An April 15 Health article incorrectly identified where a woman was examined for signs of severe acute respiratory syndrome. It was at Georgetown University Hospital's emergency room. (Published 4/22/03)
Two weeks ago, a woman arrived at the Georgetown University Medical Center emergency room stricken with anxiety, says assistant professor of emergency medicine Eric Glasser.
Her Vietnamese hairdresser had coughed on her, the woman explained, and she had come to be examined to see if she might have contracted SARS -- severe acute respiratory syndrome, which is believed to have infected more than 2,000 people worldwide since February and killed more than 100.
Had the hairdresser been to Vietnam lately? Glasser asked. The woman didn't know.
Glasser called the hairdresser, learned she hadn't been to her homeland in quite some time and sent the nervous patient home.
That woman is not the only Washington area resident to bring fears about the fast-spreading global malady to local doctors, emergency rooms and clinics. SARS is in the air, after all -- or at least it could be -- and some people feel a need to know that they don't have it.
They are inevitably told that unless they have recently been to Hong Kong, parts of China or one of several other hot zones in Asia and one in Canada, or had close contact with someone who has, the likelihood their fevers or coughs are SARS is extremely remote.
Loudoun Hospital Center, which in February treated a woman suspected of having SARS, is seeing at least one patient a day who fears he or she has contracted the illness, says hospital spokesman Roger A. Raker. That's up from up from one or two patients a week in March.
So far, says Raker, each has been SARS-free, noting that the patient who was seen for SARS in February has recovered and has apparently not spread the virus.
Emergency rooms around the area have prepared for patients who arrive with symptoms or fears of the disease, with baskets of surgical masks and typed notices taped to walls: "If you have had a fever, a cough and difficulty breathing, please put on a mask before approaching the admissions desk."
Silver Spring internist Smith Ho, who serves a largely Asian clientele, says he has been bombarded with patients worried that they have SARS. His patients have more reason to be concerned than most. Several each day arrive in his office after visits to affected areas like Hong Kong, Vietnam and Thailand, he says. With seasonal influenza going around now and bringing on some symptoms similar to those of SARS, he says, the concern grows.
So far, though, Ho has seen no cases of SARS. Mostly, he tries to calm his patients, telling them that, in addition to a cough and a fever higher than 100.4 degrees, SARS is marked by a distinct shortness of breath. None of his patients have had that.
Other Washington area doctors report hearing from patients who aren't sick and haven't traveled to Asia or Canada, but nevertheless fear they may have been exposed to SARS.
"We've had several calls from people saying they've come in contact with someone who just came in contact with someone who may have come in contact with someone who just came from China," said Mary E. Schmidt, an infectious disease specialist in Fairfax.
"And a lot of people call thinking if they've just come in contact with someone that had a cough or cold, they could get it," Schmidt added. "We just try to calm them down."
That said, Schmidt acknowledges there's a fine line between not overreacting to signs of cold or flu and failing to report symptoms that might actually be SARS. While aware of the potential for panic among the public, she said, the need for disease containment makes it critical that anyone who is experiencing fever and flu-like symptoms with a shortness of breath seek prompt medical attention if they have been to a SARS hot zone or come in contact with anyone who has.
Meantime, some physicians are getting calls from patients asking if they should cancel their trips to the Far East. Based on a warning from the World Health Organization (WHO) against travel to the most heavily affected areas and similar advice from the U.S. Centers for Disease Control and Prevention (CDC), doctors are saying: Yes, cancel.
"I tell them: 'The World Health Organization and the CDC say don't go, so don't,' " says Martin Wolfe, a tropical medicine physician in the District. "But if they really must, I tell them to wear a face mask and stay away from crowded areas."
"I tell them that unless it's really urgent, I wouldn't bother -- better safe than sorry," adds Washington internist Alan Pocinki.
For those calling to express worry about the illness, Pocinki says he tries to quell their fears by emphasizing that the vast majority of people suspected to have gotten SARS have recovered, including all those treated in the United States; 4 percent of those stricken worldwide have died.
Context is key, agrees Dan Hanfling, director of emergency and disaster management for the Fairfax-based Inova Health System.
"It's easy to focus on SARS because we didn't know about it a month ago," said Hanfling. "But you have to have perspective. Influenza kills 36,000 people in this country every year. SARS hasn't killed anyone in the U.S. We want to be vigilant, but we don't want to be alarmist."
Still, Inova is playing it safe. Anyone coming to the system's hospitals exhibiting any SARS symptoms gets covered with a mask and escorted right into an isolation room for evaluation.
So far , the virus has infected 2,890 people, killing 109 in 17 countries, mostly in Hong Kong and the Guangdong region of China, Singapore, Hanoi and Toronto, according to the WHO. In the United States, 166 people in 30 states are suspected of having SARS. Most of the U.S. cases have been seen in California (37) and New York (21), with two in Virginia. The woman treated at Loudoun Hospital Center was considered the first suspected case in the United States, said Raker.
With people coming and going from far-flung cities to Washington on a daily basis, doctors here are wondering why SARS hasn't hit our area.
"I'm so very, very surprised we haven't seen it in Washington," said Margaret Barron, director of Providence Hospital's emergency department. "We are all just amazed there haven't been any cases, given the amount of travel that people are involved in."
Barron was part of a phone chain among Washington area hospitals the day the WHO issued its travel warning. On that day, April 2, local hospitals urged each other to put out the masks and the signs, warning patients and health care workers alike that they'd better cover up if anyone arrived with a mysterious cough, fever and shortness of breath, said Barron.
And while the CDC toils away on researching the virus that is believed to be responsible for SARS and developing tests to diagnose it conclusively, doctors here are just pleased the area has been SARS-free.
Says Joseph Timpone, assistant professor of medicine in Georgetown's division of infectious diseases: "For now, D.C. has dodged a bullet."
Suz Redfearn, a frequent contributor to Health, last wrote about hormone therapy.