Scared of SARS? Here’s what you should do

The SARS (Severe Acute Respiratory Syndrome) scare spread rapidly throughout our country when news that Adela Catalon, a Filipino nursing assistant, died of SARS after she was infected by her roommate’s mother in Toronto, Canada. Our fears increased when her father, who had cancer, died soon after. Because SARS has caused more deaths in recent weeks, the World Health Organization (WHO) has called for a global hunt to track down every possible SARS case.

As I was watching news on TV last week, I became concerned about the safety of the female reporter interviewing the lady who had been Adela Catalon’s seatmate during Adela’s flight from Canada to the Philippines because the interviewer was not wearing a mask. I think it is commendable that the members of the ABS-CBN news team that covered the Adela Catalon story subjected themselves to voluntary quarantine. It is the social responsibility of anyone who has had contact with a suspected SARS patient or who has recently visited places declared to have SARS cases to voluntary submit himself for quarantine.

Despite the SARS scare, Filipino humor continues to be evident in jokes like, "Pareho tayong may SARS… Severe Absence of Romance and Sex" and in text messages like "Good news: katas ng papaya, gamot sa SARS; bad news: lahat ata ng papaya sa ’Pinas ginawa nang sabon!"

I think what is scaring us is that there is still no definite cure against SARS and that a vaccine against the virus has yet to be made. Scientists have at least identified the SARS virus as a mutated corona virus. How this mutated virus got transmitted to man is still a mystery.

Because of SARS, there has also been a rush to have vaccinations to fight flu and pneumonia. Of course, it is advisable to be immunized against these diseases. However, this does not mean you will be completely protected from SARS. Why? Because the flu vaccine is an immunization specifically against Haemophilus Influenzae type B and the pneumonia vaccine offers specific immunization against a bacteria, Streptococcus pneumoniae.

I have repeatedly been asked by my patients, their relatives, readers of this column and even by the driver of a taxi cab I took on my way to the Medical City how one can be less vulnerable to SARS. Let me thus share with you the contents of the hand-out information about SARS given by the Commission on Audit Medical-Dental Division, The Medical City and the Department of Health to lessen your apprehension about SARS. To quote:

"SARS is a disease with pneumonia as its main outcome. To be diagnosed to have SARS, you should have the following: 1.) history of recent travels to SARS-infected countries mainly, Hong Kong, China (Guandong, Shanxi, Beijing), Singapore and Vietnam 2.) history of SARS contact (lived with, worked closely with, cared for a known SARS case) 3.) signs and symptoms of SARS (a.) the main symptom of SARS is high fever – more than 38 degrees centigrade b.) body aches c.) respiratory syndromes – dry cough, sore throat, difficulty of breathing (sign of pneumonia) over five to six days after onset of fever); take note that the initial symptoms of SARS resemble flu d.) SARS may be associated with other symptoms, including headache, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhea."

"To avoid SARS: S — Strengthen your immune system (eat proper diet, take vitamins A and C, exercise regularly, stop smoking); A — Avoid contact with people with confirmed SARS; R — Respiratory difficulty is a sign of pneumonia for those infected with SARS, report to hospital for treatment; S — Survey symptoms very carefully; stay calm; I — believe and transmit only accurate information."

SARS is atypical pneumonia. "The main symptoms of atypical pneumonia include fever, malaise, chills, headache and myalgia (muscle pain). Chest X-ray shows radiological changes compatible with pneumonia. Other symptoms include cough, shortness of breath or difficulty of breathing. The incubation period of an atypical pneumonia is estimated to be between two to seven days. It is advisable to seek early medical advice if you suspect that you have the signs and symptoms of pneumonia. Transmission of the virus is by droplets and direct contact with the patient’s secretions. Based on available information and the result of epidemiological analysis, transmission is most consistent with droplet spread of respiratory secretion. However, the other routes of transmission have not yet been ruled out."

"No epidemiological evidence suggests SARS could be transmitted through swimming. No infection through swimming has been reported so far. People who are not feeling well should refrain from using public swimming pools. There is no evidence that SARS could be transmitted via handling money. People should pay attention to their personal hygiene.

For Prevention:

• Maintain good personal hygiene. Cover your nose and mouth when sneezing or coughing; wash hands when they are dirtied by respiratory secretion, e.g., after sneezing, use liquid soap for hand washing and disposable towel for drying hands; do not share towels.

• Develop a healthy living style.

• Maintain good ventilation.

• People who care for patients with respiratory symptoms should wear masks.

• Consult with your doctor promptly if you develop respiratory symptoms.

• If not feeling well, one should seek early medical advice and refrain from reporting to work. The office should maintain good ventilation by keeping the windows open. If the air-conditioner is in use, one should clean the filter regularly. Office furniture and equipment should be kept clean. Clean and disinfect the facilities using one part of household bleach to 99 parts of water at least once a day. If facilities are contaminated with vomit, wash/wipe with diluted domestic bleach mixing one part of bleach with 49 parts of water immediately.

• Wash your clothes after visiting hospitals.

• Hospital staff in the emergency room setting should question patients with complaints of cough and fever regarding history of travel and/or contact with SARS suspects/cases.

• Suspected cases should be directed immediately to the isolation room and should be asked to wear masks.

• Clinicians evaluating suspected SARS cases should use standard precautions (e.g. hand hygiene), together with airborne (e.g. N95 respirator) and contact (e.g. gown and gloves) precautions."

Suspected SARS cases should be referred to either the Research Institute for Tropical Medicine (IRTM) or to the San Lazaro Hospital immediately.

Keep in mind that you can avoid contracting SARS by following the above preventive measures. Not all patients with SARS will die from the atypical pneumonia. Majority of those reported to have succumbed to SARS had been infected with other medical illnesses, and hence were more vulnerable.

So dear readers, stay healthy to be SARS—free.

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(In case you have other problems particularly about love, looks and relationships you would want me to discuss in this column, do send your letters to The Philippine Star c/o Allure Section or send them directly to Suite 506 Medico Bldg. Lourdes Street cor. San Miguel Avenue, Pasig; fax no. 631-38-77; tel. no. 633-38-93.)