Medical Articles by Dr. Ray - Collection of health news, health articles and useful medical information you can use in everyday life.

Jun

2003

Exercise Saves Lives In Women Over 65

By Ray Schilling | Cancer, Fitness, Health, Heart Disease, Prevention, Stroke, Women’s Diseases

A recent study released in the Journal of the American Medical Association (JAMA Vol. 289 No. 18, May 14, 2003) has found a profound effect of exercise on the survivial of elderly women. Dr. Gregg et al. have followed 9518 women aged 65 or older for a total of 12.5 years with a follow-up visit in between at about the 6 year point. They found that women who exercised (walking, aerobics etc.) and who were compared with a control group who was sedentary (no form of exercise), had the following improved survival rates.

These findings were independent of other factors up to an age of 75 years. In other words, age, smoking, weight and a number of pre-existing diseases did not influence these improved survival figures from the effect of exercise. However, when a woman had a significant chronic disease or was older than 75 years of age, the survival improval from exercise was not as strong as indicated in the table above. Also, the follow-up visits showed that those women who exercised continually, had the highest survival advantage.

Exercise Saves Lives In Women Over 65

The bottom line: increasing and maintaining a physical exercise program will likely lead to a longer life. At the same time the exercise program needs to be started early enough to be of benefit to those who are older than 75 years of age.

Disease and death rate reduction from exercise in women aged 65 and over
Reduction of:	Effect of risk reduction:
overall death rates	48%
cardiovascular disease	36%
cancer	51%

Some of the Associations that were contributing to this important study were: The National Center for Chronic Disease Prevention and Health Promotion (Atlanta, Ga), the Graduate School of Public Health, University of Pittsburgh (Pittsburgh, Pa), the Prevention Sciences Group, Departments of Medicine and Epidemiology and Biostatistics, University of California (San Francisco) and the University of Minnesota and Section of General Internal Medicine, Veterans Affairs Medical Center, Minneapolis.

Here is a fitness link: http://www.nethealthbook.com/articles/fitness.php

Last edited December 9, 2012

May

2003

Allergies, Asthma And Diabetes All Helped By Fish Oil

By Ray Schilling | Allergies, Arthritis, Diabetes, Heart Disease

Cod liver oil was what your grandmother told you to take. It turns out she was right as two studies from Manchester/England and Boston/US have shown. The common denominator are omega-3-fatty acids, which are found in fish oil, cod liver oil, mackerel, salmon and other fish, generally speaking all sea food that feasts on plankton.

1. A prospective study with a cohort of 1100 children from before their birth until their 5th birthday, which will be next year, is being conducted in Manchester/England.

A smaller pilot study with 37 children (4-year-olds from this cohort) was recently analyzed as reported in Denver by Dr. Clare Murray, a pediatric lung specialist from the University of Manchester. The investigators have done detailed diet analyses with the help of the parents. They found that children with severe asthma were taking in a lot less omega-3-fatty acids than a healthy control group. Further analysis showed that the asthmatic group took in a lot of the inflammation provoking omega-6-fatty acids, whereas the control group had a much better balance between these two unsaturated fatty acids. Apparently it is the ratio between omega-6 to omega-3 fatty acids that determines whether the prostaglandin metabolism is switched versus pro-inflammatory (ratio more than 3 to 1) or versus anti-inflammatory (ratio 3 to1 or less). This article can be found in the Medical Post, Vol39, No.17 (page 19), April 29, 2003.

2. Another study is mentioned on the same page of the Medical Post: Dr. Frank Hu from the Harvard School of Public Health is the lead author of a study published in Circulation: Journal of the American Heart Association. 5103 female nurses with established type 2 diabetes have been followed for about 18 years and their medical histories, life styles and eating habits were updated every two years.

