With Dr. Sarah Park
Epidemic Intelligence Service Officer
Centers for Disease Control and Prevention
Monday, April 28, 2003; 2 p.m. ET
The U.S. has only 41 confirmed cases of severe acute respiratory syndrome (SARS) and many medical officials worry that Americans might have a false sense of security. While officials caution that the contagious virus should not be dismissed, they also worry about heightening fears and causing mass hysteria. Recently, the World Health Organization reported that the SARS outbreak had peaked in Asia, except for China, and that Vietnam became the first infected country to be declared free of the virus.
What are the early warning signs of SARS? What precautions should people take? How is it spread?
Dr. Sarah Park, Epidemic Intelligence Service (EIS) officer was online Monday, April 28 at 2 p.m. to discuss SARS detection, treatment and prevention. She will also talk about how the epidemic is affecting the Asian American community.
Park is trained as a pediatric infectious disease physician. She came to CDC as an EIS officer in 2002 and works in the National Center for Infectious Diseases. Prior to CDC, she was an attending physician in pediatric infectious diseases at University of California San Francisco.
A transcript follows.
Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.
Arlington, Va.: How many cases have involved young children, and what were the outcomes? The media coverage hasn't specified. It is my understanding that SARS is particularly dangerous to the old and very young. What should I do as a concerned parent of a 10 month old? I of course don't want to profile all Asians out of concern for my child. And I don't want to think I should run to the E.R. every time my son gets a runny nose and a cough.
Thank you for your time,
Concerned Dad
Dr. Sarah Park: Proportion of children that have been affect has been very small compared to the number of adults over 18 -- potentially because adults travel more frequently to affected areas. Just as the flu for example, we presume this virus would be more likely to affect the old and young. As a concerned parent, unless you are traveling to the affected areas, you should have a low level of concern for your child with regards to the SARS virus. However, as a general preventive measure for any type of infection, you should wash your hands frequently and contact your physician if you have further concerns.
Rockville, Md.: It was mention that 35 states are involved which have people containing SARS. What are these states and the effects SARS is having on the people?
washingtonpost.com: Fears of SARS Virus Spreading (Post, April 24)
Dr. Sarah Park: The list of affected states is available at www.cdc.gov/sars under US case counts. There have been no deaths in the US attributed to SARS, a small number have had serious respiratory illness, but the majority have recovered without serious complications.
Woodbrige, Va.: When traveling to other states should I be concerned with contracting SARS and should I wear a mask?
Dr. Sarah Park: It is not necessary to wear a mask when traveling to other states. At this time the only areas at risk are in foreign countries.
Pittsburgh, Pa.: Last week reports from Winnipeg, Canada indicated that 20% of the patients with SARS symptoms who failed to meet the case definition tested postive for the SARS virus in a PCR test. It would seem, based on this report, that the SARS case definition is in serious need of revision.
Do you have any comments on these cases (I believe there were at least 50 positive individuals from the Toronto area)? Are SARS virus levels in those in affected areas who have milder symptoms a cause for concern, and are contacts of these individuals being traced?
Dr. Sarah Park: We cannot comment directly on the Canadian investigaion. Health Canada is in charge of those efforts. The case definition has been written to be broad to detect as many cases as possible. As our knowledge increases based on experience and laboratory findings, the case definition will to continue evolve.
Rockville, Md.: What is your advice about travelling to Japan in the next few weeks? Do you think it is necessary to cancel the trip or could travel cause any problem re-entering the U.S.?
Dr. Sarah Park: At this time neither the CDC nor the WHO have issued a travel advisory to Japan. Consult the CDC or WHO websites for future travel advisories. You should not encounter any problems re-entering the US at this time.
Temple, Ariz.: Has anyone tried fitting the (admittedly scanty) data to mathematical models of epidemics, and if so, with what results?
I am not a biologist, but my instinctual impression is that SARS isn't yet a major problem (unless there are very many more cases in China than has been revealed) but could become one in a few years if neglected. That is, it isn't worth the trouble for the general public in North America to worry about catching it yet, but it IS worth the trouble for public health authorities to exert themselves to stop it spreading.
Further to the above, do you think it is possible to eradicate SARS (as smallpox was eradicated)? It seems too "low-profile" as a disease (e.g., easily mistaken for other diseases) to be easily eradicated.
Dr. Sarah Park: Epidemiologic analysis is ongoing at this time with all of the available data in all countries involved. Also, there are a number of studies which have begun to further our understanding of this new virus and its clinical presentation. It is too early to comment on the possibility of eradication. Our efforts are currently focused on containing the spread of SARS.
Reston, Va.: Hello and thank you for being available to answer questions.
I was planning a trip to Thailand this summer. I know Thailand itself has not had much of a problem, but should traveling through airports in the region a concern?
Also, what type of medical conditions would put someone at an increased risk? One of my traveling companions has a bad liver. Would this increase her chances of contracting SARS or having additional complications if it was contracted?
Dr. Sarah Park: Review your itinerary and be aware of any travel advisories for those areas which is available on the CDC or WHO websites. SARS epidemic is constantly evolving and it would be difficult to comment on what the conditions may be this summer. At this time there is limited information regarding SARS infection in immunocompromised individuals. As with other infections, those who have medical conditions which could affect their immune status should be more cautious and adhere to careful hand hygiene practices.
Virginia: My husband and I hope to travel to China next month. (We are waiting for our travel permission.) We are adoptive parents and will traveling at the earliest possible time. We have latex gloves, Clorox wipes, baby wipes and are trying to find masks. We will limit our sightseeing and exposure to crowds. Anything else we should do/not do to stay healthy? What can we do to protect our daughter?
