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Friday, April 11, 2003



New SARS case
has an isle link

A flight attendant who was
in Waikiki is hospitalized after
her return to Taiwan


By Sally Apgar
sapgar@starbulletin.com

A China Airlines flight attendant who spent the night of March 31 in a Waikiki hotel before returning home has been hospitalized in Taiwan with a suspected case of the mysterious respiratory illness from Asia.

At a news conference yesterday afternoon, state Epidemiologist Paul Effler said that staff of the Centers for Disease Control working in Taiwan contacted him Wednesday night with the news of a case "strongly suggestive of being" severe acute respiratory syndrome.

To date there are no confirmed cases of SARS in Hawaii. There are five "possible cases," but the CDC has not confirmed them as SARS.

As of yesterday the CDC said it is investigating 166 cases from 30 states. There have been no deaths from SARS in the United States, but 60 suspected SARS patients have been hospitalized. Worldwide, about 2,700 cases are suspected, and there have been 111 deaths from SARS.

Effler emphasized yesterday that the best way to treat SARS is early detection of the virus and immediate isolation of the patient so that others are not affected.

Also yesterday, Effler took the "precautionary measure" of issuing guidelines to control the spread of SARS and prevent it from becoming established in Hawaii. The nine-point guide was sent yesterday to every physician in the state.

Effler said his staff has been working with the Holiday Inn in Waikiki, where the flight attendant stayed, and has not detected any possible SARS illness among the staff.

"The SARS virus doesn't hang around in an environment, so the hotel does not pose a risk," said Effler.

SARS, which is transmitted by "close contact," has an incubation period of two to seven days. Effler said it has been 10 days since the flight attendant was in Waikiki, just past the incubation period, and there is "no information to suggest transmission of SARS."

Effler noted there is no "gold standard" or definitive test for the virus, but according to testing standards in Taiwan, officials there determined the attendant was "positive" for SARS. Effler said she is expected to recover.

Effler said the attendant, part of a China Airlines flight crew based in Taiwan, flew on March 25 to Hong Kong, one of the first places the disease broke out. Two days later, she flew to Tokyo and then to Honolulu.

When she landed March 31, six days after possible exposure in Hong Kong, she was not feeling well and immediately went to the hotel and took meals in her room. Other guests on the same floor were fellow flight crew members. Taiwan officials have not determined if any of the other flight crew have SARS.

The attendant flew to Tokyo April 1 where she saw a doctor who did not apparently suspect SARS. On April 4 a Taiwanese doctor tested her for SARS, and the results were confirmed April 9, the same day Effler was contacted.

Effler said that "front-line clinicians" in Hawaii have a critical role in the early detection and rapid isolation of suspected cases.

Clinicians were urged to screen patients complaining of fever, particularly one of 100.5 or higher, chills or respiratory symptoms and determine quickly whether they have been exposed to someone with SARS or traveled within the past 10 days to mainland China, Hong Kong, Singapore or Hanoi, Vietnam.


SARS information is available at www.state.hi.us/doh/sars.
Clinicians with questions can call the CDC hotline
at 888-488-7100. Members of the public can call
the CDC at 888-246-2675.



State Health Department
Centers for Disease Control
Hong Kong Department of Health

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