State: Kaua’i cases weren’t SARS

The state Department of Health has investigated, and come up with a negative diagnosis of two suspected Kaua’i cases of a mysterious and deadly respiratory illness from Asia.

The two cases involve a Kaua’i woman who visited Kowloon in China for about a week in February and a Wilcox Hospital staffer, a woman, who treated the patient upon her return to Kaua’i and became ill.

The Kaua’i cases are of key concern in Hawai’i because worldwide nine people have died and there have been a reported 264 suspected severe acute respiratory syndrome (SARS) cases so far.

Both Kaua’i women had symptoms of SARS including a low-grade fever, respiratory problems and exposure to the illness after Feb. 1, when an outbreak in Hong Kong was believed to have started at a hotel, resulting in 150 suspected cases there.

The Kaua’i women are not suspected of having SARS partly because they both recovered after a short illness, according to Dr. Paul Effler, an epidemiologist with the DOH.

Effler said the two Kaua’i women also were suspected of having SARS only because they had symptoms of the illness as defined by the Centers for Disease Control and Prevention in Atlanta, Ga.

“We don’t have any evidence of any severe respiratory illness related to those suspected cases of SARS, according to the CDC definition,” Dr. Effler said. “(At this point) there is no test we can use to rule (the Kaua’i women) them in or out, so they remain suspected cases.”

As a result of the Kaua’i cases and because of the cases worldwide, the state DOH has begun an active surveillance statewide to find additional suspected cases.

To date, the surveillance of hospitals statewide has yielded no new suspected cases of SARS, Dr. Effler said.

DOH sent advisories to physicians statewide after the World Health Organization announced Feb. 19 that blue flu contributed to deaths in Hong Kong.

DOH launched its surveillance for SARS cases after the WHO and CDC raised concerns about the flu.

On March 16 and March 17, the two organizations released information about SRS and speculated the flu might have originated from southern China and Hong Kong, Dr. Effler said.

In connection with the Kaua’i cases, the female patient had stayed in Kowloon from Feb. 18 to Feb. 25.

Upon her return to Kaua’i on Feb. 25, the woman got sick and was admitted to Wilcox Hospital the following day.

The woman’s doctor, mindful of a DOH advisory to doctors on the bird flu, became concerned her illness might be attributed that flu bug, Dr. Effler said.

The woman didn’t developed pneumonia, recovered and was discharged after a three-day hospital stay, Dr. Effler said.

Based on opinions of medical experts in Hong Kong who studied the characteristics of the bird flu, Effler said it appeared the woman’s case was probably not tied to that flu because the illness is not easily transmitted.

But DOH officials decided to give the case a second look after WHO and CDC officials circulated information suggesting SARS might have originated in southern China and Hong Kong, Dr. Effler said.

“We remembered the woman who had been admitted for bird flue a few weeks ago, and we decided we should look into this individual’s stay in the hospital and people who came in contact with the woman,” Dr. Effler said.

He said a Wilcox Hospital staffer came in contact with the woman, became sick on March 6 and was admitted to the hospital with pneumonia on March 9.

The woman stayed two nights and has “recovered fine and her follow-up medical exams indicate her pneumonia has been resolved,” Dr. Effler said.

He said there is a good chance neither woman contacted SARS, partly because low-grade fevers and minor respiratory problems are common and the symptoms are not indicative a person has succumbed to SARS.

Kaua’i’s two suspected SARS cases are among 11 suspected cases in the United States. Worldwide, there were 264 suspected cases of SARS reported.

For more information about SARS cases, contact the Hawai’i DOH at 1-888-256-2675 (a tow-free number) or go to

Staff writer Lester Chang can be reached at 245-3681 (ext. 225) and


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