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Panel outlines SARS treatments and rehabilitation procedures


A panel of medical researchers and specialist clinicians joined the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong today (May 10) at a press conference to outline advances in treatment protocol and rehabilitation programme for severe acute respiratory syndrome (SARS) patients.

Dr Yeoh was accompanied by Dr Leung Pak-yin, Deputy Director of Health, Dr Yu Wai-cho, Consultant of Medicine and Geriatrics at Princess Margaret Hospital, Dr Loretta Yam, Chief-of-service of Department of Medicine at Pamela Youde Eastern Hospital, Dr Chan Kin-sang, Chief-of-service, Pulmonary and Palliative Care Unit at Haven of Hope Hospital, Professor Yuen Kwok-yung of the Department of Microbiology at the University of Hong Kong, and Professor Joseph Sung of the Faculty of Medicine at the Chinese University of Hong Kong.

The experts described a particular facet of research or treatment that helped the public understand how SARS affects the body and which treatments were most effective.

Summarising the experts' statements, Dr Yeoh said it had been recently established through research done in Hong Kong that SARS passed through three phases, each lasting about a week. This new knowledge is enabling our specialist clinicians to adjust our current treatment with different medicines to correspond better to the phases of illness.

Of the patients who responded to treatment, about 10 per cent needed further rehabilitation and a pulmonary rehabilitation programme would be launched at the Tung Wah Group of Hospitals Wong Tai Sin Hospital to help them.

Professor Sung said studies had shown that patients passed through a viral replicative phase, when the SARS virus multiplied rapidly in the body, an immune hyperactive phase, when the body's defences attacked the virus, and a pulmonary-destructive phase, when the lungs were severely damaged and patients needed extra help.

Experience and studies had found that the initial procedure of giving patients large doses of Ribavirin and steroids early in the cycle could be modified.

During the first phase, patients were given an anti-viral agent such as Ribavirin and another drug, Kaletra which has been found to be active in laboratory experiment in inhibiting growth of coronavirus.

As the second phase began, steroids were added to help soften the body's immune response and limit lung damage from the eighth day to the 21st day while the anti-viral agent was discontinued after 14 days.

Dr Yeoh said this adjustment of the previous treatment, where Ribavirin and steroids were given together very early in the cycle, was being made in the light of new findings that had arisen during the SARS epidemic.

It had been shown that there was no great difference in the result if steroids were held off until the second phase, but the patient could potentially benefit from receiving a lower overall dose.

Dr Chan described the rehabilitation procedures being devised for the 10 per cent of recovered SARS patients who suffered shortness of breath and were unable to resume their previous activities.

He said training in breathing techniques and exercises tailored to fit the individual's work and lifestyle could restore proper lung function, even when some damage persisted.

As well as the physical effects, some former patients experienced a post-disease psychological trauma and this also had to be treated, he said.

At the session, it was announced that seven new patients were admitted to hospital with SARS up to 1 pm today, bringing the cumulative total to 1,674, while 20 were discharged, meaning that 1,035 patients have recovered from the disease and been discharged. Another 89 have recovered and are still convalescing in hospital

Two people died, a man aged 79 and a woman aged 73, both of whom had a history of chronic disease. They brought the death toll to 212.

End/Saturday, May 10, 2003


Floor/ Cantonese/ Putonghua/ English

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