SARS Test Kit Now Available

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Scientists at the World Health Organization (WHO) collaborative network of thirteen laboratories around the world have developed various diagnostic tests for Severe Acute Respiratory Syndrome (SARS). Among them is a test called "PCR" which allows detection of the distinctive genetic information of a virus. The primers, which are key pieces for a PCR test, was made available on the WHO website on April 4th and have since been used by various countries around the globe.

On April 12th, a laboratory in Vancouver, Canada, reported it has cracked the genetic code of the SARS virus, a mind-boggling feat, considering the speed with which this success came about. Sequencing of the genome, which was also accomplished in the United States, is a significant step towards identification of the specific etiologic agent, development of diagnostic tests, treatment and vaccine for SARS.

The medical community is optimistic that the present PCR diagnostic test can be fined-tuned to be able to rule out the presence of coronavirus in suspected cases of SARS, which the current PCR is unable to do. On Monday, April 14th, the Bernhard-Nocht Institute for Tropical Medicine in Hamburg, Germany, apprised WHO that primers "which have built-in quality control and are available in a ready-to-use kit by a Hamburg-based bitotechnology firm, will be offered at no cost to laboratories participating in the WHO collaborative network."

The key measure of the effectiveness of the test is its ability to detect SARS at an early stage. While the existing PCR tests are very specific, "they are unable to detect all patients who are excreting coronavirus, thus allowing too many virus carriers to slip past undetected." The WHO network of laboratories are laboring around the clock to improve their PCR testing protocols and primers to enhance their reliability to contain the rapid spread of SARS.

More sensitive and fool-proof tests for SARS are expected to come out of the medical horizon, until an accurate standard and universal diagnostic test is developed.

The rapid development of these present diagnostic tests for SARS is a good example of how scientific knowledge, when efficiently generated and generously shared by an international collaborative group of dedicated scientists, can be quickly translated into a practical life-saving tool for the peoples of the world. The speed (less than two months) with which all these 13-nation collaborative scientific achievements came about is unparalleled in the history of the world.

SARS Super-spreaders

The WHO scientists have now proven beyond doubt that the culprit virus in SARS is a new member of the coronavirus family. Coronarvirus is commonly associated with mild common colds, but this new strain has obviously mutated to a deadly one, very distinct and unique.

Certain individuals, afflicted with SARS atypical pneumonia, who have been found to spread the dreaded Urbani SARS virus to a great number of people, are called a "super-spreaders."

There are persons who, somehow, are "very efficient" in spreading the virus. They are infected, could be asymptomatic and undetected, and infect a lot of people around them, and the chain of transmission goes on. Luckily, not everyone is a super-spreader.

Mainland China delayed reporting SARS

SARS started in Foshan City, Guangdong Province of China, November 16, 2002, where 305 cases of SARS were found, with five deaths. China's repressive regime had intentionally delayed reporting the onset of SARS in Guangdong, where SARS originated from, which negligence has allowed SARS to spread like wild fire to the following of May 13, 2003: Hong Kong (1686 cases, with 225 deaths), Taiwan (207 cases, 24 deaths), Singapore (208 cases, with 28 deaths), USA (64, with no deaths, and previous 184 suspects were cleared), Canada (143, with 22 deaths) Vietnam (63 cases, with 5 deaths; no more cases for more than 20 days, Viet Nam is declared SARS-free), to a total of 26 countries. Had China reported the outbreak promptly, SARS could have been contained, and its spread to other countries could have been prevented, and death tolls minimized. Following criticism and pressure from the international scientific community, mainland China has finally started reporting their SARS statistics, which were the worst in the world, having almost 5086 cases, with 262 deaths. The worldwide cumulative total, as of May 13, 2003, was 7548 cases, with 573 deaths; and 3298 have recovered.

SARS in the Philippines?

As officially listed by the Center for Disease Control and Prevention in Atlanta, Georgia, there are ten suspected SARS cases in the Philippines, one involving a 64-year-old foreigner, who has recovered. Two patients died. The homecoming this Lenten season of a multitude of overseas workers from the various countries with reported cases of SARS was a source of spread of this dreaded viral infection in the country.

Children Resistant to SARS?

There were some comments made early this month that children appeared to be resistant to SARS, because there were no reported cases of SARS among children. This is not true. There were confirmed cases of SARS involving children. Complacency and presumptuousness have no place in dealing with a deadly disease like SARS. And so with panic. We advocate calm, vigilance, and caution.

Urbani virus?

Some members of the scientific community involved in the research and fight against SARS have recommended that the SARS virus be named Urbani virus, in honor of Dr. Carlo Urbani, the 46-year-old Italian scientist, who first recognized and reported this deadly coronavirus. Dr. Urbani himself died of SARS in a hospital in Thailand on March 29, 2003, a month after being exposed to his SARS patient, a US businessman he was treating in Hanoi, who subsequently succumbed to the dreaded virus. Dr. Urbani's detection and discovery has alerted the world medical community to the killer virus, which has led to the acute awareness and early suspicion of SARS among patients presenting with dry cough, malaise, fever and shortness of breath. This has then led to more effective containment of the disease by early isolation, and strict precaution among those people exposed to the infected or suspected cases of SARS. Without Dr. Urbani's discovery, SARS would have been a much more widespread pandemic around the world, with far greater mortality than what it is today. Dr. Urbani is considered a modern-day hero by the scientific community the world over. Indeed, humanity owes him a great debt.

Cockroaches in Hong Kong?

Cockroaches, contaminated with the SARS virus, have been suspected as possible mode of spread in a hotel in Hong Kong. And so with contaminated sewer water on the streets, where people walk, resulting in contamination of their shoes. When they take off their shoes and touch the nasal area of the face, the SARS virus is inhaled, resulting in the transmission of the disease. These postulates are being investigated. At the present, only close contact with an infected SARS patient, and his/her nasal or throat secretions, is the known mode of spread.

Vaccine against SARS?

Laboratories around the world, especially the 13 members of the international network coordinating with the World Health Organization, are optimistic that a vaccine against SARS could be available within a year. The most notorious virus that killed millions of people around the world was smallpox. The pandemic wiped out families, villages and cities. Smallpox has been eliminated from the surface of the earth with the small pox vaccine. It is hoped that a vaccine against this Severe Acute Respiratory Syndrome will likewise rid the world of SARS once and for all.

Precautions

Travel to countries where cases of SARS have been reported, especially to China, Hong Kong, Singapore, Viet Nam, is best postponed. While many SARS patients will recover (3298 out of 7548 cases, thus far, with about 4.4% mortality, as of May 13th) it behooves everyone to be on guard and to take all precautions. Foremost is frequent hand washing, especially after touching door knobs in public places/toilets, etc., washing the face and nostrils at least twice a day, and covering your nose with facial tissues or handkerchief, and NOT with your hands, when someone near you coughs or sneezes, or when you yourself cough or sneeze). If you develop dry cough, fever, malaise, shortness of breath, consult a physician, even if you think what you have may be the common flu. When dealing with SARS, it is best to play it safe.

SARS Number Projection

With scientific mathematical extrapolation, the March 2003 case projection for SARS was as follows (figures given in low-high range), if the current trend continues: By the end of April, 3982-4269 (the actual figure on April 30th was 5663); May 31st, 7358-7887; June 28th, 12,810-13,732; July 31st, 24,624-26,396; August 31st, 45,495-48,769; and September 31st, 82,407-88-338. Hopefully, an effective treatment, and perhaps a vaccine, will be developed soon and the high number of cases of SARS in this projection would not come to fruition.

©2003Raoul R. Diez, M.A.O.D.