District health officials and doctors at the World Bank, faced with an influx this weekend of 2,700 delegates from around the world, have adopted a rapid-response plan to handle any visitors who report symptoms of the new respiratory illness spreading across Asia.
Delegates at the bank's spring meeting who show early evidence of severe acute respiratory syndrome will be placed in isolation either in their hotel rooms or at residences owned by the bank, doctors said.
Virginia health officials, meanwhile, reported two new suspected SARS cases in Northern Virginia, bringing the statewide total to six. No cases have been reported in the District or Maryland.
The vast majority of SARS patients experience a minor illness. The few who become critically ill and need breathing assistance are hospitalized, doctors say.
D.C. health authorities are most concerned about the 50 to 100 World Bank delegates coming from China, Hong Kong, Singapore and Vietnam, the countries with the largest outbreaks of SARS. Delegates from those countries were asked to stay home if they exhibited any flu-like symptoms, such as headache, fever, muscle ache, cough and shortness of breath.
District hotels have been notified that delegates with suspicious symptoms should be referred to nearby George Washington University Hospital, which has been designated by the city to handle all such cases, said the District's senior medical officer, Michael S.A. Richardson.
The disease is spread when someone with SARS coughs or sneezes and someone else breathes in the airborne droplets. Richardson said local residents and visitors should not be anxious.
"All precautions possible have been taken to ensure the delegates' safety and to protect them," he said. "We would never ban them from coming . . . Everyone realizes that, just like any other disease, we have to make sure that everything is in place to diagnose and treat people and not stigmatize them purely because of where they are coming from."
Still, fears about the disease have rattled many workers at the World Bank and the International Monetary Fund's downtown headquarters.
"Fretful World Bank staff have kept up a steady stream of e-mails about the virus, including a recent exchange about whether laptops, some of which visit Asia, should be sprayed with antibiotics," said one employee who asked not to be identified. "The answer from managers who conferred with doctors is no."
SARS is believed to be caused by a virus, and antibiotics have no effect on it.
Richardson and World Bank medical director Bernard Demure agreed that patients with suspicious symptoms would be evaluated on-site by World Bank doctors, who would find out where the patient had traveled recently and take X-rays if necessary.
Then the bank doctor would consult emergency physicians at George Washington, who would decide whether to send the patient into monitored isolation or bring the visitor to the emergency room. Any such patient would be given a surgical mask immediately and whisked into an isolation room to prevent the spread of pathogens, said the hospital's emergency department chairman, Robert Shesser.
A delegate suspected of having SARS will be housed in isolation until 10 days after the symptoms have disappeared, Demure said.
Of the two new Northern Virginia SARS patients, one was hospitalized in Fairfax County and the other was treated elsewhere in the region, said experts familiar with the cases. Both are now isolated at home. One of the patients had traveled recently to Beijing, and the other was in Shanghai, according to Lucy Caldwell, a Virginia Department of Health spokeswoman.
Of the 2,781 people worldwide who have been diagnosed with SARS, 111 have died, a death rate of about 4 percent, according to the World Health Organization.
Staff writer Michael Laris contributed to this report.