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Friday, April 25, 2003



3 suspected isle
SARS cases ruled out

An official says three other
suspected cases here are questionable

UH cancels travel plans


Hawaii technically has six suspected cases of severe acute respiratory syndrome, but three have been ruled out and the others are questionable, says state Epidemiologist Paul Effler.

Negative test results were reported by the U.S. Centers for Disease Control and Prevention for the state's first suspected case, a Kauai woman who had traveled to Hong Kong and had respiratory illness in late February, Effler said at a news conference yesterday.

That eliminates two other suspect cases -- health-care workers who were in contact with the patient at Wilcox Memorial Hospital -- because that was the only way they would have been exposed to SARS, Effler said.

While the three have been ruled out as SARS victims, they remain on the state's official list because the CDC in Atlanta will not officially take any suspected cases off the list until it develops a policy on what evidence is needed for removal.

Still, many cases are being ruled out nationally based on CDC tests of blood and other specimens of coronavirus, identified as the cause of SARS, Effler said.

In other SARS developments:

>> A sixth suspected case with mild symptoms was reported in Hawaii Wednesday. Specimens were collected and flown to the CDC in Atlanta.

>> The CDC is shipping material to all states to advance investigations with local tests for DNA unique to SARS. Effler said he was told the turnaround time is about four hours from receipt of a specimen to a result.

The remaining suspected SARS cases in Hawaii are listed because they meet the broad definition for symptoms of the virus, Effler said, but he thinks the lab results will also officially rule them out because the illnesses were mild.

"When you cast a net widely to do surveillance, you're going to catch some illnesses in that net that ultimately aren't SARS," he said, pointing out that travelers could have more common respiratory illnesses.

Effler said a man who arrived Tuesday from Shanghai was the latest suspected case. He developed mild respiratory symptoms that night and went to a clinic Wednesday morning.

The clinic took appropriate action, masking the staff, isolating the patient and calling the state Health Department, he said.

The patient is isolated at the home of relatives and was in stable condition yesterday, Effler added.

He said blood tests are good for ruling out a case but not for a timely diagnosis of an acute infection because it takes time for a person to develop antibodies.

The new genetic test that can be done locally will "be very welcome by the people doing this work and also by the public if we're able to know definitely in a more timely manner what we have," Effler said.

He said he is encouraged by the quick reporting of the latest case, which allowed his staff to respond quickly.

He emphasized the importance of public awareness and expressed support for recommendations by the CDC and World Health Organization to limit travel to China, Hong Kong, Vietnam, Singapore and Toronto. People who travel to those areas and become ill within 10 days of return need to isolate themselves and call a doctor, he said.

Those who become ill without traveling to those places "shouldn't panic" because other things cause respiratory illness, he said.



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

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