Did Adela infect 600?

The Department of Health (DOH) is monitoring 600 people who may have had varying degrees of contact with nursing assistant Adela Catalon, the country’s first "probable" fatality from Severe Acute Respiratory Syndrome (SARS).

The 600 people were guests at a wedding in Moncada, Tarlac last April 6 where Catalon acted as one of the sponsors, according to Dr. Eric Tayag, assistant director for DOH-Central Luzon.

Catalon did not travel to Tarlac, Baguio City and Metro Manila as reported, Tayag said, but the wedding guests came from these places.

Thus far, the DOH has contacted 400 of the 600 wedding guests and a majority of them did not manifest any symptom of SARS during a 14-day quarantine. Tayag said.

"We advised the guests to undergo quarantine. The quarantine period ended last Sunday and it appeared that no one among them had manifested SARS symptoms, not even the newlywed couple," Tayag said.

He added that the DOH is now trying to get in touch with the 200 other wedding guests so they can get proper medical attention if needed.

Health authorities are also monitoring more than 250 other relatives, neighbors and friends who came in contact with Catalon.

Four people who have had close contact with Catalon were brought to the Research Institute for Tropical Medicine (RITM) last Saturday: Catalon’s father, an infant she cuddled, an 11-year-old boy and Catalon’s brother-in-law who acted as her chauffeur during her stay in the country.

Catalon’s 74-year-old father died yesterday of colon cancer at the RITM, but is considered a suspected SARS case because he developed fevers and had to be hospitalized after contact with his daighter, who died last April 14 after arriving from Toronto, Canada, Health Secretary Manuel Dayrit said.

She had returned to the Philippines to look for an oncologist for her father, but she rapidly developed pneumonia-like symptoms. She died at the San Lazaro Hospital in Manila, two days after she was brought to a hospital in Villasis, Pangasinan.

The dead nursing assistant is believed to have contracted SARS from her roommate’s mother in Canada, which has reported 14 SARS deaths and about 300 suspected and probable SARS cases. Toronto, where she lived, is the center of the largest SARS outbreak outside of Asia.

"The final diagnosis of death (of Catalon’s father), according to RITM director Dr. Remigio Olveda, is that he may have died of an intra-abdominal tumor… and of course, the patient is a suspect SARS (case)," said Dayrit.

He added that it was unlikely for the father to have died of SARS because he did not manifest the symptoms of pneumonia.

A sample of the elder Catalon’s blood will be sent to a Japanese laboratory, which is already examining blood from his daughter and a 64-year-old foreigner who fell ill of probable SARS but recovered, Dayrit said. The tests will confirm whether the three were infected with the virus.

Dayrit said that the elder Catalon’s body will be brought to Pangasinan on April 26 in time for the release of his relatives from a two-week quarantine.

He urged the members of Catalon’s community not to hold a large gathering unless the three people who have had close contact with Catalon have been determined to be free of SARS.

"We are not encouraging a wake. We will advise the relatives to bury the body as soon as it arrives in Pangasinan. In the first place, the body will only be kept in a freezer at the RITM and will not be embalmed," Dayrit said.

Doctors will only perform "modified embalming" on the elder Catalon’s remains by making a small incision in his abdomen to take samples of the tumor. The samples will then be sent to Japan for examination.

Aside from the 250 people under quarantine because of contact with the nursing assistant from Toronto, health officials have investigated nearly 100 others for possible SARS, but no SARS cases have been confirmed.

President Arroyo has gone to lengths to prevent a local outbreak, organizing a crisis team headed by Dayrit to prevent infections and ordering authorities to tighten checks at points of entry.

Jean-Marc Olive, the World Health Organization’s representative in the Philippines, said it was too early to say whether the nurse’s case could spark an outbreak of the disease in the country.

The younger Catalon’s case has put the government’s anti-SARS campaign to a test.

While emphasizing that there is still no confirmed SARS case in the Philippines, Dayrit admitted that this deadly illness is "slowly" creeping into the country.

"Remember, we did not have a probable case for four weeks. Then we had one probable case just when the fourth week was ending, and a probable case just when the fifth week was ending. Cases will occur," he said at a press briefing.

Dayrit added that because of the nature of the SARS virus, which keeps on mutating, "we will not be able to shut this out from the community all the time."

However, he expressed optimism that the government will be able to minimize any potential "havoc" to be created by SARS.

"Our plea, the government’s plea, the World Health Organization’s plea, the plea of… I guess our President, and the plea of everybody who understands what’s happening, is for everybody to take no chances. We hope everybody will follow the precautions," Dayrit said.

The DOH has urged travelers from SARS-affected countries to quarantine themselves at home or have themselves confined if they manifest SARS symptoms.

Families of returning Filipino overseas workers should encourage them to wear masks, avoid contact with family members and submit to voluntary quarantine for 14 days, the DOH said.

"These are things that people will have to do. As we understand this better, we (can) develop the vaccines… but it will take some time before these (can) happen," Dayrit said. — With AFP