NZ readies to fight killer pneumonia

By ANGELA GREGORY, health reporter

An Auckland patient showing signs of the infectious disease that has killed people overseas has prompted an urgent revision of safety procedures at the city's hospitals.

Health services, airlines and airports are on heightened alert to deal with suspected cases of the killer pneumonia that authorities fear will reach New Zealand shores.

The severe acute respiratory syndrome (Sars) has killed nine people and infected hundreds of others in Canada, Indonesia, China, Hong Kong, the Philippines, Singapore, Taiwan and Vietnam.

An Auckland District Health Board spokeswoman said the admission of a patient to Auckland Hospital on Monday night with atypical pneumonia caused concern as he met the clinical symptom criteria described in the overseas outbreaks.

He had also been overseas recently, but it was later found that he did not fit the case definition because he had not travelled in areas where Sars cases had been confirmed.

The scare prompted the board to hold high-level planning meetings yesterday to develop its response to suspected cases of Sars, particularly as Auckland is an international gateway city.

The chief medical officer, Dr David Sage, said dozens of cases of atypical pneumonia were seen at the hospital each month.

"But clinical staff were right to take a cautious approach in light of the current Sars outbreak," he said.

Auckland Hospital intensive care specialist Tony Smith said it was not uncommon for people to die of viral pneumonia in New Zealand.

Dr Smith said about half the pneumonia cases he saw were atypical.

"Some people no longer use the term ... Atypical virus pneumonia are common, and it is not uncommon for them to be fatal."

Dr Smith suspected the pneumonia from south China was caused by a virus, not bacteria, because of the way it was behaving and there were few treatments for viruses.

Patients would be supported by hospital staff taking care of their breathing and blood pressure while waiting for their bodies to cure themselves.

About 70 people were isolated when an Air New Zealand flight landed in Wellington yesterday after two passengers described by airline staff as sweaty and agitated were suspected of having the illness.

Sergeant Neil Gascoine of Wellington airport police said an Air New Zealand staff member alerted authorities yesterday to the two passengers on a flight from Auckland.

The passengers, believed to be New Zealanders, were travelling separately.

Mr Gascoine said one of the men had flown in from Bangkok and the other was a domestic traveller.

A medical team from Wellington Hospital assessed the pair and sent them on their way.

The contact details of other passengers - who were isolated in a transit lounge - were recorded on Health Ministry advice.

A man on the flight said the passengers were then sent off with no indication of whether they should be alarmed or concerned. No advice was offered on risks they might face.

Air New Zealand declined to give any details of the incident.

In Gisborne, a man claiming to have been diagnosed with the deadly strain in Bangkok, declared himself at an Air New Zealand check-in desk at the airport yesterday morning.

But medical checks found he did not fit the profile.

Three Australians who recently travelled in Asia were admitted to hospital yesterday with flu-like symptoms. A 47-year-old woman is being treated at Ballarat Base Hospital in Victoria, a 44-year-old man is in a stable condition at Royal Melbourne Hospital and another woman is being treated in Perth.

It had been feared the illness could be as deadly as the 1918 influenza epidemic, which killed at least 20 million people worldwide.

Wellington public health physician Nick Wilson said if it was an influenza virus he would expect that to have been established by now. He said present precautions seemed reasonable.

"But it is hard to say how justified it is to recommend people not be travelling to Southeast Asia."

The Director of Public Health, Dr Colin Tukuitonga, said most of those who had contracted Sars in countries such as Vietnam and China were healthcare workers.

"All the evidence to date is that whatever the organism causing this condition is, it is not spread by casual contact."

Clinicians were being told to look for Sars symptoms, such as high temperatures, coughing, a history of travelling to Asia within the previous 10 days or close contact with people with respiratory illness having that travel history.

Dr Tukuitonga said it was the time of year for cases of influenza and illnesses that resembled Sars.

"Inevitably there will be some false alarms, but better to be sure than sorry."

Air New Zealand and airport authorities have instituted precautions and travel agents are being given advice on what to tell travellers.

Health Minister Annette King said national infectious disease experts had met several times to discuss plans to cope with an outbreak in New Zealand.

They had decided to implement the first stages of a national public health emergency plan.

Ms King said airlines were also ensuring that people with symptoms were not being allowed to travel.

Travel agents have reported people reconsidering travel plans.