Dr. Sarah Park: There is advice for this exact situation available at http://www.cdc.gov/ncidod/sars/adoption.htm
You sound as though you are well prepared, keep abreast of the latest developments until you are ready to leave. Good luck with your adoption.
Washington, D.C. : Is it really any more dangerous to frequent areas such as Chinatown in New York City than other locations in the U.S.? 95% of my workplace is made up of Chinese and Chinese-Americans, and many of my colleagues are avoiding going to places such as New York's Chinatown and churches with Chinese congregations. I personally would not feel the need to avoid Chinatown.
Dr. Sarah Park: There is no need to avoid visiting areas where there is a large Asian community. The risk has been traveling to the areas in Asia that are listed on the CDC and WHO websites. At this time there has been no documented cases of SARS in individuals whose only exposure has been to a largely Asian community within the US.
Columbia, Md.: How does quarantine work? What is the period of quarantine, ideally? A healthy person quarantined with a sick person can catch the disease and be released during the incubation period. Is this a problem?
Dr. Sarah Park: Information about quarantine and precautions for household contacts is available at http://www.cdc.gov/ncidod/sars/isolationquarantine.htm.
Rockville, Md.: I stand near people who are coughing all the time, stores, elevators or even in the Starbucks this morning while they were pouring my coffee. They usually put their hand in front of their mouth but should I be concerned? How easily does SARS transmit? Thanks for you help.
Dr. Sarah Park: The risk for SARS has been documented only in travelers to the areas at risk outside of the US. In general, as for many types of infections like the flu, it is always a good idea to use good hand hygiene to lower your risk of infection.
Arlington, Va.: I was supposed to travel to China next month, and have put off my plans in part because of the CDC warning.
However, a part of me keeps thinking...even with 3,000 cases in China, what are the odds that one of those people, amid 1.3 BILLION, is going to come in close enough contact with me to give me SARS?
Does the CDC have a point that the probability of such contact is so low that a travel advisory seems overkill?
Dr. Sarah Park: At this time there is still a travel advisory for unnecessary travel to China. This is the advice of many international experts who are currently working in affected areas. Whether you decide to travel is ultimately your decision. However please keep in mind, should you travel to China at this time, be aware of any respiratory symptoms or fever that may develop within 10 after your travel.
Washington, D.C.: Should I be concerned about taking my infant on a domestic flight within the United States? I wonder about the lack of ventilation on airplanes and if another passenger has been exposed to SARS. Is SARS more dangerous for infants? Thanks.
Dr. Sarah Park: Domestic flights have not been identified as a risk factor, so traveling with your infant should be a very low risk at this time. Most of the cases in the US have been linked to travel in the affected areas. For more information on risk to infants in general, please read the answer to the first question.
Houston, Tex.: Some friends of ours are having visitors over from Hong Kong for about two-three weeks in May. What should they do? Are there any travel advisories regarding this between HK and the US? Thank you.
Dr. Sarah Park: Unless your visitors from Hong Kong are having respiratory illness, there is little cause to limit their activities while in the US. However, they are traveling from an infected area, so they should be aware of any unusual respiratory symptoms that occur within 10 days of their arrival.
Washington, D.C.: Thanks for taking the time to answer questions. Do you think antibacterial hand cleaners are useful against SARS?
Dr. Sarah Park: In general good hand hygiene with simple soap and water is useful for preventing many infections.
Washington, D.C.: In addition to SARS, is there another flu virus going around right now? My husband and I are both recovering from nasty colds that have gone around our offices. Friends and family, of all ages, across the country have recently come down with symptoms including: colds, sinus infections, cough, fever, laryngitis, nausea, ear infections, pinkeye, etc. Everyone seems to get slightly different symptoms that last from a week to two weeks, Coincidence?
Dr. Sarah Park: We are near the end of the cold and flu season in most parts of the country, as well as the beginning of the spring allergy season. Despite the SARS concern for international travelers, we cannot forget that there are a number of other common respiratory problems that normally occur at this time of year.
Bethesda, Md.: Could a person get SARS without having travelled abroad?
Dr. Sarah Park: The possibility is small and would only occur if the individual had close contact with a known SARS case. The majority of reported cases in the US are international travelers.
Melrose, Fla.: I want to know if an individual can get SARS twice. Does surviving it once mean an individual is immune? Thanks.
Dr. Sarah Park: We are still learning about the characteristics of the virus and the clinical syndrome it causes. At this time we do not have information regarding immunity to this virus.
Frederick, Md.: Is there any risk, in USA Airports?
Dr. Sarah Park: Risk for traveling domestically is very low. None of the reported cases are individuals who have only traveled through US airports. The highest risk at this time is still travel to affected areas outside the US.
Bethesda, Md.: A friend of the family just returned from China, he was suprised to see how little CDC is doing to quartining people from coming to america. What is the CDC doing to ensure our safety from this virus?
Dr. Sarah Park: CDC is working closely with each state health department in conducting surveillance for possible cases of SARS based on the case definition posted on the CDC website. A number of studies have begun involving reported SARS cases to improve our understanding and ultimately implement better protective measures and advisories for our nation. CDC also has sent a number of our experts to affected areas not only to help with efforts to contain SARS but also to learn from the experience of other countries.
Dr. Sarah Park: Thank you very much for your interest in this topic and all of the great questions I received. Due to time constraints I attempted to answer the most commonly asked questions. Updated information is always available at www.cdc.gov and the WHO website.
washingtonpost.com:
That wraps up today's show. Thanks to everyone who joined the discussion.
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