Published: Monday, June 25, 2007 | 6:43 PM ET
Canadian Press: HELEN BRANSWELL
TORONTO (CP) - Many of Toronto's SARS survivors largely regained their physical health within a year after their brush with the new disease, but for some the psychological toll of their illness lingered for months after their recovery, a new study reveals.
The authors suggest the finding underscores the need to build psychological support services into any planned response to a major disease outbreak, whether that is a flu pandemic or some other new disease.
The study, published in the Archives of Internal Medicine, found that 33 per cent of studied survivors reported a significant decline in their mental health a year out from their recovery.And at that year anniversary point - when the followup formally ended - 17 per cent of patients in the group still had not returned to work.
"We saw that the vast majority of people were returning to work, were quite functional and doing quite well," said senior author Dr. Margaret Herridge, a respirologist and critical care physician at Toronto's University Health Network.
"There is no question, though, that there was a very small but real minority of patients - most of whom were critically ill - who did have some longer-term physical sequelae (medical consequences) of SARS. A couple of those people I continue to follow."
The study evaluated at three, six and 12 months the recovery of 117 of Toronto's 387 probable and suspect SARS cases. More than half the participants in the study - 65 per cent - were health-care workers.
Dr. Alan Tallmeister, an anesthesiologist at Toronto's Scarborough Grace Hospital, is one of the lucky ones.
An exercise buff, Tallmeister recovered to the point where his times - whether swimming laps or on a rowing machine - were as good as they were before his brush with severe acute respiratory syndrome.
"As far as I'm concerned, now I just added it to my past repertoire of viral illnesses like mumps, measles, chickenpox when I was a kid," he said Monday.
Like many SARS victims, Tallmeister saw the disease spread in his household. His daughter, who was 15 when SARS hit Toronto in March 2003, caught the disease from him. She too has made a full recovery.
But for others, the impact of SARS lingers, in the lungs and in the psyche.
At the one-year mark, 18 per cent of the survivors still had a significant reduction in the distance they were able to walk in a six-minute period. And a small number of the cases - the people who were most severely ill - sustained lung damage that plagues them still.
"But we do have a couple of people who have significant lung disease that will be irreversible," said Herridge, who still treats some of these patients.
Vicki McKenna, first vice-president of the Ontario Nurses Association, said some nurses remain off the job because of the emotional trauma they experienced.
"They have anxiety disorders such as panic attacks. It's a general feeling that they have even just driving by a hospital. They have an overwhelming sense of panic and fear," she said.
The study noted that some of these patients were heavy users of mental health services during their recovery period; 51 required 668 visits to psychiatrists or psychologists.
There were 387 SARS patients in the Toronto area during the outbreak, which lasted from March to July of 2003.
One side-effect Toronto SARS patients seem to have avoided is the bone loss experienced by some SARS patients in China and Hong Kong, where in the early days of the outbreak heavy doses of corticosteroids were used in a desperate bid to try to treat the then unknown disease.
"By the time SARS got to North America we were tending to use much more modest doses of corticosteroids, because we had learned from the Chinese physicians' experience," Herridge said.
