National 8 (Spotlight Weekly)

Growing Concern

With the growing mobility of the people, Nepal cannot be immune to an outbreak of the latest killer disease

By KESHAB POUDEL

After hundreds of patients abroad were infected by a new case of respiratory illness, a sense of panic has gripped employees of hospitals and nursing homes in the capital. Although there are large numbers of people infected with other kinds of respiratory illnesses in health-care institutions of the country, no patient has been admitted with a case of what international experts have tentatively named Severe Acute Respiratory Syndrome (SARS).

Although the World Health Organization (WHO) has issued a global alert about the cases of SARS, the Nepalese government, which is more concerned with opening formal peace talks with the Maoist rebels, is yet to come up with a preparedness plan.

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Kathmandu has four flights a week from Hong Kong and there is large-scale mobility between people. Nepal is also connected to the Chinese city of Shanghai and other East Asian destinations. There is every possibility of the virus entering Nepal, which has already killed about 50 people in various parts of world.

International records show more than 1, 500 cases of SARS, and 54 deaths. The disease, which was first detected in East Asia, has spread to other regions of the world.

According to a WHO press release, since mid-February the organization has been actively working to confirm reports of outbreaks of SARS in Vietnam, Hong Kong Special Administrative Region (SAR) of China and Guangdong Province on the mainland.

The Nepalese government has not reported any case of such infection. "No cases of such pneumonia virus are reported in various hospitals," said a senior official at the Ministry of Health.

The WHO reveals that the signs and symptoms of SARS in Hanoi include initial flu-like illness (rapid onset of high fever followed by muscle aches, headache and sore throat). These are the most common symptoms. According to the WHO, early laboratory findings may include thrombocytopenia (low platelet count) and leucopenia (low white blood cell count).

In some, but not all cases, this is followed by bilateral pneumonia, in some cases progressing to acute respiratory distress requiring assisted breathing on a respirator. Some patients are recovering but some patients remain critically ill.

"The government must formulate immediate action plans to prevent infections. At a time when countries like China, Hong Kong SAR, Canada and Singapore are facing the challenges in containing the virus, an outbreak in Nepal would cost many lives," said a public health expert.

One of the complications of the disease is that it easily infects hospital staff and health-care workers. In Hong Kong, the disease has infected more than 50 health care workers.

In mid-February, the government of China reported that 305 cases of typical pneumonia, with five deaths, had occurred in Guangdong province. According to the WHO reports, those at highest risk appear to be staff caring for the patients.

"We are constant touch with the World Health Organization and making every possibility to prevent any outbreak. The hospital authorities in various parts of the country have already informed about the possibility of out break," said a senior official at the ministry.

As the country does not have resources to cope with the existing situation, an outbreak of SARS would be unmanageable for hospitals.