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SARS
'super-spreaders' appear to be elderly
or
those already suffering ailments: WHO
Channel
News Asia, May 12, 2003
Extremely infectious patients of the SARS virus or
"super-spreaders" appeared to be the elderly or those already
suffering medical ailments, a World Health Organization official said
Monday.
According to the official, the make up of "super-spreaders," is
becoming clearer.
"Super spreaders" of Severe Acute Respiratory Syndrome are a
handful of carriers who have infected 10 or more people, often family
members and medical workers treating them.
They are seen as a key link in the transmission of the respiratory
disease.
"We are getting more and more information on 'super spreaders' and it
appears that they are mainly elderly people who have already been
immunologically compromised," Mangai Balasegaram, a WHO spokeswoman
in Beijing said.
The "viral load," or the concentration of the virus in the
carrier, has appeared to be higher in elderly people, especially if they
are already afflicted by some other ailment, like diabetes or kidney
problems, she said.
"A high viral load has appeared to make these people more infectious,
it is also more detrimental to the health of these people," she
added.
Last week, the WHO raised its estimate of the SARS fatality rate to about
15 per cent - and higher in the elderly, where it can be fatal to over 50
per cent of those aged 60 or more.
A 72-year-old Beijing man is believed to be the "super spreader"
that led to SARS taking hold in northern China, including Beijing, Inner
Mongolia and possibly in subsequent epidemics in neighboring Tianjin and
Hebei province.
The man got SARS after visiting his niece in a Hong Kong hospital in March
and spread it to nine Hong Kong tourists, three Taiwanese businessmen, a
Singaporean woman, two Chinese government officials and two stewardesses,
on a March 15, CA 112 flight.
He then infected a whole group of Beijing medical workers as he was
transferred to three different hospitals before he died on March 20,
according to SARS infection tracing data compiled by China's Center for
Disease Control and Prevention and given to the WHO.
The two stewardesses eventually came down with SARS, but were only
diagnosed after they returned to their homes in Inner Mongolia, where they
have been linked to many of the 288 SARS cases there.
An 82-year-old woman has been identified as the main source of infection
of more than 50 SARS cases in Beijing's east, the hardest hit area of the
capital that has been reeling from the disease with 2,304 cases and 129
deaths.
The women, named Li Jiecui, had spent two months in Hong Kong prior to
being hospitalized at the Dongzhimen hospital on March 21, where she died.
The hospital has been quarantined for weeks.
A 64-year old Chinese doctor named Liu Jianlun, Hong Kong's first recorded
and most famous SARS case, is believed to have infected 13 guests at Hong
Kong's Metropole Hotel in late February and was seen as the "index
case" of what eventually became a global epidemic.
Those 13 guests went on to infect people in Vietnam, Singapore, Germany,
Canada and Hong Kong, according to the Center for Disease Control in the
United States.
Dr Liu was from China's southern Guangdong province where SARS was first
discovered in November.
He died in a Hong Kong hospital on February 23.
Not all of the super-spreaders have been elderly though.
The man who caused the SARS cluster that spread to over 300 people in the
Hong Kong apartment complex, Amoy Gardens, in late March was only 33, but
was being given drugs for a kidney disease that had suppressed his immune
system, Ms Balasegaram said.
Afflicted with diarrhea, a known SARS symptom, the man apparently
transmitted the disease through the sewage system of the apartment
complex.
And in another Hong Kong cluster, a 26-year-old Chinese man gave the
disease to 112 doctors, nurses and medical students in a local hospital.
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