Date:26/04/2003 URL: http://www.thehindu.com/2003/04/26/stories/2003042604980400.htm

Southern States - Kerala

SARS: Health dept. issues guidelines

By Our Staff Reporter

THIRUVANANTHAPURAM April 25. The Health Department has issued a set of guidelines as part of stepping up surveillance to prevent cases of Severe Acute Respiratory Syndrome (SARS) viral infections being carried into the State through international air passengers.

So far, two air passengers, one from Singapore and the other from Toronto, have been kept under observation at isolation wards in the Thiruvananthapuram Medical College and the General Hospital, Kochi, after their pneumonia-like symptoms raised suspicions among treating physicians.

The serum samples of the patients, collected at the Public Health Laboratory, have been despatched for sophisticated confirmatory tests to the National Institute of Virology (NIV), Pune.

Meanwhile, the Director of Health Services, V. K. Rajan, has issued directives to District Medical Officers to strengthen surveillance and preventive measures against SARS.

A team of medical experts has been stationed at the international airports in Thiruvananthapuram, Kochi and Kozhikode to augment screening of incoming passengers.

Ambulance facilities have also been made available to reach suspected cases to designated Government hospitals, which have put in place special isolation wards to deal with such cases.

The Additional Director of Health Services, P. K. Sivaraman, who is leading preventive measures, has urged the public against getting panicky as the department was fully equipped to safeguard SARS infections from spreading in the community.

Meanwhile, in its set of guidelines, the Health Department has underscored the need for vigil against the SARS virus, whose mode of spread, is through the respiratory route. Since travellers may carry this virus of a highly contagious nature, it was imperative to identify a suspected case without delay and quarantined to protect the public.

As fever and respiratory symptoms are very common in the community, persons routinely reporting with these clinical signs, should not be suspected to have probability of SARS without adequate reasons.

However, at the same time, it should be known both among clinicians and the lay public that SARS, in its initial phase, could be mistaken for common respiratory ailments.

Any individual who has contact with anyone with SARS, or suspected for SARS, or has been in an aircraft in which a passenger was suspected to have SARS, must disclose the fact within 24 hours of reaching Kerala, to the doctor/clinic/hospital, to which the person would ordinarily go for medical attention or the nearest health care institution.

Any health care worker (doctor or physician of any system of medicines, any medical practitioner) who is approached by any person with fever and respiratory symptoms (cough, sore throat, nasal discharge) must take a detailed history of travel by the person, in the two weeks prior to the consultation.

In case of travel, the following details are to be recorded in order to assess the poteintial risk: Anyone who has visited China, Hong Kong or Singapore within the past two weeks, persons who has travelled to any country outside India in the past fortnight, or anyone who has travelled to Goa or Pune in the past two weeks.

The responsibilities of health care worker/institution are to immediately report to the DMO concerned or Corporation Health Officer. In case of contact being not established with these officers, the Additional Director of Health Services (Public Health) or the Director of Health Services, should be intimated on these numbers 2302160, 2331177, 2302490 ext: 277, or over mobile: 9447204987).

Patients are required to be kept under observation for 24 hours and also keep in contact with the subject for close follow-up on a daily basis until all suspicion is over.

Whether or not any investigations are conducted by any institution, appropriate specimens will have to be collected and forwarded with all infection containment precautions, to either of the two institutions identified for SARS investigations, namely NIV, Pune or the National Institute for Communicable Diseases, New Delhi. The Health Department will collect and despatch the specimens.