ISOLATION POSSIBLY THWARTED SARS SPREAD
03 Apr 2003
Source: Washington Post, April 3, 2003
Isolation Possibly Thwarted SARS Spread
Suspected Va. Case Tests Region's Response to Health Threat, Bioterrorism
By Michael Laris, Washington Post Staff Writer
The Virginia woman who is the region's first suspected case of a mysterious new respiratory ailment was isolated in a sealed hospital room in February after returning from China complaining of suspicious symptoms, a move that health officials said yesterday may have prevented her from infecting others.
The Loudoun County woman -- one of two suspected cases of severe acute respiratory syndrome, or SARS, in Virginia -- provided a test of the new systems that local health officials put in place to fight bioterrorism and other potential public health threats, and her case offers a window into how the region might respond if more suspected cases of SARS appear here.
On Feb. 17, weeks before the World Health Organization warned of the global threat of the potentially deadly lung infection, the woman was placed in a respiratory isolation room at the Loudoun Hospital Center. A hospital spokesman said a string of government briefings on bioterrorism and his institution's role as "the front line response hospital" for the Dulles International Airport had "sensitized our staff -- especially the emergency department staff."
Local hospital workers and health officials said a series of bizarre medical problems that have appeared in Loudoun over the past year-and-a-half -- including the inhalation anthrax contracted by a State Department mail contractor in Sterling (case 20) and three rare cases of locally contracted malaria -- had them primed to move quickly in case of a potential emergency.
Their quick response "really helped prevent any secondary cases" of SARS among health workers or others, said Dr. David Goodfriend, director of Loudoun's Health Department.
When the Loudoun woman arrived in the emergency room in February, no one had heard of SARS.
"This was before SARS as a syndrome was really identified," said Denise Sockwell, Northern Virginia's regional epidemiologist.
The woman's symptoms and travels, though, had health workers worried.
The Loudoun woman was in China's Guangdong province to celebrate Chinese New Year before she became ill Feb. 5. She returned to the United States five days later, and went to see her family physician Feb. 12, heading home with a prescription for antibiotics. The drugs didn't treat the symptoms.
In the emergency room, she had a high fever, a cough and was having trouble breathing. She and a relative mentioned that she had been in Guangdong and that a flu seemed to be going around there. A triage nurse put the woman in a sealed room that had a dedicated ventilation system to prevent her from passing along the infection.
At first, health officials suspected avian flu, a serious ailment that has appeared in and around Hong Kong.
Officials then settled on a diagnosis of an unusual pneumonia and decided to keep the woman isolated, instructing health workers to wear masks when treating her.
"Just like if it's a tuberculosis patient, if you take appropriate precautions, you don't have to be concerned you might catch it," Goodfriend said.
State and local health officials and hospital workers then launched a surveillance program to try to determine if any of the hospital employees who initially had contact with the woman had been infected. Officials said they spoke to the affected employees at the time and in later weeks to see if they had any symptoms.
Although some had flu symptoms, additional tests determined that no health workers -- either at the hospital or at the family physician's office -- showed signs of being infected with SARS, officials said.
A similar program monitored the woman's family members, none of whom have shown signs of infection. State health officials discussed whether they should notify the airline that the woman flew from China, but decided not to because other people she came into close contact with had not become infected, Sockwell said.
The woman was released from the hospital about three weeks after she was admitted, hospital spokesman Roger A. Raker said. "Her condition was very good," he said.
It wasn't until after she was released that health authorities suspected she had SARS.
As more people across the country and around the world have been afflicted with the ailment, the number of suspected cases in this area decreased by one yesterday when Virginia Department of Health officials reported that a second suspected case in Northern Virginia had been deemed a bacterial infection instead.
That reduced to two the number of suspected cases in the Commonwealth, including the Loudoun case and a second in Virginia's Hampton Roads area, Virginia state health spokeswoman Lucy Caldwell said. The Centers for Disease Control and Prevention has reported no cases of the viral infection in Maryland or the District.