The Severe Acute Respiratory Syndrome that has been responsible for the illness of over 2,200 people worldwide and nearly 80 deaths has arrived in North America.
The virus, characterized by pneumonia-like symptoms including high fever and respiratory symptoms such as cough, shortness of breath, and difficulty breathing, was first diagnosed in Vietnam and rapidly spread to other southeast Asian countries.
"There are more than 50 cases currently being investigated in the United States and Canada in individuals who have recently traveled to these regions," said Dr. John Turco, Director of Dartmouth College Health Services, in a campus-wide announcement.
Kathryn Kirkland, epidemiologist at the Dartmouth-Hitchcock Medical Center and a specialist in infectious diseases, said that while SARS has not yet reached the Dartmouth campus, it is conceivable that it could. She pointed out that minor cases of SARS have already been reported in Vermont. Much of Kirkland's job lately has been preparing for a possible SARS outbreak at Dartmouth or in the nearby area.
Turco encouraged anyone traveling to southeast Asia, including mainland China, Hong Kong, Vietnam or Singapore to consult the Center for Disease Control and Prevention prior to their departure.
The CDC has not yet made any formal, explicit advisories against traveling to the region. However, as of yesterday the World Health Organization officially began recommending that travel to the infected regions within southeast Asia be avoided, if possible.
"As a measure of precaution, WHO is now recommending that persons travelling to Hong Kong and Guangdong Province of China consider postponing all but essential travel. This temporary recommendation will be reassessed in the light of the evolution of the epidemic in the areas currently indicated, and other areas of the world could become subject to similar recommendations if the situation demands," the WHO announced in an online press release.
This recommendation does not, however, apply to passengers in transit through airports in those areas.
Summer Foreign Study Programs to China and Japan are currently scheduled to run this summer, and no plans have yet been made to cancel or delay the trips, Director of Off-Campus Programs John Tansey said.
"We will monitor state guidance and the WHO and CDC advice and check with our contacts at the sites to see if it is safe to continue our programs," Tansey said. "If it is not safe to run we would cancel it."
Authorities have yet to determine the exact cause of the illness, though they have established that it is a viral infection. Consequently, the use of antibiotics is not an option. Doctors from the WHO are currently analyzing the viral strand responsible in an attempt to pinpoint the viral family or even specific virus from which this likely mutation originated.
Though cases of SARS have sprung up in over 15 countries, the majority have been single cases of travelers returning home after trips to southeast Asia. The majority of these cases have been well-contained, preventing further transmission. The only documented chains of transmission remain in China, Singapore, Vietnam, and Toronto, Canada, where 58 have been diagnosed and six have died from SARS.
SARS has killed 4 percent of those diagnosed with the disease, said Turco. "When talking about deaths from infectious illness, that's high," he said.
Though no infections have been found on the Dartmouth campus or anywhere in the state of New Hampshire, the Dartmouth-Hitchcock Medical Center is fully capable of handling any cases.
"DHMC is as well equipped as any place in the world," Turco said.
Current treatment focuses on quarantine combined with a regiment of supportive treatment. The goal is to isolate the infected person and help their body fight the virus, letting it run its course.
"Only 20 percent of cases are critical," Kirkland said. "Those cases need to be supported with mechanical respirators. All we can do is make sure the support systems are working and let the body fight it."
