Shiloh
Editor, Senior Moderator
Source: http://torontosun.com/News/World/2008/02/26/4876940-sun.html
Tue, February 26, 2008
A Hong Kong hotel that gripped the world
Tracing the roots of the SARS crisis as we wait for the next outbreak of disease
By SHARON LEM, SUN MEDIA
HONG KONG -- Riding down the elevator to the ninth floor from the hotel's rooftop swimming pool, an Australian family of four coming back from a swim is oblivious to the fact that they're staying at ground zero in a health-care crisis that would rock Asia.
This is where the Severe Acute Respiratory Syndrome (SARS) outbreak began.
The couple's children are giggling about the fun they had swimming and ask their dad where they're going for dinner. The hotel lobby of the former Metropole Hotel is bustling with guests checking in by the busloads.
Arriving on the ninth floor, the dim hallways are lined with dark wood-panelled walls. Halfway down the corridor is Room 911. From here, it would only take one infected person to carry the virus back to Canada, creating an unprecedented crisis in Toronto.
It has only been five years since the virus disrupted the Canadian health-care system. Since then, Hong Kong hotels are full again and the economy has been remarkably robust.
In Toronto, tourism hasn't come back to pre-SARS levels, but the economy is on a roll.
Health authorities on both continents warn it's only a matter of time when another such virus becomes airborne. The lessons of SARS are more prevalent than ever. In an era of global travel, public health can be a fragile beast.
At the Metropole Hotel, now known as the Metropark Hotel after the negative publicity that ensued, the room number 911 no longer exists and has been changed to Room 913.
When a house cleaner is asked what happened to Room 911, he shakes his head and mumbles it was because of SARS.
The SARS epidemic originated in China when a farmer with it fell ill and died in November 2002. China failed to report the illness to the World Health Organization until February 2003.
Dr. Malik Peiris, chair of the department of microbiology at the University of Hong Kong, said he first heard of SARS in December 2002 and had started investigating all pneumonia patients in intensive care by February.
"The problem was there is no way of knowing if it was a new pneumonia. It takes a lot of time and effort -- it was like looking for a needle in a haystack," Peiris said. "It was a huge pressure, not just to the world health-care workers and colleagues were getting sick."
But when a medical professor from China checked into Room 911 the Metropole Hotel in February 2003 to attend a wedding, he had no inkling he was creating a global health crisis.
SPREADS EASILY
The potency of the virus is such that it took the simplest of incubators to spread the disease: The professor is thought to have shared an elevator with six other guests, who visited the ninth floor.
"We looked for something unusual," said Peiris. "One patient was from China and one from Hong Kong, but he was from the Metropole Hotel.
"At that time, Metropole wasn't known as the source. We were working in the dark."
On the other side of the world, Canadians were also working in the dark.
In a chilling series of coincidences worthy of a Hollywood thriller, the professor would infect Siu Chu Kwan, a 78-year-old grandmother from Canada.
Kwan flew home to Toronto carrying the airborne infectious disease and became patient zero in Toronto upon her return on Feb. 23, 2003. Before dying, she infected her son and husband. Her son, in turn, infected two other men in nearby hospital beds. A chain of infections involved relatives and church members who visited the emergency ward. It spread like wildfire, infecting a total of 387 people in the Greater Toronto Area and killing 44 from Feb. 23 to June 7, 2003.
Meanwhile, Canadian Dr. Lap Chee Tsui, former head of genetics at Toronto's Hospital for Sick Children and University of Toronto professor of molecular genetics, had just moved to Hong Kong five months before SARS hit to become the University of Hong Kong's vice-chancellor. Being trained in microbiology, he knew a lot about infectious diseases.
Tsui mobilized the medical faculty at the University of Hong Kong to battle the SARS outbreak. Tsui said his team became the first in the world to identify the cornavirus SARS. Subsequently, their research helped to contain the outbreak in Hong Kong and the techniques were adopted worldwide.
HAD A FEVER
"I remember one of the SARS patients had a fever and we were thinking of how to detect SARS in people. I had general knowledge of SARS and I thought if we could use an infrared camera, we could see who had a fever. It's not rocket science and the theory worked," Tsui said.
The first phase in Hong Kong started at the Prince of Wales Hospital, where more than 100 medical staff and personnel were infected by the initial outbreak at the Metropole Hotel-- including the 78-year-old grandmother who would bring it to Toronto.
