Monday, June 25, 2007

SARS Survivors

 

#933

 

In 2003 SARS erupted out of China, and spread around the world, infecting approximately 8,000 people and killing 800.  Toronto, Canada was one city particularly hard hit.

 

Helen Branswell takes  a look back at the recovery of some of the survivors, and some of the ongoing physical and mental after effects of the illness.

 

 

SARS survivors regain physical health but mental health toll lingers for some

Helen Branswell, Canadian Press
Published: Monday, June 25, 2007

TORONTO (CP) - Many of Toronto's SARS survivors largely regained their physical health within a year after their brush with the new disease, but for some the psychological toll of their illness lingered for months after their recovery, a new study reveals.

 

The authors suggest the finding underscores the need to build psychological support services into any planned response to a major disease outbreak, whether that is a flu pandemic or some other new disease.

 

The study, published in the Archives of Internal Medicine, found that 33 per cent of studied survivors reported a significant decline in their mental health a year out from their recovery.

 

And at that year anniversary point - when the followup formally ended - 17 per cent of patients in the group still had not returned to work.

 

"We saw that the vast majority of people were returning to work, were quite functional and doing quite well," said senior author Dr. Margaret Herridge, a respirologist and critical care physician at Toronto's University Health Network.

 

"There is no question, though, that there was a very small but real minority of patients - most of whom were critically ill - who did have some longer-term physical sequelae (medical consequences) of SARS. A couple of those people I continue to follow."

 

The study evaluated at three, six and 12 months the recovery of 117 of Toronto's 387 probable and suspect SARS cases. More than half the participants in the study - 65 per cent - were health-care workers.

 

Dr. Alan Tallmeister, an anesthesiologist at Toronto's Scarborough Grace Hospital, is one of the lucky ones.

 

(Cont.)

 

All of this may have some bearing on Avian Flu.   Like SARS, avian flu can cause ongoing sequelae, such as permanent lung damage.  We hear surprisingly little about how the roughly 200 survivors of H5N1 are doing. 

 

We do know, based on historical accounts, that many survivors of the Spanish Flu of 1918 had protracted recovery times, and some suffered chronic problems.    

 

In its present incarnation, H5N1 produces a far more serious illness than normal influenza.  That could change if the virus loses some of its virulence, but there is no guarantee that would happen.   In 1918, some patients required a month or longer to recover.

 

Something to keep in mind when employers figure a patient would be `out sick' for a week or two with the flu in a pandemic.