persons arriving in the United States from areas with SARS. Available at https://stacks.cdc.gov/view/cdc/25053
7. CDC. Interim guidance for businesses and other organizations with employees returning from areas with SARS. Available at https://stacks.cdc.gov/view/cdc/25052