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March Mania

Area health workers learn SARS still poses dangers

Though it has dropped out of the headlines, the highly communicable disease known as SARS is still a major concern to national public health officials.

"We need to prepare for the possibility that it will re-emerge," said Dr. Julie Louise Gerberding, director of the Centers for Disease Control and Prevention. "It can spread very quickly."

Gergerding was part of a live national teleconference on Thursday, titled "SARS: When a Global Outbreak Hits Home." It was shown locally for public health workers in Duluth, Virginia, Grand Rapids and Ashland, Wis.

The focus was on preparing communities for a possible return of Severe Acute Respiratory Syndrome (SARS), based on lessons learned in Toronto, Canada. That city suffered the worst outbreak outside of Asia, keeping it in a state of siege for several months.

The outbreak was traced to a traveler who had been exposed overseas and then infected her 43-year-old son, who subsequently became the city's first victim.

During that same period -- March to June -- Duluth reported one probable case, and there were several others statewide according to the Minnesota Department of Health.

"We had to execute drastic public health care measures," said Dr. Sheela V. Basrur, with Toronto Public Health. Those measures included the quarantine and isolation of people with the disease and those thought to have been exposed.

At the time, Toronto was developing an emergency plan for a possible influenza outbreak, which helped speed its response to SARS.

"People weren't happy about being quarantined," said Marg Mulholland, manager of Communicable Disease Control for Toronto Public Health. "That was the reaction -- a lot of people lost their jobs."

Dr. William L. Roper, dean of the School of Public Health for the University of North Carolina, said the quarantine stigmatized people. He said people were fired and there was a racial component.

But health care workers were the hardest hit. At one time a Toronto hospital quarantined more than 4,000 workers and family members.

Dr. Allison McGeer, an infectious disease consultant in Toronto, caught what she described as a mild version of SARS. McGeer compared it to having a bad case of mononucleosis for about three weeks.

Basrur said over 2,000 people had to be investigated, and each case took about nine hours. During the outbreak, a SARS hotline received over 300,000 calls, with the daily record at 48,000.

"Every call had intensity, anger, hurt or grief," she said.

To keep the public and the medical community informed, health and safely officials held daily press conferences that became the most watched program in the city.

In the U.S., quarantine regulations are usually state or local mandates. Gerberding said the CDC is reviewing public health laws to come up with a model and some states might have to change.

"Public health needs to be prepared," Roper said. "The next outbreak could be little more than an airplane ride away."

The presentation coincided with an international conference by the World Health Organization on how to handle the next possible outbreak. The Canadian SARS experience was also scheduled for discussion at disaster response training in Duluth this week.