The second phase swept through Amoy Gardens, a Hong Kong apartment building complex of 15,000 residents, due to defects in the sewage system.
Patient zero at Amoy Gardens was a 33-year-old man from China visiting his brother who lived at Unit 7 on Floor 16 of Block E. He had diarrhea and used the toilets there, and subsequently infected his brother and sister-in-law with SARS along with 326 other residents at Amoy Gardens, killing 42.
The virus spread at Amoy Gardens because toilet U-traps were not functioning properly. Water droplets containing the virus were located on these U-traps - which are typically used to prevent sewer gases from entering the home. A faulty flush water system helped spread the disease.
"We were overwhelmed with hundreds of specimens every day. This was a huge excess workload. It was very difficult to keep track of results and difficult to relate results back to the clinicians to make a big picture and put all these together to see what is true and what is not true. We were looking up and tracking of a huge amount of information without resources," Peiris said,
By moving the entire block of residents to an isolation camp, the outbreak was contained. The government has since promoted environmental and personal hygiene.
Once again, it was the Canadian Dr. Tsui who was instrumental in figuring out how residents got infected at Amoy Gardens. But it wasn't his scientific expertise that solved the riddle - it was his part-time job as a plumber.
"I did repair plumbing back in North America as an odd job," said Dr. Tsui. "I know how these toilet plumbing things work and using my knowledge, I thought this would be a probability ... so I looked at the U-traps and the spread of SARS."
Canada was the only country outside Asia to have people die from SARS, which knows no international boundaries. Scientists at the World Health Organization say that most of the 8,422 SARS cases -- including 916 deaths in 29 countries worldwide, except in China -- spread directly from the Metropole Hotel via international flights in February 2003.
Here in Hong Kong, 1,755 became ill with SARS and 299 died in a population of 6.7 million. Hong Kong was the hardest hit by the disease, especially with its dense population and proximity to China with 300,000 people crossing the border each day.
But the international spotlight on SARS in Toronto shone a light on the fact that it only takes one person to disrupt a system.
While science still hasn't caught up to the super bug, it's important to remember the people who are working on the front lines to keep ahead of the game. The heroes are not just in Afghanistan or Iraq, but in scientists such as Tsui and Peiris who put their lives on the line when dealing with infectious diseases - and the coming of the next, inevitable outbreak.
Tue, February 26, 2008
A Hong Kong hotel that gripped the world
Tracing the roots of the SARS crisis as we wait for the next outbreak of disease
By SHARON LEM, SUN MEDIA
HONG KONG -- Riding down the elevator to the ninth floor from the hotel's rooftop swimming pool, an Australian family of four coming back from a swim is oblivious to the fact that they're staying at ground zero in a health-care crisis that would rock Asia.
This is where the Severe Acute Respiratory Syndrome (SARS) outbreak began.
The couple's children are giggling about the fun they had swimming and ask their dad where they're going for dinner. The hotel lobby of the former Metropole Hotel is bustling with guests checking in by the busloads.
Arriving on the ninth floor, the dim hallways are lined with dark wood-panelled walls. Halfway down the corridor is Room 911. From here, it would only take one infected person to carry the virus back to Canada, creating an unprecedented crisis in Toronto.
It has only been five years since the virus disrupted the Canadian health-care system. Since then, Hong Kong hotels are full again and the economy has been remarkably robust.
In Toronto, tourism hasn't come back to pre-SARS levels, but the economy is on a roll.
Health authorities on both continents warn it's only a matter of time when another such virus becomes airborne. The lessons of SARS are more prevalent than ever. In an era of global travel, public health can be a fragile beast.
At the Metropole Hotel, now known as the Metropark Hotel after the negative publicity that ensued, the room number 911 no longer exists and has been changed to Room 913.
When a house cleaner is asked what happened to Room 911, he shakes his head and mumbles it was because of SARS.
The SARS epidemic originated in China when a farmer with it fell ill and died in November 2002. China failed to report the illness to the World Health Organization until February 2003.
Dr. Malik Peiris, chair of the department of microbiology at the University of Hong Kong, said he first heard of SARS in December 2002 and had started investigating all pneumonia patients in intensive care by February.
"The problem was there is no way of knowing if it was a new pneumonia. It takes a lot of time and effort -- it was like looking for a needle in a haystack," Peiris said. "It was a huge pressure, not just to the world health-care workers and colleagues were getting sick."
