BILL FARRELL
Observer-Dispatch

UTICA -- A patient shows up at the local emergency room coughing, short of breath and feverish. Is it SARS?

Probably not, especially if that person hasn't done any recent traveling to SARS-affected countries like China or Vietnam or come in close contact with someone who has.

But local hospitals are preparing nonetheless for when that first case of severe acute respiratory syndrome might walk or be wheeled through the ER doors.

"Any person that presents to the Emergency Department with any kind of respiratory symptoms is being given a mask during triage," said Kathy O'Rourke, department director at Rome Memorial Hospital.

"We're not taking any chances because SARS symptoms are not unlike other common respiratory problems," she said.

There's added concern among health-care workers because Central New York is so close to another popular tourist spot that's feeling the strain of SARS -- Toronto.

"We're taking this very seriously, especially now that Toronto is on the travel advisory list," said Linda Kokoszki, infection control coordinator at St. Elizabeth Medical Center in Utica.

On Wednesday, the World Health Organization added Toronto to its list of places that travelers should avoid because of the SARS threat. Canada has reported 16 SARS deaths, and officials there said hundreds of people in Toronto might have been exposed to SARS by two hospital employees who ignored orders to stay home after they showed symptoms.

Angry Canadian officials challenged WHO's decision, but visits there had already dropped in recent weeks.

An estimated 4,300 people worldwide have been infected by SARS, and WHO reports at least 250 deaths, mostly in Asia. The United States reports just 39 probable cases and no deaths.

The symptoms of SARS are a lot like pneumonia or the flu. People get a high fever -- at least 100.4 degrees. They also usually have shortness of breath or other problems breathing and a dry cough. Some people get other symptoms, including a headache, stiff or achy muscles, a loss of appetite, fatigue, a rash and diarrhea.

Ken Shilkret, the epidemiologist for the Oneida County Health Department, said the county is up on the latest information from both the CDC and the state Health Department, and he receives daily reports from the local hospitals.

"There are no cases of suspected or probable SARS" in Oneida or Herkimer counties, he said. And if there were, he believes hospitals and health-care providers are prepared to handle them.

Kokoszki said STOP signs listing the criteria for suspected SARS cases are posted at each entrance to the St. Elizabeth ER as well as at all outpatient settings in the community.

"A lot of people with upper respiratory symptoms will present to our physicians' offices first," she said, adding that the arrival of pollen season will further complicate things.

"When people come to the emergency room with respiratory problems, we're looking for symptoms and we're asking them about their recent travel (within the last 10 days)," said Debra Altdoerffer, vice president of communications and development at Faxton-St. Luke's Healthcare.

She said the hospital, like others, has always had guidelines for handling infectious diseases and is equipped with isolation and negative pressure rooms. And staffs make ample use of masks, gowns and latex gloves. SARS is a virus, but one for which no vaccine is yet available.

Little Falls Hospital came up with a policy so the staff "is not left to wonder" what to do if, and when, a SARS case arrives, probably by ambulance, said Patty Seifried, infection control nurse.

"We'd most likely have the staff gowned and gloved and go right into the isolation room so there's no chance to be exposed," she said.

"We've posted questions we need to ask. People with pneumonia might meet the criteria, but you narrow it right down when you ask if they've done any recent travel" to a SARS-affected country, she said.

Rome Memorial's O'Rourke said all health-care providers have stepped up their surveillance and reporting of unusual clusters of symptoms since the Sept. 11, 2001, terrorist attacks and are required to notify the Department of Health of anything out of the ordinary.

Responding to emergency health threats requires a different mindset than before, she said.

"We have to think beyond the routine because something as simple as a cough and fever can be symptoms of something much more dangerous."

To say the least, health threats since Sept. 11 have kept health care workers on their toes.

"Between SARS, smallpox, anthrax and preparing for bioterrorism, they're really working around the clock," Kokoszki said.