Allergies, Asthma And Diabetes All Helped By Fish Oil

In the beginning of the study every patient was free of heart disease and cancer. The big surprise was that eating fish 5 times per week diminished the risk for developing heart disease by 65%. Even the women in the study who ate fish once or twice per week had 40% less heart disease than those who did not eat fish. In addition, fish eaters survived those who were not fish eaters much better (lower mortality). Controls of women without diabetes who ate fish five times per week had also a reduction of heart disease by 35% compared to non fish eating controls. Dr. Hu stated that it is the omega-3 fatty acids in fish that are the active ingredient. They are known to reduce irregular heart beats (arrhythmias) that can lead to sudden death. Omega-3 fatty acids also reduce blood fat levels (triglycerides), clot formation and improve blood vessel function. He also noted that both genders have the same benefit (no difference between male and female), just that the study was done on female nurses.

Comments: For your information the table below shows what foods contain omega-3 and omega-6 fatty acids.

Omega-3 and omega-6 fatty acids in our food
Type of unsaturated fatty acid:	Foods that contain this type of unsaturated fatty acid:
omega-3 fatty acid	flaxseed oil, walnuts, macadamia nuts, fishoil, canola oil, mackerel, salmon, sardines, tuna and most cold water fish
omega-6-fatty acid	corn oil, cotton seed oil, grape seed oil, safflower oil, soybean oil and sunflower oil

In the past 50 years the food industry has changed the ratio of omega-6 to omega-3 fatty acids in many common foods to the point that the ratios are now 12 to 1 and up to 25 to 1. It is cheaper to produce these foods in that manner as they often have a longer shelve life. Read food labels. Inform yourself about omega-3 fatty acids. Take 2 capsules of a high strength, molecularly distilled (to remove PCB’s, mercury and other heavy metals) fish oil once per day and include more fish in your meals. Avoid deep fried foods, as they contain omega-6 fatty acids.

Here are some links explaining this more:

Link about balanced nutrition.

More details about fat and fatty acids.

Last edited October 26, 2014

May

2003

Early SARS Treatment In Hong Kong Reduces Death Rate Dramatically

By Ray Schilling | Infectious Disease, Lung Disease

Dr. Loletta Kit-Ying So from the Pamela Youde Nethersole Eastern Hospital in Hongkong reported on May 10, 2003 in the medical journal The Lancet (Lancet 2003;361:1615-1617) about their experience with early SARS treatment. Key to the success of this group is early recognition and early treatment of SARS. They found that high doses of corticosteroids to control the inflammatory reaction of the airways coupled with the antiviral antibiotic ribavirin has meant a breakthrough in the treatment of SARS. They have treated 50 patients with the new combination protocol.

Medication protocol:

Initially the patient is started on the fluoroquinolone antibiotic levofloxacine 500 mg once per day. This has an immunomodulating effect and keeps the virus at bay. Methylprednisolone at 1 mg per kg of body weight given three times per day is the corticosteroid used for 5 days, the gradually tapered to nothing over 16 days. The virus itself is treated with the antiviral drug ribavirin 400mg three times daily intravenously for three days or until the patient becomes stable, followed by tablets (1200mg twice per day) by mouth.

Outcome:

The good news with this protocol is that 70% of patients have left the hospital and are recovered; 27% are treated and are stable; three patients are mechanically ventilated (on a respirator), but stable. One patient who was an elderly diabetic patient has died of a heart attack.

Early SARS Treatment In Hong Kong Reduces Death Rate Dramatically

There are no major side-effects of the treatment protocol. Some modifications are made with patients who have tuberculosis and with patients who are pregnant.

Here is an overview of SARS with links to the CDC.

Last edited October 26, 2014

May

2003

Blood Clot Dissolving Therapy Saves Lives

By Ray Schilling | Heart Disease, Prevention, Stroke

Clot dissolving therapy (fibrinolytic therapy) has saved many lives when it is applied fast enough with patients who have a heart attack. In younger patients up to age of 65 to 70 years this method was applied without questioning by the treating physicians.

