SARS Still Spreading In China Despite Controls, Says WHO

Independent (UK) ^ | 4-29-2003 | Jeremy Laurance

[blam]

Sars still spreading in China despite controls, says WHO

By Jeremy Laurance, Health Editor
29 April 2003

The outbreak of severe acute respiratory syndrome has peaked in most hot spots for the disease but is getting worse in China, the World Health Organisation said yesterday.

The WHO declared Vietnam the first country to contain Sars and said Canada, Singapore and Hong Kong appeared to be winning the battle against the disease. But it said China was still not providing full information about its cases.

It was also revealed yesterday that the Centres for Disease Control and Prevention (CDC) in Atlanta was in disagreement with the WHO about the warning against travel to Toronto. The US has not followed the WHO's advice to the 62 million North Americans who cross the US-Canadian border each year to avoid travelling to Canada's biggest city because the CDC said there was no significant risk to visitors to Toronto.

David Heymann, the WHO's head of communicable diseases, said in Bangkok, where he is attending an international conference on Sars, that transmission of the disease within Canada had stopped completely "and they are at the very bottom of the down slope".

Hong Kong and Singapore had fewer cases every day and Vietnam had reported no new cases since 8 April, he said. The WHO lifted its travel warning for Vietnam yesterday.

But the prevalence in China remained worrying. "We are receiving more and more reports of cases and it doesn't appear it has peaked," Mr Heymann said. Taiwan, where there had been multiple cases arriving from the mainland, was also "on an increasing curve", he said.

Beijing reported 96 new cases yesterday, taking the total there to 1,199 with 59 deaths. The capital has about 7,600 people in quarantine and has kept schools and nightspots closed while it builds a 1,000-bed isolation camp for Sars cases on its northern outskirts.

Indonesia said it suspected a Taiwanese businessman had died of Sars, in what would be the country's first fatality from the pneumonia-like virus.

Vietnam's success is the first indication that the virus can be beaten. There were five deaths after the disease spread in February through Hanoi's only international hospital. Sixty-three people contracted the virus, including several doctors and nurses. Hanoi's French Hospital was cordoned off on 11 March, a move credited with keeping Sars from spreading beyond its doors.

Pascale Brudon, the WHO's representative in Vietnam, said: "Vietnam has been able to show the world there is hope that Sars can be contained."

China began openly reporting cases nine days ago, before which Beijing officially had just 37 cases and four deaths. But Henk Bekedam, the WHO's representative in Beijing, said yesterday that the Chinese authorities were still hampering international efforts by the withholding details of the cases.

"The key question is what do we know about the 96 new cases? Who are the 96? When did they start? Where did they live? This kind of data at this moment is the big challenge," he said.

"This information is crucial for everybody to have an understanding of what's going on. We do think it is now high time that it becomes available."

In the US, Julie Gerberding, head of the CDC, said Toronto was not included in its travel warning. WHO travel warnings were based on evidence of the spread of the disease in the community where there were no known links between cases. All cases of Sars in Toronto had been spread in hospitals or through close relatives or could be traced back to a family known to have brought the disease from Hong Kong, she said. "There is no evidence that travellers to Toronto are at any different risk of acquiring Sars than they are from going to any number of the other countries in the world where sporadic cases have cropped up among returning travellers," Dr Gerberding said. "US citizens travelling to Canada are not at risk for Sars if they stay out of hospitals and follow some common-sense precautions."

The Toronto outbreak had centred on hospital staff. Dr Gerberding said the infection control precautions may have been inadequate. "I can only speculate [but] one of the major issues is that in this illness you need to be 100 per cent adherent to the airborne precautions, because we know there are certain patients that appear to be very highly infectious.

"If a mask is recommended for healthcare personnel they need to make sure that it's properly fitted. If there's any leakage around the mask, it really negates the whole value of having that filtration factor in front of your breathing zone."

The WHO has set a 20-day window – double the disease's incubation period – as the standard for lifting travel warnings and declaring that the disease is no longer spreading.

[blam]

How long before the Chinese start stampeding toward the borders?

[SwinneySwitch]

"...and Vietnam had REPORTED no new cases since 8 April, he said."

and we all know they wouldn't lie!