BREAKING NEWS - 22 April 2003

Gov't confirms first death
from SARS in Philippines

Posted: 0:05 AM (Manila Time) | Apr. 22, 2003
By Armand Nocum
Inquirer News Service

THE DEPARTMENT of Health (DOH) announced Monday the Philippines' "second probable SARS case" -- a 46-year-old Filipino woman who died at the San Lazaro Hospital in Manila on April 14 after returning from Toronto via Tokyo earlier this month.

Health Secretary Manuel Dayrit told reporters that the ailment of the woman, a nursing attendant, was "reclassified" as probable Severe Acute Respiratory Syndrome (SARS) after "contact tracing" by local and Canadian health officials found that she could have been infected by her roommate's mother, who was in turn infected by a Filipino doctor who died of SARS in Toronto on April 18.

(The Filipino doctor mentioned in this Inquirer report is alive, the head of the Philippine National Epidemiology Center told INQ7.net.)

The DOH has ordered quarantine for 200 "casual contacts" and 54 "close contacts" of the woman, with the initials AC. However, she will not be considered a confirmed SARS case until lab testing in Japan shows her blood sample positive for the carrier coronavirus, Dayrit said.

He also said AC was not yet in the contagious stage prior to her confinement at the San Lazaro Hospital. Contagion was in effect only when she came down with fever on April 12 and died of pneumonia two days later.

Nevertheless, Dayrit said all those who had contact with her would be closely observed until April 26. "Local transmission" will be deemed to have set in if any of them comes down with fever, cough or respiratory attacks.

Asked whether the second probable SARS case and the big number of people quarantined would make a SARS outbreak here possible, Dr. Jean Marc Olive, the World Health Organization's representative to the Philippines, said: "There is a possibility. But for the time being, no one of those [who got in close contact with AC] has developed fever. Local transmission will be established once we have [SARS] cases among those who got into contact with [her]."

The Philippines' first announced probable SARS case is a 64-year-old foreigner who has since recovered and is not known to have infected anyone, officials said.

Among AC's 54 close contacts were her father, a driver, an 11-year-old boy and a baby she had cuddled.

All four developed fever last week and were taken to the Research Institute of Tropical Medicine in Manila's Alabang suburb.

Dayrit said the driver, the boy and the baby no longer had fever as of Monday morning.

But the father remains with fever, Dayrit said, adding: "His case is complicated because he has cancer."

Dr. Antonio Amparo, chief of the Bureau of Quarantine detail at the Ninoy Aquino International Airport, said the DOH National Epidemiology Center was tracking the passengers of the Japan Airlines flight from Narita that AC took on April 4.

"We are asking the airline to give us a copy of the seating arrangement of the flight," Amparo told reporters at a news conference.

He said contact tracing started with the acquisition of the flight manifest.

At a briefing that preceded the news conference, an official of the airline said: "We are ready to give them the documents, but they have to give us their request in black and white."

Dayrit said that upon her arrival in her native province of Pangasinan, AC immediately went around Luzon in search of a doctor to treat her cancer-stricken father.

The search reportedly took her from Pangasinan to the provinces of Tarlac and Pampanga, the northern city of Baguio, and Metro Manila, and brought her in casual contact with as many as 2,000 persons. All have been told to go on voluntary isolation.

Pangasinan provincial health officials said they had isolated at least three households that AC visited. Among those with whom she had contact were children with ages ranging from 3 to 16.

Dayrit said the woman could have been infected by the mother of her roommate in Toronto, with the initials DC.

"It turned out that the mother of DC was already ill of SARS when [AC] bade her goodbye on April 1. But the mother did not know she had SARS," Dayrit said.

He said the mother was taken to a hospital in Canada on April 4 and was now considered a SARS patient. DC still has no symptoms of SARS, but her father has contracted pneumonia.

Dayrit said the mother was most probably infected by a Filipino doctor who contracted the disease from another SARS patient. The patient, who has since also died, was a member of the Bukas-Loob sa Diyos, a Philippine Catholic charismatic group.

Dayrit said AC and the woman who infected her had "no connection" with the Bukas-Loob sa Dios.

Members of DC's family reportedly visited the Philippines in the first week of March, and returned to Canada via Hong Kong.

Canada has reported 14 SARS deaths and about 300 suspect and probable SARS cases. Toronto, its largest city, is the epicenter of the largest SARS outbreak outside of Asia.

The DOH has added Canada, Japan and the United States to its alert list. Travelers from these countries will undergo health checks at Manila's Ninoy Aquino International Airport and other ports of entry and aircraft will be disinfected.

In Hong Kong, two more overseas Filipino workers -- a nurse and a domestic helper -- were taken to hospital for SARS.

The two are "out of critical condition" although they are still under observation in the hospital, Dayrit said.

Labor undersecretary Manuel Imson said the Philippine Overseas Labor Office in Hong Kong was still verifying how the OFWs were infected.

The two new cases brought to 27 the total number of Filipinos in Singapore and Hong Kong who had been afflicted with the mysterious ailment. One of these Filipinos died of SARS in Hong Kong last month.

Source : www.inq7.net

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