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N.H. takes early aim at SARS

Fearing outbreak, health officials eye proactive measures

MANCHESTER, N.H. -- State public health officials are planning for a possible outbreak of SARS this winter.

That means people who show up in a doctor's office or hospital with a cough and high fever could be asked to don surgical masks.

There were no cases of the sometimes fatal virus in the state last year; currently there are no confirmed cases anywhere in the world. But public health officials expect severe acute respiratory syndrome to reemerge this winter.

"We are assuming that it will come back, and we are planning for it," said Dr. Jose Montero, head of disease control for the state Department of Health and Human Services.

So far, the state plans to distribute posters to hospitals and other health care centers promoting the masks. The posters are to be displayed in waiting rooms, with a box of disposable masks attached.

Montero said a group of medical specialists met during the summer to come up with guidelines for managing the spread of the disease.

Doctors and clinics should consider the guidelines now, although the department is not yet recommending that they be universally adopted. But that could change if the disease comes back and spreads rapidly, Montero said.

Elliot Hospital in Manchester and Dartmouth-Hitchcock Medical Center in Lebanon are planning to post signs in their waiting rooms with a simple message: a cough plus fever equals mask.

Lynda Caine, director of infection control at Elliot Hospital and a member of the panel that came up with the state guidelines, wants to promote better "respiratory etiquette" and awareness.

"To have those masks available and have the staff thinking, `Fever and cough, give them a mask. Fever and cough, I'll put on my mask," she said. "SARS helped us to realize that we can do a lot more to protect everybody from respiratory illnesses," including flu and colds, she said.

Elliot Hospital will also install alcohol-based hand gel dispensers in public waiting rooms to help patients and visitors get rid of germs, she said.

SARS emerged in China in November 2002 and spread to more than two dozen countries over the winter.

Symptoms include a high fever and a dry cough. Some patients may also have a headache, body aches, or diarrhea. Nearly all develop pneumonia.

Worldwide, there were 8,098 confirmed cases and 744 deaths through July, mostly in China and Hong Kong, according to the national Centers for Disease Control. Many victims were health care workers.

There were 29 cases in the United States.

The virus is spread through close contact with infected people, especially exposure to airborne droplets of saliva from sneezing and coughing. Its spread can be controlled by sneezing and coughing into tissues, as well as frequent hand-washing.

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