Several studies have shown that elderly patients have more complications such as strokes, where there can be a brain hemorrhage causing another disaster, namely a stroke from a hemorrhage as a side-effect of the clot dissolving medicine. It’s a case of too much of a good thing overthinning the blood. A new study from Sweden, which was published in the Archives of Internal Medicine on April 29, 2003 (Arch Intern Med 2003;163:965-971) showed that elderly patients with a heart attack can also benefit from this clot dissolving therapy. The main investigators, Drs. Ulf Stenestrand and Lars Wallentin, have followed 6,891 patients who have sustained their heart attacks between 1995 and 1999. They were at least 75 years of age and older, but not older than 85 years. Of these patients 3,897 received fibrinolytic therapy and 2,994 did not. Combined survival statistics and statistics of whether or not the patients suffered a stroke as a result of the clot dissolving therapy were recorded over the next year.

There was a drop of 13% of deaths and of strokes in the treatment group when compared to the controls. There were some other ways that the investigators analyzed the data statistically, but the treatment group was always better off.

Blood Clot Dissolving Therapy Saves Lives

The investigators concluded that there is no reason to withhold this clot dissolving treatment from elderly patients as the practice had been up to then. Until randomized studies with more details can be done, they stated, one should treat elderly patients who have acute heart attacks until the age of 85 with clot dissolving treatments.

Here are some links that may be of interest:

This link explains what a heart attack is.

Last edited December 9, 2012

May

2003

Bipolar Disorder In Children And Teens Different From Adults

By Ray Schilling | Mental Health, Prevention

Bipolar disorder used to be called “manic-depressive illness” in the past, now it is termed “bipolar disorder”. It is a multifaceted mental illness where subtle changes in the mix of brain hormones can lead to periods when the patient is euphoric, manic or even psychotic (manic episode), but at other times it seems that someone “pulled the plug”, so to speak, and the patient is depressed, lethargic and perhaps even suicidal.

To complicate matters even further,and this was the subject of a recent seminar at the Child and Health Resource Institute in London/Ontario, symptoms in children and teens are often completely different from symptoms in adults. This can be very misleading to the healthcare workers and the immediate family members. It can also delay the diagnosis and appropriate treatment of bipolar disorder. The Medical Post in its April 1, 2003 edition (page 54) published a review of this topic, based on a presentation by Dr. Margaret Steele at this seminar in London/Ont. Dr. Steele is a child psychiatrist of the University of Western Ontario.

Dr. Steele explained that bipolar disorder is relatively rare in children and adolescents. About 0.5% or less of children in pre-puberty and about 1% of adolescents are affected. But these children/adolescents usually have a family history of either bipolar disorder or depression. 20% of adults with bipolar disease experienced their first episodes of the disease during the teen years.

Bipolar Disorder In Children And Teens Different From Adults

Below is a summary of her findings with regard to depressive symptoms in children/teens when compared to adults in tabular form.

Comparison Of Symptoms Of Depression In Bipolar Disorder Patients Depending On Age
Adult Symptoms:	Symptom Presentation In Children/Teens:
depressed mood	irritability is more common; normally easy-going, but suddenly being oppositional and grouchy
anhedonia (difficulty to think positive and enjoy living)	“I am bored” may be the only comment, retreating into a shell
sleep disturbance, mostly insomnia (problems sleeping)	they may have the opposite, namely hypersomnia (sleeping too much and too long); this may cause problems when they sleep in during the week or they fall asleep in school
appetite disturbance (usually associated with weight loss)	young children fail to grow and gain weight; adolescence may crave junk foods (sugar and starch) and overeat
lethargy	in children a decrease in concentration may only become evident as a decrease in school performance (slipping marks)
psychomotor agitation or retardation	these symptoms are similar in both adults and children, may be evident as pacing, fighting (agitation) and as “laziness”, moving slowly (retardation)
Suicidal thoughts or behavior	similar in adults and children, but could be more concealed at a younger age (see below)
hopelessness	when asked “what do you see in the future?” an answer like “I see nothing at all, I have no goals” could indicate hidden suicidal thoughts
masked depressive symptoms	younger children may have temper tantrums, which would be out of character from their normal behavior; adolescents may “act out”
somatic complaints	adolescents present with headaches and other physical symptoms (e.g. abdominal pain etc.) meaning a “screen of mood” should be done

The other part of the equation of bipolar disorder is mania. Different names are used for this hyperactive state of the mind depending on how severe it is: ‘hypomania’ for the lower end, ‘mania’ for an abnormally elevated and expansive mood lasting for at least 1 week. The most severe form of mania is a ‘manic psychosis’ where the person is “completely out of it” and needs to be hospitalized. Again there are some differences of how a manic episode is expressed in children/teens when compared to adults. Dr. Steele covered this in the seminar mentioned above as well and I have summarized the findings in tabular form again as follows.

