The masks have been fitted, the isolation rooms checked, the battle plans updated.
As U.S. hospitals and their physicians prepare for patients with severe acute respiratory syndrome, they know one chilling fact about the mysterious new disease: It is spreading through medical centers in Asia and Canada, striking a disproportionate number of health care workers as it goes.
Adding urgency to those efforts, federal health officials now believe SARS can be spread more easily than initially believed.
Early on, disease specialists at the U.S. Centers for Disease Control and Prevention believed SARS spread only through close contact - an infected droplet falling from a patient onto someone's hand, for example. Then, that person would have to place hand to mouth or nose.
But a recent account of the disease colonizing a Hong Kong apartment building has forced officials to consider the possibility that SARS can be transmitted by more casual contact.
It became obvious on the last Saturday of March that hospitals in the United States had begun to learn from the deadly mistakes made by their counterparts in Canada and Asia, who had been broadsided by an outbreak they didn't anticipate and who failed to adopt measures in the first days of the epidemic to protect themselves.
On that Saturday, doctors at Baystate Medical Center in Springfield, Mass., received a phone call from a local pediatrician reporting that a 15-month-old girl, recently adopted from China, had symptoms of SARS.
"At the time she hit the hospital, she was already in a mask," said Dr. Richard Brown, chief of the adult infectious disease division at Baystate.
From there, the girl was whisked to a specially designed isolation room on the hospital's pediatric ward. Doctors, nurses, and other workers who treated the girl always wore snugly fitting masks known as N95s and made sure they wore gowns and eye protection. The hospital is monitoring the health of the workers who tended to the infant.
BY THE NUMBERS: At least 45 new cases of SARS were reported Tuesday in Hong Kong, the epicenter of the global spread. That brought the total in that international gateway to 928. At least 25 residents have died.
In the Florida Panhandle, two suspected cases of SARS were confirmed Tuesday by the CDC. The victims, a child and a related middle-aged woman, have not required hospitalization. That brings the total in Florida to seven suspected cases.
Worldwide, the number of suspected SARS cases increased to 2,671 in 17 nations, a jump of 70 cases from the day before. At least 103 people have died, with five new deaths reported Tuesday, including two in Hong Kong, two in Singapore and one in Canada.
The overwhelming majority of cases have been in China, where 2,207 of the cases have been reported along with 78 of the deaths.
U.S. health officials are investigating 149 suspected cases in 30 states. In Canada, the hardest hit nation outside of Asia, officials reported that 232 cases were being investigated, up from 226 a day earlier. Most have occurred in the Toronto area, where an elderly woman spread the infection after visiting Hong Kong at the end of February.
- Information from the Boston Globe, New York Times, Washington Post and Associated Press was used in this report.[Last modified April 18, 2003, 13:36:43]