Press Releases

Transcript of Secretary for Health, Welfare and Food

Following is the transcript of remarks by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, on the treatment protocol of severe acute respiratory syndrome (SARS) at a press conference today (May 10):

Secretary for Health, Welfare and Food: Basically the treatment that we are giving now has been adjusted based on our experience and the research evidence. And we have heard two presentations, one from Professor Yuen (Kwok-yung) and the other Professor (Joseph) Sung. The information from the two research studies demonstrates that for SARS that is a tri-phasic disease which is the handout given to you. The first phase is what we call the viral replicative phase where the virus multiplies, so you get large number of viruses in the body. From this observation, the conclusion must be that you give the anti-virals at this stage. So we are now adjusting our treatment that we're giving anti-virals in the first two weeks because you're really trying to suppress the viral replication. In addition to Ribavirin we should use, we now have another drug called Kaletra which is a protease inhibitor. So we're giving them either singly or in a combination to tackle the viral replication.

The second phase is what is called the immune hyperactive phase where the body responds to the virus because in the process of getting rid of the virus, our body mounts in the immune response. In order to get rid of the virus, obviously that is just a response but at the same time, this response also causes damage to the body itself, to the lung tissue. And that's why at this stage you're giving steroid to suppress this immune response. So this is the second phase where we're now adjusting it so that we give steroids to tackle the second phase. Professor Sung demonstrated that the experience in the Prince of Wales Hospital is that if you give steroids either at this stage or early on, there is really no difference. So you don't need to give steroids early because if you're giving steroids early, you're just adding on to possible accumulation of the dose and of course when you give steroids, there are also side effects because steroids cause suppression of the immune system. So you get more side effects if you give steroids early. So we're now adjusting our treatment to give steroids only at the second phase.

The third phase is the phase where 20 per cent of the patients going to this pulmonary destruction phase. Despite the treatment that we give, about 20 per cent of the patients will enter into this third phase where you need to give additional treatment because these are patients who do not respond well. So this is now the treatment protocol which is being adjusted based on our experience and research evidence. At the bottom will be other treatments because there are certain patients that do not respond routinely so you then have add-on treatments or alternate treatments like pentaglobin, convalescent plasma. Of course in the late stage, in the so-called pulmonary destruction phase, you need then to give oxygen and different types of assisted-respiration.

End/Saturday, May 10, 2003
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