Child psychiatrists are most familiar with assessing whether a child or adolescent has bipolar disorder. Apart from symptoms being quite variable as mentioned above, there are also lower-key versions of bipolar disorder.

A milder, scaled down version of a manic episode is called ‘hypomania’ as explained above and when expressed in bipolar disease this can lead to ‘bipolar II disorder’. In 60% of adolescents with bipolar disease a ‘mixed bipolar episode’ can be diagnosed. Typically, in these cases the teenager would have depressive symptoms in the morning (feeling low energy, feeling terrible etc.), but later in the day after school would get revved up having problems winding down at night. Often such behavior is very stressful for the parents, particularly as bipolar disorder is running in families and one of the parents may have established bipolar disorder that is being treated.

The reason for including this overview here is that many parents may recognize some symptoms in their offspring that warrant a closer look by a child psychiatrist. By diagnosing this condition early and treating it, these children and teens can have a normal life and prevent a lot of needless suffering and danger.

Click for links about bipolar disorder , depression and watch for suicide.

Manic symptoms in bipolar disorder patients depending on age
Manic symptoms in adults:	Manic symptoms in children/teens:
inflated self-esteem	elevated, irritable mood; it is beyond being giddy and silly, which many teens normally display; children may say that they are ‘Spiderman’, it can be difficult to separate from normal play, but on further questioning manic children have racing thoughts and hear voices (delusions), which normal children do not have
racing thoughts, often detected in conversation as ‘flight of ideas’	racing thoughts express themselves more as ‘distractibility’; a child might pick up a toy, drop it after a short time and suddely play with something else
pressured speech	increased chattiness
excessive pursuit of activities that are potentially harmful (speeding in car, excessive drinking or drugs, risk taking in the stock market, etc.)	risk taking expressed differently: kids might steal despite never having done this before; manic children may exhibit sexual behavior such as flirtatious behavior, etc.
medical conditions may mimic symptoms of mania (e.g. diabetes out of control)	side-effect of oral corticosteroid therapy for asthma can lead to a psychosis and mimic a manic episode

Click for links about bipolar disorder , depression and suicide prevention.

Last edited October 25, 2014

May

2003

How Dangerous Is West Nile Virus…

By Ray Schilling | Infectious Disease, Prevention

West Nile Virus (WNV) is a flavivirus. Related flaviviruses cause Dengue fever and Yellow fever. The reason WNV has been on the news is that until 1990 the virus has not been observed in North America.

Up to that point it was only known to be present in Africa, India, the Middle East, southern France, the former Soviet Union and Indonesia. But since 1999 WNV has been spotted in dead crows in New York and recently also in Toronto/Ont. It is predicted that in 2003 the virus likely will reach the western parts of Canada. It has been spotted already in Washington late in 2002. It is mainly transmitted between birds and mosquitoes. Humans only get infected with WNV through infected mosquito bites. Only about 1% of all mosquitoes are infected with the WNV in endemic areas. The incubation time is 2 to 15 days after a mosquito bite.

Symptoms:

About 80% of people who get infected with West Nile Virus are without symptoms. About 19% will develop mild flu-like symptoms with muscle aches, a fever and a headache.

There may also be a skin rash and swollen lymph glands. After a week or less the symptoms disappear and the patient has recovered. In 1% of patients the infection can be severe with a high fever, a headache and a stiff neck due to meningitis.

