First SARS case in Nevada suspected

Mary Manning and Dan Kulin

Tuesday, April 15, 2003 | 11:14 a.m.

SARS Symptons

The Centers for Disease Control and Prevention uses these symptoms and criteria for identifying possible cases of SARS, or severe acute respiratory syndrome:

Fever of more than 100.4 degrees Fahrenheit.

Clinical findings of respiratory illness, including cough, shortness of breath, difficulty in breathing or confirmed pneumonia.

Travel within 10 days of onset of symptoms to Taiwan, mainland China, Hong Kong, Hanoi, Vietnam or Singapore.

Close contact within 10 days of onset of symptoms with either a person with a respiratory illness who traveled to an area with SARS or a person known to be a suspected SARS case.

Travel includes being in an airport in an area with documented or suspected community illness from SARS.

Close contact includes caring for, having lived with or having direct contact with respiratory secretions or bodily fluids of a patient with SARS.

Anyone with all of the above criteria should seek medical attention and inform the doctor about recent travels and possible exposure to the disease.

A Las Vegas woman is quarantined in her home with the first suspected case of SARS in Nevada, Clark County health officials said Monday.

The woman, who is undergoing testing by federal health authorities, recently traveled to an Asian country that has had documented cases of the mysterious new respiratory disease.

The patient's name, age and other identifying information cannot be released due to patient confidentiality rules, health officials said.

After the woman complained of a low-grade fever, a mild cough and shortness of breath, her physician contacted the Clark County Health District on Monday, district epidemiologist Rose Bell said.

"She was not hospitalized," Bell said. "She has been asked to stay at home for 10 days after her fever returns to normal. She willingly agreed to do so."

SARS, or severe acute respiratory syndrome, has killed at least 133 people worldwide, and more than 3,000 people have been infected, mostly in Asia.

There are 193 suspected cases of the disease in the United States, according to the Centers for Disease Control. No one in the United States has died from the disease.

Health district officials weren't sure if the woman returned to work after her trip, but she saw a doctor within 24 hours of her first symptoms, so her co-workers were not considered in any danger, health district spokeswoman Jennifer Sizemore said.

"I think she was aware of the possibility of SARS and took good precautions," Sizemore said.

Dr. Kevin Slaughter, assistant director of the emergency department at Desert Springs Hospital, said it's possible the Las Vegas patient does not have SARS at all, but rather a common cold.

Because the woman has been to Asia recently, however, Slaughter said it was a good idea to report the case to the county as a precaution.

"I am 99 percent sure this patient doesn't have SARS, otherwise (she) wouldn't have left the hospital," Slaughter said. "There's a low probability, but you try to be extra cautious.

"The hardest thing about SARS is distinguishing it from a common influenza."

The woman's trip to Asia was a crucial factor in classifying her illness as a suspected SARS case, officials said.

"If she had not traveled to Asia, she would not meet the case definition," Bell said. "The definition is broad, it is easy to fall into it."

Samples of the woman's blood and nasal discharge will be sent to the CDC laboratory in Atlanta in an attempt to diagnose the illness, Bell said.

There is no test to identify SARS. The CDC eliminates other possibilities, such as flu, before it calls an illness a possible case of SARS, health district spokeswoman Jennifer Sizemore said. That should take a couple of weeks.

In addition, health officials will interview people close to the woman and monitor them for signs of the illness.

SARS, a virus, appears to be transmitted by prolonged contact with an infected person or the sharing of bodily fluids, Slaughter said.

"It doesn't appear it can be transmitted with casual contact such as shaking hands and talking," he said.

There is no reliable test for the virus, he said.

Officials from Sunrise Hospital and Medical Center and University Medical Center referred questions about SARS to the county health district Monday.

State epidemiologist Dr. Randall Todd said that a suspected SARS case in Las Vegas was not a surprise to health officials.

"If there's a surprise, it's that it didn't happen sooner," Todd said, noting that millions of people visit Las Vegas every year.

"Part of the problem with this disease is that the testing (for it) is in its infancy," Todd said.

The new federal law that guarantees medical privacy to patients went into effect on Monday, preventing health officials from releasing more details about the woman with the suspected SARS case.

The rules took years to write and prohibit disclosing patient information without the individual's permission.

Sun assistant metro editor Jean Reid Norman contributed to this story.