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Mystery Illness Spreads to Patient Vistors in Toronto

Recombinomics Commentary

October 3, 2005

Seventy-one of the 249 residents at Seven Oaks Home for the Aged in Toronto's east end are sick. Six employees and two visitors are also ill.

The Ontario Public Health Lab has been running several tests on samples taken from hospitalized patients.

"We've run tests for over a dozen different viruses and bacteria, from run-of-the-mill influenza to bird flu and SARS," said Dr. Donald Low, the lab's medical director. "So far, everything's come up negative."

Residents at the nursing home began to show symptoms one week ago. The first patient died on Sept. 29. A coroner will begin performing autopsies on Monday.

Low said once they have tissue samples from the deceased patients, lab technologists will be able to run more sophisticated tests.

He added it's unfortunate the autopsies weren't done sooner.

Although all tests thus far are negative, false negatives are common in the absence of the correct clinical samples.  Frequently, autopsy material is required to isolate the etiological agent.

The above comments indicate that those infected include six employees and two visitors, demonstrating that the infectious agent is easily transmitted.  The number of residents infected is up to 73 from a 249 bed facility, and since the outbreak is less than a week old, that number will likely rise.  Similarly, the number of employees infected has gone up as have the number of infected visitors, so those two groups likely trail the residents in exposure dates.

More details on ages in symptoms of the casual contacts would be useful.

There has been little discussion of tracing contacts, and visitors have been kept out of the nursing home and in the community.  Since the highly infectious agent is unknown, this policy seems dangerous.  The failure to have begun autopsies of the dead, who died last week, is cause for concern

Toronto seems more focused on early press conferences than early identification and control of the agent.  Since the agent has not been identified, this complacency is cause for concern.

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