Waning outbreak in Canadian nursing home isn't SARS, officials say

Aug 22, 2003 (CIDRAP News) – A mysterious illness that sickened more than half of the residents of a nursing home in British Columbia and raised concern about a possible return of SARS (severe acute respiratory syndrome) is nearly over, according to Dr. Perry Kendall, provincial health officer of British Columbia.

Kendall told CIDRAP news that only 11 residents and 2 staff members at the Kinsmen Place Lodge nursing home in Surrey, a Vancouver suburb, are currently symptomatic. All 11 residents are in isolation, and the staff members will not return to work until they have been asymptomatic for 72 hours, he said. The virus sickened 94 of 142 residents and 49 of 160 staff, with the outbreak peaking in the third week of July.

Kendall said the illness does not fit the clinical definition of SARS, even though in some cases a coronavirus has been detected. Patients had symptoms similar to a cold, with a runny nose and cough but little or no fever. The World Health Organization (WHO) agreed that the outbreak is not SARS, according to a report by Agence France-Presse.

"There is clear consensus that this is not SARS," Kendall said. "Some speculate that it is a different coronavirus that we already know about. We know, for example, that human coronaviruses can cause influenza. Some people believe this virus might be a mutated SARS virus that produces only mild respiratory symptoms."

In the eight weeks since cases came under investigation, 11 residents of the nursing home have died, Kendall reported. The home would typically have eight deaths over that time period, he said. Six of those who died had evidence of pneumonia, but pneumonia was not necessarily the cause of death. In contrast to this outbreak, the fatality rate of SARS was nearly 50% for people 65 and older, according to Kendall.

Visitors to the nursing home are being asked to stay away to avoid spreading the illness. So far, there have been no reports of similar illness in a nearby hospital or within the community, Kendall reported. If there are no new cases, the ban on visiting will likely be lifted next week. The current visiting restrictions are similar to those that would be in place during a flu outbreak.

Kendall said three labs, including the Centers for Disease Control and Prevention (CDC) in Atlanta, are testing blood samples from the residents and staff to determine the cause of the illness. According to the Canadian Press (CP), the CDC did not detect any antibodies to the SARS coronavirus in several samples. Dr. Frank Plummer of Health Canada's National Microbiology Lab in Winnipeg said his lab ran five different antibody tests on samples from sick residents and staff, the CP report said. Three tests showed antibodies to SARS and two did not. The third lab conducting tests is the Michael Smith Genome Sciences Center in Vancouver, which is working with the British Columbia Centre for Disease Control, Kendall said.

Kendall also said that media reports of a similar outbreak at another British Columbia nursing home are not true. It now appears that another nursing home in Vancouver likely had an outbreak of the common cold, he said.

See also:

Report on the outbreak by British Columbia epidemiologist David Patrick, on ProMED-mail site

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