How Dangerous Is West Nile Virus…

Meningitis in this case is from an infection and inflammation of the lining of the spinal cord and brain with the WNV. In some more severe cases the virus can enter the brain tissue and cause a viral encephalitis with a high death rate. People over 50 years of age are particularly susceptible for developing the more severe forms, which often lead to death. Extreme muscle weakness and headaches are usually the presenting symptoms along with a high fever. They may turn unconscious, particularly with encephalitis, may stop breathing and may need to be intubated and put on a ventilator.

Diagnostic tests:

After clinicial suspicion the physician likely will either do a blood test or do a spinal puncture to remove a sample of spinal fluid for specific anti-WNV antibody testing.

Prevention:

The risk is very small as stated above as only 1% of mosquitoes are infected. Prevention consists in steps to prevent mosqitoes from breeding and to prevent them from stinging you. Instal screens on doors and windows.

Stay indoors at dawn, dusk and in the ealry evening. Avoid forested areas during the course of the day. Wear light colored, baggy clothes ( mosquitoes like dark clothes) with long sleeves and long pants. Your lawn should be mowed short to cut down on places for mosquitoes to hide. Still waters such as in clogged gutters, in saucers under plant pots, puddles of water under tarps or in old tires need to be eliminated. Bird feeders need to be flushed out with a garden hose every two to three days to interrupt the mosquito breeding cycle. Use a mosquito repellant with DEET in it (should not contain more than 30% for adults or 10% for children to avoid toxicity). Do not use DEET on children younger than 6 months old.

Treatment:

At the present time there is no treatment other than supportive therapy in hospital for sick patients. Remember that the main breeding cycle in nature for WNV is between birds and mosquitoes. As humans we need to watch that we stay “out of the loop” by following the above preventative measures.

Here are a few useful links regarding West Nile Virus:

Health Canada site on West Nile Virus

CDC site on West Nile Virus (question and answer style)

Last edited December 9, 2012

Apr

2003

Edible Vaccines From Lettuce, Tomatoes And Other Plants

By Ray Schilling | Health, Infectious Disease, Prevention

Can vaccines be taken by mouth (orally)? Yes, we know this from the polio vaccine.

Can vaccines be produced by plants? This does not sound likely, but this is exactly what researchers have already achieved and what they are working on now. A group of researchers under Dr. Robert Rose from the University of Rochester in New York have been working on a number of vaccines with the help of genetic engineering.

The rationale is simple: in developing countries it can be difficult to keep vaccines refrigerated and to administer them by injection in a sterile manner through doctors and nurses. Also, the cost of production can be a major factor with regard to effectiveness of the vaccine on a population basis, if large parts of the community cannot afford the vaccine. For many vaccines to be effective more than 85% of the population have to be vaccinated. Newer research has shown that the protein envelope of a virus, which has a certain surface antigen associated with it, can be broken down into smaller subunits. According to a review article in The Medical Post ( March 4, 2003, page 29) Dr. Rose and his team have isolated the DNA sequence of the human papillomavirus (HPV) envelope in the early 1990’s. They were able to program potatoes to grow the protein subparticles that were immunologically active, but were not infective (no virus activity). In other words after genetic engineering the plant grows a vaccine, which can be safely consumed and the body mounts an immune response to this modified virus protein similar to the polio vaccine, but without a trace of virus.

Edible Vaccines From Lettuce, Tomatoes And Other Plants

As potatoes have to be cooked before consumption, some of the effectiveness of the vaccine gets lost. The researchers have since concentrated on other plants like apples, bananas, tomatoes and lettuce, which are eaten in the raw state. The various diseases that are being tested at the present time are: hepatitis B, respiratory syncytial virus (RSV), Norwalk virus, rotavirus and even the measles vaccine.

Dr. Charles Arntzen from the Arizona State University in Tempe, Arizona, has successfully applied the above technology to the production of plant vaccines against the Norwalk virus, the E.coli enterotoxin and hepatitis B in potatoes and tomatoes. He is taking this a step further as he is developing a technique of freeze-drying tomatoes containing the vaccine against the Norwalk virus, which allows the vaccine to be stored for long periods of time. When it is needed, it can be rehydrated and could also be delivered in pill form to vaccinate the population at risk at the time of an epidemic of enteritis the with Norwalk virus.

