Concerns are growing over the way suspected SARS cases are being dealt with in the State after it emerged last night that the case of a woman in the south-east suspected of having contracted the virus was not notified to her local health board for several days, writes Eithne Donnellan, Health Correspondent.
The woman, who recently returned from holidaying in Toronto, Canada, where there have been 16 deaths from SARS, was examined at Waterford Regional Hospital yesterday and was later discharged in accordance with "national" guidelines. These differ from World Health Organisation guidelines, which say suspect cases should be hospitalised.
The chief executive of the South Eastern Health Board, Mr Pat McLoughlin, confirmed the woman had attended her GP with flu-like symptoms some time after returning home but the health board was not contacted by the GP "for a number of days".
He said the first the health board knew of the case was yesterday. The woman's GP contacted a consultant microbiologist at Waterford Regional Hospital late on Wednesday night and the microbiologist contacted the health board early yesterday.
He could not reveal how many days the board had been left in the dark. Asked if he was concerned at the delay in being informed, he said he respected the clinical judgment of the GP involved. All GPs, he said, had been sent guidelines on the treatment and management of suspected cases.
However, those guidelines are now out of date, a spokesman for the National Disease Surveillance Centre admitted. He said they had not been updated since its public health doctors went on strike 11 days ago.
Monaghan-based GP Dr Illona Duffy said the guidelines were, in any event, very unclear. Furthermore, she said GPs were told they would be sent posters to put up in their surgeries warning people of the signs and symptoms of SARS but they never arrived.
The Department of Health expert group on SARS yesterday considered issues such as how athletes travelling to the Special Olympics from SARS affected countries should be dealt with. Last night the chairman, Dr Jim Kiely, defended State guidelines for the management of suspected SARS cases. Speaking on RTÉ's Prime Time, he said they were based on international experience and were effective.
He acknowledged, however, the guidelines had been breached last Friday when a suspected SARS case was released from St Vincent's Hospital, Dublin, to a hostel, where she spent the weekend before being admitted to another hospital on Tuesday. She has since tested negative for SARS but Dr Kiely, chief medical officer at the Department of Health, said sending a suspected case back to a community setting was not "best practice".
He said there were less than 20 isolation beds to treat suspect cases in Dublin but he had every confidence that the system in place "was more than capable" of dealing with the threat of SARS.
Meanwhile a consultant microbiologist at the Mater Hospital, Dublin, Dr Margaret Hannan, has said athletes should be banned from travelling to the Special Olympics from countries where the virus is out of control.
Also yesterday the Midwest Regional Hospital in Limerick warned people to check with the hospital before visiting as a precautionary measure against any possible spread of SARS.
SARS has infected 4,630 people and killed around 261, WHO officials and national health authorities indicated yesterday.China had its first piece of good news on SARS when the number of reported new cases in the southern province of Guangdong, where the disease is believed to have originated, are starting to fall, WHO said, though it remains worried about the situation particularly in Beijing, Shanghai, and Shanxi province.