DOH reports 7 more SARS cases

Seven more cases of Severe Acute Respiratory Syndrome have been reported in the country, bringing to 10 the total number of people known to have been infected here by SARS.

Dr. Consorcia Lim-Quizon, chief of the National Epidemiology Center, said all but one of the new cases contracted the virus from the first two SARS cases — Adela Catalon, a nursing aide who caught it in Canada, where she worked, and her father Mauricio. Both of them died. A third case, a 64-year-old German national who frequently traveled to the Philippines from Hong Kong, recovered.

The new cases include a hospital technician who took an x-ray of Catalon the day before she died, Catalon’s mother, a niece and a brother-in-law as well as a female doctor and a male nurse at the Research Institute for Tropical Medicine (RITM) in Alabang who treated Catalon’s father.

The seventh case is a Filipino worker who returned recently from Hong Kong.

Of the seven new cases, one has "already recovered" and the rest are in "the recovering process" and are confined at the RITM, a Department of Health (DOH) statement said. None of those recovering are in critical condition and "there is a big possibility that they will recover."

Quizon said the seven SARS cases were earlier categorized as SARS suspects until they were "declassified" by a five-member panel of experts that includes a representative of the World Health Organization (WHO).

"After careful deliberation yesterday, they declassified seven of the suspects as SARS cases. Of the seven, six are contacts of Catalon and her father. One is an imported case — a Filipino from Hong Kong," she said.

Catalon’s niece, Jennifer, was the first to fall ill among those infected by Catalon because she took care of Mauricio just before he died.

Asked if RITM personnel made a mistake by allowing Jennifer to help in caring for the elder Catalon, Quizon said, "Have mercy on the health workers. It is an indication of how they are risking their lives. The risk is always there but they continue to serve our patients. Imagine what will happen if our health workers stop doing their jobs."

"RT," the female x-ray technician who took Catalon’s x-ray at San Lazaro Hospital, was supposed to be discharged from quarantine yesterday after recovering from SARS, but will be released tomorrow instead.

"The WHO had recommended that suspected SARS cases who are symptomatic (showing symptoms of SARS) be quarantined for three weeks instead of two weeks as an extra precaution. So RT will complete her three-week quarantine on May 8 and it will be then that she will be released," Quizon said.

RT, she said, is the second person in the country to have recovered from SARS.

The detection of seven new SARS cases, according to a DOH statement, "only shows the importance of thorough contact tracing of any probable SARS case and adequate isolation facilities for patients."

Quizon said another seven suspected cases are under observation in government hospitals. Four, including a two-year-old boy, are relatives of Catalon, she said.

Catalon’s four relatives initially "did not show anything on x-ray but as the observation period progressed, they developed (pneumonia)" as shown on x-ray results, Quizon said.

"Initially, some of them responded to antibiotics so we thought, it could not be a viral (infection). That’s the reason why we have a panel (of experts) from different fields to evaluate if these are SARS cases," she said.

Quizon said that the neighbors and relatives of the Catalons in Barangay Vacante in Alcala, Pangasinan need not fear that SARS will spread in their community because the Catalons’ six contacts have been in isolation "from the first day we found out that they were contacts."

"That’s the importance of immediate identification and isolation of SARS suspects. They are kept in quarantine before they can infect others. There is no need to place the community under quarantine again," she said.

The DOH, however, advised some people in Alcala who had varying degrees of contact with the Catalons’ SARS-infected relatives to go on home quarantine as a precaution.

Quizon said the expert panel actually had a list of 14 SARS suspects, and 12 of them have been reviewed. This resulted in the finding of seven cases positive for SARS, while the other five cases were of infections other than SARS.

"Our case definition for SARS cases is the history of travel to a SARS-affected (area), contact with a known SARS case and the x-ray finding that there is pneumonia," she said.

The DOH has already sent blood samples of the seven SARS patients to Japan to determine the presence of the coronavirus, an organism suspected of causing SARS.

Japan has not yet released the test results, perhaps because "they are overwhelmed" with the number of samples sent to them from various countries, Quizon said.

Despite the increase in local transmission cases, Quizon said the DOH remains confident there will no longer be any new cases of local transmission traced to contact with the Catalons.

Quizon said the WHO will declare the country SARS-free if no new case is found by May 20.

President Arroyo said in a statement that the country’s SARS Crisis Management Committee, headed by Health Secretary Manuel Dayrit, will continue to find ways "to deepen and broaden the education of the public" on the disease and how to contain it.

"The resurgence of the threat can be strong and rapid," she said. "Let us not take chances. Our vigilance against SARS… must be unrelenting."

In a related development, the body of Mauricio Catalon was finally cremated yesterday afternoon at the San Lazaro Hospital’s crematorium. His ashes will be brought to his relatives in Alcala.

Earlier, private crematoriums refused to cremate Mauricio’s body for fear that the SARS virus would spread. This prompted the DOH to study if it could revoke a private crematorium’s license to operate if it refuses to cremate the body of a person who died of SARS.