In summary, the new plant technology of vaccine production allows for much cheaper vaccine manufacturing. It eliminates the problems surrounding sterile injection techniques. The vaccine delivery by mouth allows for a much simpler distribution to a population at risk and can be done by lay persons. Also, a variety of vaccines will be able to be manufactured this way in future. The plant production is similar to the photocopying process where a template (the specific viral protein subparticle) is being copied by the plant. This allows for a number of vaccines against different strains of viruses to be programmed fairly quickly. It is an exciting new technique.

Here is a link to Influenza, which is one of the viral illnesses that can be significantly suppressed by vaccination.

Here is a link that explains the rationale of vaccinations and vaccination schedules.

Last edited October 25, 2014

Apr

2003

Menopause And Perimenopause In Women

By Ray Schilling | Hormones, Women’s Diseases

In the February 19, 2003, issue of The Journal of the American Medical Association there was an extensive review of the topic of menopause and the time before and after menopause, called “perimenopause”.

The authors, Dr. Lori A. Bastian, from Duke University, and colleagues critically reviewed 1,246 articles on this topic and identified 16 studies that were accepted as being reliable regarding the review of this topic.

They were interested in finding menopause symptoms, signs and blood tests that would be reliable in terms of assessing whether a woman would be approaching menopause or would be in menopause. The result was that no single test or symptom was reliable, but that a number of tests and symptoms in combination were very helpful.

Menopause And Perimenopause In Women

They measured reliability by “likelihood ratios (LRs)”. What this means is that any value above 1.0 is significant, but the higher the number, the more reliable and important is this fact or sign. I summarized the findings in table form below.

Results of a Review Study on Menopause in Women

(modifed according to Feb.19, 2003, issue of The Journal of the American Medical Association)

Findings:

Likelihood ratio (LR):

Comments (by Dr. Ray Schilling):

self assessment of going through the transition

1.83

this is based on the effects of the changing hormones on the woman and how she feels it
is affecting her

symptoms of hot flashes

3.10

lack of estrogen from ovaries leads to a lability of the skin blood vessels with increased skin perfusion as well as stimulation of the sweat glands

night sweats

1.90

sleep pattern is changed and there is a loss of the day / night rhythm of skin perfusion

vaginal dryness

2.64

due to lack of estrogen

high follicle-stimulating
hormone levels

3.06

feedback from estrogen missing, which stimulates the hypothalamus of the brain to produce more
FSH hormone

low inhibin levels

2.05

this is a newer test, which is more specific than the FSH test and also has some importance in fertility work-ups

Self-assessment of perimenopausal status

0.25

this is not a reliable test as it is below 1.0. It was included to show how good the other tests are in comparison

The authors concluded that there is no need for blood tests for menopause diagnosis in a woman, if several points of the first 4 findings are positive (top part of the table).

Here is a link regarding menopause.

Last edited December 9, 2012

Apr

2003

Flu Shots Prevent Heart Disease, Lung Disease, Strokes And Deaths

By Ray Schilling | Heart Disease, Infectious Disease, Lung Disease, Prevention, Stroke

It has been known for some time that flu shots would be beneficial. But it was not known until now whether in larger field studies people who are 65 years or older would benefit significantly and to what degree from yearly influenza vaccinations (“flu shots”).

The April 3rd, 2003 issue of The New England Journal of Medicine published the answer to this question. Dr. Nichol from the University of Minnesota, Minneapolis, and his collegues have followed 140,055 patients of whom 55.5% were vaccinated against the flu in the 1998/1999 flu season.

They also followed 146,328 subjects during the 1999-2000 flu season of whom 59.7% were vaccinated against the flu. Below is a breakdown how they fared when compared to non-immunized controls (see table).

Flu Shots Prevent Heart Disease, Lung Disease, Strokes And Deaths

The examiners of this study concluded that high risk patients (asthma patients, patients with diabetes, cancer, elderly patients, arthritic patients and patients with high blood pressure) should have a yearly Flu vaccination.

