As SARS spreads, so too do passengers’ anxieties

As if travelers didn’t have enough to worry about, many are now concerned about SARS, severe acute respiratory syndrome, the new mystery illness that originated in Southeast Asia and is now circling the globe. As the number of cases climbs, so do the anxiety levels of airline passengers and would-be travelers uncertain whether to board a plane at all, regardless of the destination.

SARS-related calls to health-care professionals have increased dramatically, perhaps fueled by nightly newscasts showing Asian residents and travelers wearing masks.

Dr. Terri Rock, a Santa Monica family physician who specializes in travel medicine, is getting about a dozen calls a day -- and that’s just from those wondering whether to cancel their travel plans. Rock says she has also been deluged with calls from people who are worried they may have caught SARS from someone who has traveled recently to an affected area.

“They all say, ‘Normally, I wouldn’t come in for this,’ ” she says of worried patients, who ask whether they can be seen for a cough. She asks patients about recent travel and about their symptoms, sometimes scheduling an appointment just to reassure them they’re fine.

Rock advises travelers to check the travel advice from the federal Centers for Disease Control and Prevention and the World Health Organization. As of the Travel section’s press time Tuesday, WHO advised travelers to postpone nonessential trips to Hong Kong and Guangdong Province, China. The CDC’s advisory is broader: Besides Hong Kong, it suggests avoiding nonessential travel to all of China as well as Singapore and Hanoi.

SARS is thought to be caused by a new kind of coronavirus, a virus also associated with the common cold and other respiratory illnesses. Symptoms of SARS surface seven to 10 days after exposure and may include a fever of 100.4 degrees or higher; chills, headache, malaise and body aches, followed by a dry cough; and difficulty breathing. (Up to 20% of those affected need mechanical ventilation to breathe.)

By the Travel section’s deadline, more than 2,600 cases of SARS had been diagnosed, and more than 100 people had died of the disease, although none in the U.S. The mortality rate is about 4%.

CDC experts think the disease is transmitted mainly through coughing or sneezing. The CDC hasn’t ruled out airborne transmission or the possibility that contaminated objects could also spread SARS.

“Coronaviruses can last on surfaces for several hours,” says Dr. Julie Gerberding, director of the CDC.

Those who are at most risk of contracting the illness, according to the CDC, include health-care workers and family members who care for, live with or have had direct contact with respiratory secretions and bodily fluids of those with SARS.

“If you look at the number of cases and who’s been sickened, by and large, it’s been people who have sustained, direct contact,” says Dr. Bradley Connor, a New York physician who specializes in travel medicine.

Anxiety is widespread nonetheless, even among travelers who do not plan to go to the affected areas. “People are already at an all-time high in terms of stress and tension,” says Robert E. Thayer, a psychologist at Cal State Long Beach and an expert in anxiety treatment. He cites the Iraq war as a primary cause of that tension.

“We’ve known for a long time that mood affects how you see the world in basic ways,” Thayer says. “The more tired and tense you are, the more negative everything seems.”

Other diseases have claimed many more lives than has SARS to date. The Spanish flu of 1918, for instance, killed more than 20 million people, according to the CDC. The Hong Kong flu of 1968 killed 34,000.

Despite the prospect of SARS, some travelers plan to go ahead with their trips, even those going to affected areas, and they want to know how to avoid getting the disease.

Connor’s advice: “Avoid large crowds. Wash your hands often. Avoid public conveyances, especially if they are overcrowded.”

Rock of Santa Monica echoes that advice, adding, “What I am saying to people is it’s not too late to get flu shots and pneumonia shots.” These immunizations won’t prevent SARS, of course, “but if you can do anything to prevent secondary infections, it’s good.”

Some travelers may resort to wearing a mask. Connor says he does not know whether that’s necessary, “although no one would think you are crazy if you did.”

Gerberding said the CDC is advising mask use for patients to prevent spread of the disease, for health workers caring for patients and for household contacts of the patient if the patient cannot wear a mask.

CDC officials are working to develop tests to confirm SARS, and two look promising, Gerberding says.

If a patient seems to have SARS -- based on a doctor’s workup, which the CDC says should include a chest X-ray, tests for respiratory pathogens and other measures -- treatment is similar to that for pneumonia of unknown cause. That may include antibiotics to treat any bacterial agents, steroids and other medicines.

If you think you have SARS, consult a doctor as soon as possible and use a mask to prevent spread of the disease. Travel is not advised. Recovery time varies from a couple of weeks to a couple of months.

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Healthy Traveler appears twice a month. Kathleen Doheny can be reached at kathleendoheny@earthlink.net.