Toronto doctor held in isolation in SARS scare

Flu-like symptoms may be an early indication of deadly illness



A Toronto physician who arrived in Iqaluit on Sunday was in self-imposed quarantine at press-time this week because he believed he may have been exposed to the deadly SARS virus.

The physician, believed to be a psychiatrist, began to feel “vaguely unwell,” the day after he arrived, Health Minister Ed Picco said during a media briefing on Tuesday.

“The Government of Nunavut is treating this matter with the utmost of caution. It’s safe to say that we’d rather err on the side of caution,” Picco said.

The doctor had a fever and muscle pains, but none of the defining symptoms of the illness, such as a hacking cough and shortness of breath.

The Toronto health-care facility where he practiced has treated two suspected and one probable case of Severe Acute Respiratory Syndrome, as the illness is technically known. However, the doctor did not treat any of those patients himself.

The doctor’s case is being described as neither “suspected” nor “probable.” Instead, Nunavut health officials are using the term “under investigation.”

Such cases are so remotely connected to SARS they have not been reported in other jurisdictions, though there have been cases under investigation in the Northwest Territories and the Yukon.

“Under the guidelines set out by Health Canada, the situation in Iqaluit would not normally warrant any attention,” Picco said. “However, because of the sensitivity of small and isolated communities here in Nunavut, the health officials are paying close attention to all public concerns.”

On Tuesday morning, the doctor called Dr. Geraldine Osborne, Nunavut’s chief medical officer of health, to report his situation. He was placed in isolation, where he has remained for most of the week.

Health officials declined to identify either the doctor, the Toronto facility, his hotel or apartment building in Iqaluit or where he is being held in isolation. They said, however, that the quarantine facility is not in the Baffin Regional Hospital.

Osborne said that the doctor had seen “very, very few patients.” As Monday was a holiday and he saw no patients from Tuesday on, it is unlikely he could have posed a threat, she added.

Nevertheless, public health staff were following up with anyone in Iqaluit he might have come in contact with.

As there is no diagnostic test for SARS, the doctor was asked to stay in isolation until at least Friday, Osborne said.

“He’s having lots of tests and investigations. If another diagnosis comes up in the next few days, obviously we’ll know then [that it’s not SARS]. If he deteriorates or spikes a temperature, then we’ll know too,” Osborne said on Tuesday.

Transmission similar to TB

Little is known about SARS, but it is believed to be most common among people who have recently travelled to China and other countries in Southeast Asia.

Symptoms generally show up within 10 days of exposure, and there is no known cure or reliable treatment.

The virus is transmitted by direct contact with an infected person, in the same way tuberculosis is transmitted. The difference, Osborne said, is that SARS can live outside the body for about 24 hours, while TB particles will die if they are not immediately transmitted into the body of another person.

The syndrome is most deadly among people with already-weakened immune systems. According to the World Health Organization, it has a mortality rate of about four per cent, which is not high. Between 80 and 90 per cent of patients recover after a few days.

SARS is not necessarily one of the largest threats facing Nunavummiut, Osborne said, despite the amount of media attention it is receiving.

“The threat to Nunavut from other infections is much greater than SARS,” she said.

In Nunavut, for example, it is not uncommon to see a person walking down the street wearing a surgical mask. Such masks are often worn by people who have been exposed to TB.

In Toronto and major cities in China, many people have been wearing the protective masks out of fear that they will catch the disease or because they may have been exposed to it.

Despite the low risk that SARS poses in Nunavut, it has consumed much of Osborne’s attention lately. There are daily teleconferences with Health Canada regarding, among other things, protocols for airplane staff going between Nunavut and southern communities.

Though Nunavut has not changed its procedures for sending medical patients south for treatment, the situation is being reviewed regularly.

Osborne said the events of the past week have been a good test of the system, though some elements, like communicating with the public, still need to be examined.

“I imagine already everybody in town has heard about this,” one health department employee said on Tuesday. “I suspect that by evening about half this town will think they have SARS.”

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