Beware! The virus is-a-changin'

MUMBAI: Just when the reportage about Sars (Severe Acute Respiratory Syndrome) seemed to be getting bleaker, the World Health Organisation dished out some encouraging tidbits.
The agency said on Friday that India was Sars-free, but added the somewhat baffling caveat that the 20 cases that had tested positive were Sars-infected. With fewer cases being reported every day, WHO officials also said the epidemic that launched a thousand puns in headlines may have peaked in hot spots such as Hong Kong, Singapore and Canada.
This leaves only China and Taiwan with a large number of newly reported cases.(Since first emerging in China in November, Sars has infected more than 6,000 people and killed over 400 in close to 30 countries and territories.) “One small whoosh, but still not a giant phew for Indiankind,’’ is how Dr Rohini Chowgule, secretary of the Indian Chest Society, reacted to the WHO’s clean chit. A consulting chest physician at Bombay Hospital, Dr Chowgule warned against relaxing vigilance because “a single case could still cause awful havoc in a country like India, with its overburdened health infrastructure and large undernourished population’’.
She cited cases of Sars patients in Hong Kong who appeared to have recovered but were actually late in suffering the worst effects of the disease. Many cases have also been reported of recovered patients who may still have a live virus in their bodies when they were discharged from hospital. “Both phenomena underline how little known about the later stage of the disease and how this could create problems in controlling its spread,’’ said Dr Rajiv Mathur, consulting chest physician at Jaslok and Lilavati hospitals.
Experts say the dozen or cases of relapses raise a vexatious public health issue, because even one of these discharged patients could conceivably rekindle a fresh outbreak he or she moves around in the community while still infectious.
WHO authorities clarified that they did not consider laboratory tests to be the sole criterion for exclusion or inclusion of Sars cases. The diagnosis had to backed by clinical and epidemiological evidence. By that token, none of the Indian cases has had Sars, except the solitary patient from Goa, discharged from the hospital after he had “recovered’’.
One reason India has had mild cases may be the higher immunity of a local population that has traditionally been exposed low hygiene and sanitary conditions, along with natural viral infections, said Pramod Niphadkar, honorary secretary the Asthma and Bronchitis Association India.