But when a medical professor from China checked into Room 911 the Metropole Hotel in February 2003 to attend a wedding, he had no inkling he was creating a global health crisis.
SPREADS EASILY
The potency of the virus is such that it took the simplest of incubators to spread the disease: The professor is thought to have shared an elevator with six other guests, who visited the ninth floor.
"We looked for something unusual," said Peiris. "One patient was from China and one from Hong Kong, but he was from the Metropole Hotel.
"At that time, Metropole wasn't known as the source. We were working in the dark."
On the other side of the world, Canadians were also working in the dark.
In a chilling series of coincidences worthy of a Hollywood thriller, the professor would infect Siu Chu Kwan, a 78-year-old grandmother from Canada.
Kwan flew home to Toronto carrying the airborne infectious disease and became patient zero in Toronto upon her return on Feb. 23, 2003. Before dying, she infected her son and husband. Her son, in turn, infected two other men in nearby hospital beds. A chain of infections involved relatives and church members who visited the emergency ward. It spread like wildfire, infecting a total of 387 people in the Greater Toronto Area and killing 44 from Feb. 23 to June 7, 2003.
Meanwhile, Canadian Dr. Lap Chee Tsui, former head of genetics at Toronto's Hospital for Sick Children and University of Toronto professor of molecular genetics, had just moved to Hong Kong five months before SARS hit to become the University of Hong Kong's vice-chancellor. Being trained in microbiology, he knew a lot about infectious diseases.
Tsui mobilized the medical faculty at the University of Hong Kong to battle the SARS outbreak. Tsui said his team became the first in the world to identify the cornavirus SARS. Subsequently, their research helped to contain the outbreak in Hong Kong and the techniques were adopted worldwide.
HAD A FEVER
"I remember one of the SARS patients had a fever and we were thinking of how to detect SARS in people. I had general knowledge of SARS and I thought if we could use an infrared camera, we could see who had a fever. It's not rocket science and the theory worked," Tsui said.
The first phase in Hong Kong started at the Prince of Wales Hospital, where more than 100 medical staff and personnel were infected by the initial outbreak at the Metropole Hotel-- including the 78-year-old grandmother who would bring it to Toronto.
The second phase swept through Amoy Gardens, a Hong Kong apartment building complex of 15,000 residents, due to defects in the sewage system.
Patient zero at Amoy Gardens was a 33-year-old man from China visiting his brother who lived at Unit 7 on Floor 16 of Block E. He had diarrhea and used the toilets there, and subsequently infected his brother and sister-in-law with SARS along with 326 other residents at Amoy Gardens, killing 42.
The virus spread at Amoy Gardens because toilet U-traps were not functioning properly. Water droplets containing the virus were located on these U-traps - which are typically used to prevent sewer gases from entering the home. A faulty flush water system helped spread the disease.
"We were overwhelmed with hundreds of specimens every day. This was a huge excess workload. It was very difficult to keep track of results and difficult to relate results back to the clinicians to make a big picture and put all these together to see what is true and what is not true. We were looking up and tracking of a huge amount of information without resources," Peiris said,
By moving the entire block of residents to an isolation camp, the outbreak was contained. The government has since promoted environmental and personal hygiene.
Once again, it was the Canadian Dr. Tsui who was instrumental in figuring out how residents got infected at Amoy Gardens. But it wasn't his scientific expertise that solved the riddle - it was his part-time job as a plumber.
"I did repair plumbing back in North America as an odd job," said Dr. Tsui. "I know how these toilet plumbing things work and using my knowledge, I thought this would be a probability ... so I looked at the U-traps and the spread of SARS."
Canada was the only country outside Asia to have people die from SARS, which knows no international boundaries. Scientists at the World Health Organization say that most of the 8,422 SARS cases -- including 916 deaths in 29 countries worldwide, except in China -- spread directly from the Metropole Hotel via international flights in February 2003.
Here in Hong Kong, 1,755 became ill with SARS and 299 died in a population of 6.7 million. Hong Kong was the hardest hit by the disease, especially with its dense population and proximity to China with 300,000 people crossing the border each day.
But the international spotlight on SARS in Toronto shone a light on the fact that it only takes one person to disrupt a system.
While science still hasn't caught up to the super bug, it's important to remember the people who are working on the front lines to keep ahead of the game. The heroes are not just in Afghanistan or Iraq, but in scientists such as Tsui and Peiris who put their lives on the line when dealing with infectious diseases - and the coming of the next, inevitable outbreak.