Patients after Flu vaccinations. How did they do?

(based on 1998/99 and 1999/2000 flu seasons)

Complications:

Observation:

Comments:

Heart disease:

reduced 19%

this included heart failure and heart attacks

Hospitalization for stroke:

reduced 16% to 23%

often hospitalization for stroke patients can be weeks and months, often resulting in other complications due to bacterial superinfections, falls or clots

Pneumonia and
influenza rate:

reduced
29% to 32%

this can lead to heart attacks and deaths from bacteria in the blood

Death rates:

reduced 48% to 50%

all of the deadly complications from getting the Flu remarkably reduced by Flu shots!

However, in my opinion anybody would benefit from regular Flu vaccinations as this boosts the immune system in general protecting against other infections and colds as well.

Here is a link to a chapter on the flu in Net Health Book.

Last edited October 25, 2014

Apr

2003

SARS (Severe Acute Respiratory Syndrome)

By Ray Schilling | Infectious Disease, Prevention

What is SARS? SARS is a new strain of an acute flu that leads to a high fever, a severe cough and an atypical pneumonia where the inflammation of the lung tissue caused by this new type of virus leads to a severe lung infiltration that can be detected with chest X-rays. Cases similar to SARS have been known to the medical profession for several decades under the name of “atypical viral pneumonia”.

Most viruses lead to a laryngotracheitis, affecting only the lining of the upper airways like the trachea and the voice box. However, SARS is not like this. It is a new strain of virus that goes right down into the lung tissue and leads to more severe breathing problems from secretions that plug the airsacs (alveoli) of the lungs. However, only about 3% to 4% of patients who get SARS actually die as explained in the links below (see CDC and WHO Internet sites). Here is a brief review explaining the evidence in the medical literature that is known at this time (April 2003). Since March 2003 it is known that SARS likely is transmitted by a small virus belonging into the same family of viruses like measles or mumps (the Paramyxoviridiae family of viruses). This WHO link explains this in more detail. However, Dr. Francis Allan Plummer from the National Microbiology Lab in Winnipeg/Canada has isolated a human metapneumo virus in six out of 8 specimens from high suspicion cases for SARS that were submitted to the Lab. It is at present not clear whether there are only one or perhaps two or three similar viruses that may work in concert in tricking the immune system not to mount an immune response in some susceptible persons whereas in the majority of patients the immune system produces enough antibodies to overcome the disease.

SARS (Severe Acute Respiratory Syndrome)

In a publication from the New England Journal of Medicine, which was released one month early on Apr.10,2003, the SARS working group noted that there has been a corona virus isolated from 18 SARS patients who died from this disease 10 to 14 days into it and that this was a new strain of virus, which likely originated from a single ill health care worker from the Guangdong Province in China. These researchers used genetic tests (reverse transcription- polymerized chain reaction), electron microscopic tests of cell cultures with throat swabs from infected SARS patients as well as immunological tests with group specific corona virus antibodies to pinpoint the cause of SARS.

The new name for this virus: Urbani SARS-associated coronavirus in honor of Dr. Carolo Urbani, a WHO investigator who died of SARS himself when he investigated the early epidemic in Asia.

There might be inborn (genetic) weaknesses in some patients. The National Institute of Health is developing a vaccine against the corona virus, which is thought to trigger SARS. At the present time the best therapy is isolation in a hospital for those who are very sick with a possible combination treatment with corticosteroids and antiviral antibiotics, which may be 70% effective in halting the disease. The most important point is prevention of further transmission by isolation procedures (quarantine). Hopefully there will be a vaccine available soon, which could possibly be incorporated into the Flu vaccine.

More information in Dr. Schilling’s Nethealthbook: http://nethealthbook.com/infectious-disease/infectious-disease-infections/severe-acute-respiratory-syndrome/

Here is a link to the official CDC site about SARS

This link brings you to the World Health Organization site (WHO) where SARS is discussed.

Last edited October 25, 2014

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