Haim Shadmi
Yesterday, the Hong Kong authorities put several dozen residents of a residential building in the Kowloon district into isolation centers at resorts, to prevent the spread of the Asian pneumonia (SARS) which has been affecting the world since November, and which originates in Asia. More than 200 cases of infection occurred in that building.
Even earlier, the residents of the building were quarantined, but this step was completely ineffective. The authorities also ordered the closing of schools. Thousands of kilometers away, in Ontario, Canada, a state of emergency was declared in recent days due to the disease, and thousands were placed in isolation. A passenger plane arriving from Tokyo was delayed at the San Francisco airport last night. The plane was placed in isolation and delayed for about an hour, after two crew members and two passengers reported symptoms characteristic of the disease.
The fear of biological terrorism contributes to the great tension surrounding the mysterious disease. Also the fact that at least half of the patients are medical professionals, and especially the lack of known curative treatment, contribute to anxiety. So far, 1,804 people have contracted the disease, in 17 countries in the world, and 62 have died from it. Most of the victims are in China, Hong Kong and Singapore.
"Bacterial meningitis also kills in such percentages, but an infectious disease that attacks the respiratory tract like this pneumonia, and causes death in such percentages, is unusual," says Dr. Itamar Shalit, Acting Head of the Epidemics Treatment Team at the Ministry of Health and Director of the Unit for infectious diseases at Schneider Children's Hospital in Petah Tikva.
However, Shalit hurries to clarify - this is not a "global epidemic". According to him, "What is now mainly troubling the world is the inability to control the main outbreak centers in China and Hong Kong. In the rest of the countries, these are isolated cases that came from Asia, so the traces of infection can be traced." Shalit adds that in Canada and Singapore the experts are currently managing to control the spread of the disease.
The disease itself is characterized by symptoms of flu and pneumonia. It is accompanied by fever, cough and difficulty breathing. Until a few days ago, there was no definite diagnosis of the virus that causes the pneumonia. Last week, the results of tests in four laboratories in the world testified that it is a virus, from a family of viruses that causes a series of diseases such as mumps and measles. However, a little later the US National Center for Disease Control announced that the source of the disease is a virus from the "Corona" family, a family that causes mild colds. The Pasteur Institute in France also reached a similar conclusion. According to Shalit, the assessment in the world at the moment is that it is indeed a virus from the Corona family.
In recent days, the Ministry of Health has been holding daily consultations with experts in Israel. The Ministry of Health continues to follow the guidelines of the World Health Organization, and acts according to them.
The Director of the Department of Infectious Diseases at the Ministry of Health, Dr. Amelia Anis, yesterday updated the chief physician of the "El-Al" company and the director of Assaf Harofeh Hospital, Dr. Benny Davidson, regarding the organization's instructions regarding flight precautions. The World Health Organization has not yet banned travel or trade in the world. However, according to the organization, in the event that the plane's crew suspects that one of the passengers has a disease, or when there is certain information about such a patient, the crew must notify the airport where he is supposed to land. Upon landing, the passenger is referred to airport authorities for condition assessment and treatment. The organization even ordered screening of passengers arriving from the outbreak centers of the pneumonia, questioning them and verifying if they suffer from signs characteristic of contracting the disease. In such a case, they should be advised to postpone the trip.
"We did not find it appropriate to recommend companies to take actions beyond the instructions of the World Health Organization," says Anis.
Yesterday, the Ministry of Health distributed a special circular among hospitals and health insurance funds about pneumonia, in which it instructs how to behave in any case of a person suspected of having the disease. In the meantime, two patients in Israel were put into isolation in hospitals, after they were suspected of having the disease, but two days later it turned out that they had the flu and they were released. "We have taken all measures so that if, God forbid, such cases appear in Israel, they will be located and isolated as quickly as possible," says Shalit.
How, if at all, will the spread of the disease be stopped? "Most viruses have a life cycle," says Shalit, "and therefore diseases often have seasonality, like the flu. We should hope that this is the case." In such a case, experts say, every effort must be made to prevent infection between people.
In the meantime, 10 laboratories around the world are working in an attempt to definitively diagnose the virus, in order to find a cure or a vaccine for it in the near future. "You have to remember," says Shalit, "that two years ago there was a similar story of an outbreak of a strain of bird flu among humans in Asia, which caused many patients and deaths. Since then, the virus has not returned to a similar extent in humans."
Zohar Blumenkranz adds: Among El-Al employees there is a fear of flying to the Far East, and Hong Kong in particular, due to the disease. The company's pilots committee addressed a letter to the head of the air operations division and asked the management to "exercise stricter judgment" regarding flights to Hong Kong. Mal Al reported that the company continues to fly to its destinations in East Asia as usual.
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