12 March 2003
WHO ISSUES A GLOBAL ALERT ABOUT CASES OF ATYPICAL PNEUMONIA
Cases Of Severe Respiratory Illness May Spread To Hospital Staff
Geneva -- Since mid February, WHO has been actively working
to confirm
reports of outbreaks of a severe form of pneumonia in Viet Nam,
Hong Kong
Special Administrative Region (SAR), China, and Guangdong province
in
China.
In Viet Nam the outbreak began with a single initial case who
was
hospitalized for treatment of severe, acute respiratory syndrome
of
unknown origin. He felt unwell during his journey and fell ill
shortly
after arrival in Hanoi from Shanghai and Hong Kong SAR, China.
Following
his admission to the hospital, approximately 20 hospital staff
became sick
with similar symptoms.
The signs and symptoms of the disease in Hanoi include initial
flu-like
illness (rapid onset of high fever followed by muscle aches,
headache and
sore throat). These are the most common symptoms. Early laboratory
findings may include thrombocytopenia (low platelet count) and
leucopenia
(low white blood cell count). In some, but not all cases, this
is
followed by bilateral pneumonia, in some cases progressing to
acute
respiratory distress requiring assisted breathing on a respirator.
Some
patients are recovering but some patients remain critically
ill.
Today, the Department of Health Hong Kong SAR has reported on
an outbreak
of respiratory illness in one of its public hospitals. As of
midnight 11
March, 50 health care workers had been screened and 23 of them
were found
to have febrile illness. They were admitted to the hospital
for
observation as a precautionary measure. In this group, eight
have
developed early chest x-ray signs of pneumonia. Their conditions
are
stable. Three other health care workers self-presented to hospitals
with
febrile illness and two of them have chest x-ray signs of pneumonia.
Investigation by Hong Kong SAR public health authorities is
on-going. The
Hospital Authority has increased infection control measures
to prevent the
spread of the disease in the hospital. So far, no link has been
found
between these cases and the outbreak in Hanoi.
In mid February, the Government of China reported that 305 cases
of
atypical pneumonia, with five deaths, had occurred in Guangdong
province.
In two cases that died, chlamydia infection was found. Further
investigations of the cause of the outbreak is ongoing.
Overall the outbreaks in Hanoi and Hong Kong SAR appear to be
confined to
the hospital environment. Those at highest risk appear to be
staff caring
for the patients.
No link has so far been made between these outbreaks of acute
respiratory
illness in Hanoi and Hong Kong and the outbreak of `bird flu,`
A(H5N1) in
Hong Kong SAR reported on 19 February. Further investigations
continue and
laboratory tests on specimens from Viet Nam and Hong Kong SAR
are being
studied by WHO collaborating centres in Japan and the United
States.
Until more is known about the cause of these outbreaks, WHO
recommends
patients with atypical pneumonia who may be related to these
outbreaks be
isolated with barrier nursing techniques. At the same time,
WHO recommends
that any suspect cases be reported to national health authorities.
WHO is in close contact with relevant national authorities and
has also
offered epidemiological, laboratory and clinical support. WHO
is working
with national authorities to ensure appropriate investigation,
reporting
and containment of these outbreaks.