The Hindu : Isolation of SARS suspects `not up to the mark'

Online edition of India's National Newspaper
Monday, Apr 28, 2003

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Other States - Maharashtra

Isolation of SARS suspects `not up to the mark'

By Our Special Correspondent

MUMBAI April 27. Maharashtra, which has seen the largest number of positive cases of the Severe Acute Respiratory Syndrome so far — three of them certainly `imports' and two locally acquired infections from them — may need to better manage the quarantining of the patients.

An element of compulsion in quarantining, despite the claims that each district hospital is equipped with an isolation ward for SARS cases, is clearly missing. SARS patients have treated this requirement quite lightly, at least in two cases.

Julia D'Silva, who tested positive in Pune, was allowed to marry because she threatened officials with dire consequences if the wedding was put off. Helpless, they allowed it to be solemnised and then `closed down' the church; those who attended the marriage, including the priest, were later isolated.

Then came the case of Bhaskara Murthy, a Hong Kong-based businessman. He reported to a hospital in Mumbai, was found positive and after being isolated, "he left against medical advice". He stayed with friends before leaving for Delhi where he was pushed back into isolation in a hospital.

Some doctors say that if "isolation is mandatory to contain a disease not yet understood fully, it has to be enforced meticulously. Even patients have to understand that they should submit to such quarantine" in the interest of everyone. The Government cannot "take it lightly" because patients "acted against advice".

In Julia D'silva's case, she was first treated as an out-patient and when she asked to submit to the test by Virology Institute at Pune, she was not in a hospital. Only when she tested positive was she sought to be isolated. That too after allowing her to get married. Later, her husband was also quarantined.

That the infection spread to her from her brother or mother who came to her wedding is evident because they travelled from the Far East on the aircraft on which a SARS suspect travelled. He got off at Singapore. Her uncle, who travelled with them in a taxi from Ambernath near Pune, also tested positive.

Two taxi drivers involved in transporting them were found and isolated. In Pune, where the largest number of people came into contact with a SARS-positive patient, most of them were asked to remain indoors instead of being moved to another place. This created some panic among the residents of the building.

It is being argued that the crucial aspect of isolating the suspects till they test either positive or negative leaves a lot to be desired.

In the beginning, patients flying into India via Mumbai's Sahar International Airport were asked to fill a questionnaire stating whether they had any symptoms including fever, cold and cough and it was expected that the detection procedures would be strengthened.

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