WHO issues a global alert about cases of atypical pneumonia
Cases Of Severe Respiratory Illness May Spread To Hospital Staff
Geneva, 12 March 2003 - Since mid February, WHO has been actively
working to confirm reports of outbreaks of a severe form of pneumonia in
Viet Nam, Hong Kong Special Administrative Region (SAR), China, and
Guangdong province in China.
In Viet Nam the outbreak began with a single initial case who was
hospitalized for treatment of severe, acute respiratory syndrome of
unknown origin. He felt unwell during his journey and fell ill shortly
after arrival in Hanoi from Shanghai and Hong Kong SAR, China. Following
his admission to the hospital, approximately 20 hospital staff became
sick with similar symptoms.
The signs and symptoms of the disease in Hanoi include initial flu-like
illness (rapid onset of high fever followed by muscle aches, headache
and sore throat). These are the most common symptoms. Early laboratory
findings may include thrombocytopenia (low platelet count) and
leucopenia (low white blood cell count). In some, but not all cases,
this is followed by bilateral pneumonia, in some cases progressing to
acute respiratory distress requiring assisted breathing on a respirator.
Some patients are recovering but some patients remain critically ill.
Today, the Department of Health Hong Kong SAR has reported on an
outbreak of respiratory illness in one of its public hospitals. As of
midnight 11 March, 50 health care workers had been screened and 23 of
them were found to have febrile illness. They were admitted to the
hospital for observation as a precautionary measure. In this group,
eight have developed early chest x-ray signs of pneumonia. Their
conditions are stable. Three other health care workers self-presented to
hospitals with febrile illness and two of them have chest x-ray signs of
Investigation by Hong Kong SAR public health authorities is on-going.
The Hospital Authority has increased infection control measures to
prevent the spread of the disease in the hospital. So far, no link has
been found between these cases and the outbreak in Hanoi.
In mid February, the Government of China reported that 305 cases of
atypical pneumonia, with five deaths, had occurred in Guangdong
province. In two cases that died, chlamydia infection was found. Further
investigations of the cause of the outbreak is ongoing. Overall the
outbreaks in Hanoi and Hong Kong SAR appear to be confined to the
hospital environment. Those at highest risk appear to be staff caring
for the patients.
No link has so far been made between these outbreaks of acute
respiratory illness in Hanoi and Hong Kong and the outbreak of `bird
flu,` A(H5N1) in Hong Kong SAR reported on 19 February. Further
investigations continue and laboratory tests on specimens from Viet Nam
and Hong Kong SAR are being studied by WHO collaborating centres in
Japan and the United States.
Until more is known about the cause of these outbreaks, WHO recommends
patients with atypical pneumonia who may be related to these outbreaks
be isolated with barrier nursing techniques. At the same time, WHO
recommends that any suspect cases be reported to national health
WHO is in close contact with relevant national authorities and has also
offered epidemiological, laboratory and clinical support. WHO is working
with national authorities to ensure appropriate investigation, reporting
and containment of these outbreaks.