New SARS cases in China may stem from lab

Apr 23, 2004 (CIDRAP News) – Chinese authorities today reported one new confirmed case of SARS (severe acute respiratory syndrome) and two new suspected cases, including one death, all of which may be linked to a laboratory at China's Center for Disease Control and Prevention (China CDC) in Beijing.

The new confirmed case is that of a 26-year-old female medical student, surnamed Song, who fell ill after working in a China CDC viral disease lab from Mar 7 to 22, according to an online report by Xinhua, China's state news service. Song's mother, surnamed Wei, died Apr 19 of viral pneumonia that is suspected to have been SARS, the report said. Her death appears to be the first SARS fatality in China since the initial outbreaks subsided last July.

Also ill with suspected SARS is a 31-year-old man, surnamed Yang, who worked with Song in the China CDC lab, according to Xinhua. Because the two patients worked in the same lab, "there is a possibility that the new cases of SARS were caused by laboratory infection," the report said.

Also today, authorities reported a link between Song and the 20-year-old nurse, surnamed Li, who was identified yesterday as having suspected SARS. Li cared for Song when Song was a patient at Beijing's Jiangong Hospital from Mar 29 to Apr 2, according to Xinhua. Because of the connection with Song, the health ministry confirmed today that Li has SARS, the report said.

The report quoted the health ministry as saying the lab where the two patients worked has been closed and is being examined to trace the source of infection.

Meanwhile, the government took steps to head off an epidemic. Authorities announced they would begin disinfecting public buildings and take the temperatures of travelers at all border stations, according to an Associated Press (AP) report today. Anyone with a fever was to be sent to a hospital, officials said.

Vice Minister of Health Zhu Qinsheng promised that the government would do its best to contain the disease and inform the public of developments, according to a Reuters report. "We are confident that SARS will not spread like it did in the past," he was quoted as saying.

The AP report said 117 people were quarantined in Anhui, where Song is a student. In Beijing, 188 contacts of Li are under observation, according to Xinhua. Five of them have a fever and are under observation at Ditan Hospital.

Commenting on the cases in a statement today, the World Health Organization (WHO) said, "The situation is considered potentially serious because of the multiple opportunities for exposure." The AP report quoted Maria Cheng, a WHO spokeswoman in Geneva, as saying Song and her mother might have exposed many people because they took several train trips together between Anhui and Beijing.

The WHO said it has classified the cases of Song and Li as probable SARS and said the cases of Song's mother and Yang are still under investigation. Under WHO guidelines, confirmation of SARS requires verification of test results by an external international reference lab, the statement noted.

The WHO also noted that the Chinese National Institute of Virology, where Song and Yang worked, is known to be studying the SARS coronavirus.

Xinhua said Song is a postgraduate student at Anhui Medical University. After working in the CDC viral disease lab, she returned to Anhui briefly, became ill with a fever, and went back to Beijing Mar 25, the report said. She was hospitalized for treatment of pneumonia Mar 29, but on Apr 2 she returned to Anhui and was treated at two different hospitals. Blood tests Apr 21 and today were positive for SARS antibodies.

Song's mother had accompanied her from Mar 31 on, according to Xinhua. Her mother fell ill with a fever Apr 8 and was hospitalized in Anhui for treatment of viral pneumonia. Her conditioned worsened Apr 19, and she died the same day, the report said. The health ministry classified Song's case as confirmed SARS and her mother's case as suspected on the basis of blood tests, clinical features, and epidemiologic findings.

Yang, the researcher who worked in the same lab as Song, fell ill with a fever Apr 17 and was hospitalized yesterday, according to Xinhua.

The SARS cases reported in China this week are the first ones since a series of four apparently unrelated cases in southern China's Guangdong province in December and January. All four patients recovered.

See also:

Apr 22 WHO statement
http://www.who.int/csr/don/2004_04_23/en/

Apr 22 CIDRAP News story, "Suspected SARS cases reported in Beijing"

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