SARS

[owenkrout]

Latest just received from Shenyang Consulate

 

TRAVEL WARNING - China

 

This Travel Warning is being issued to alert U.S. citizens that the

Department of State has now authorized the departure, on a voluntary basis, of non-emergency employees and all family members at the U.S. Embassy in Beijing and the Consulates General in Chengdu, Shanghai, Shenyang, Guangzhou and Hong Kong SAR, China as a precautionary measure due to the Severe Acute Respiratory Syndrome (SARS) situation. The Embassy and all Consulates General remain open to provide the full range of services to American citizens and the general public.

 

The Department is taking this step due to the risks posed by SARS, the

uncertainties of how it is spread and concerns over our ability to obtain

suitable medical care or evacuate our affected employees and their families.

Presently commercial airlines and most air ambulance services will not

transport SARS patients.

 

The Centers for Disease Control and Prevention (CDC) recommends U.S.

citizens defer elective or non-essential travel to areas with a large number

of SARS cases, including Mainland China and Hong Kong. U.S. citizens

resident or traveling in these areas should closely monitor the website of

the Center for Disease Control <http://www.cdc.gov> and Prevention at

http://www.cdc.gov and the website of the World Health Organization

<http://www.who.int> at http://www.who.int. for the latest information on

SARS.

For further information on travel to China, U.S. citizens should also

consult the Department of State's Consular Information Sheets for China and Hong Kong, the Fact Sheet on SARS and the SARS in Asia Public Announcement which are located at <http://www.travel.state.gov>.

[tonado]

Friday April 4, 6:26 PM

China hotspot province plays down outbreak

By Benjamin Kang Lim

 

BEIJING, April 4 (Reuters) - The World Health Organisation has warned international travellers to stay away from China's southern province of Guangdong, and foreign diplomats and businessmen have shipped their families back home.

 

But despite being the breeding ground for a deadly virus that has infected 2,400 and killed 81 people around the world, many Chinese in the wealthy province -- and the rest of the country -- are oblivious to their newfound pariah status.

 

For 26-year-old Carl Cai, who works at a state bank in Guangzhou, the provincial capital, life is back to normal after a panic attack in February when Chinese media were first permitted to report on the atypical pneumonia outbreak now known as SARS.

 

"Is it really that dangerous here? I doubt it. I don't see any big difference in the daily life here, not like Hong Hong," Cai told Reuters on Friday.

 

Never mind that international health experts believe Guangdong was the origin of the deadly virus, and that China now accounts for more than half the world's dead and infected from Severe Acute Respiratory Syndrome (SARS) -- most from Guangdong.

 

This week WHO issued an unprecedented warning against travel to the southern Chinese province as well as hard-hit Hong Kong.

 

But thousands of Chinese still travel to and from Guangdong each day by plane, train, road and boat.

 

There are 130 flights daily between Beijing and Guangzhou alone. While they are no longer packed, reflecting some anxiety over the SARS outbreak, airlines stress they have yet to cut any flights.

 

China, keen to attract tourism and foreign direct investment to keep its rapidly growing economy moving, has cried foul.

 

"The WHO travel advisory is unfair," Deng Haihua, spokesman for the Chinese Health Ministry, told Reuters.

 

"Atypical pneumonia has been effectively brought under control in Guangdong," he said. "The WHO made the decision maybe because it doesn't understand the actual situation. We hope the WHO will make adjustments after looking into it," Deng added.

 

The outbreak has taken its toll on traffic to and from China.

 

The Rolling Stones postponed concerts in Beijing and Shanghai, and the United States said it would cut back on its diplomats throughout China. The World Economic Forum scrapped its China Business Summit, one of Beijing's top financial events.

 

In Guangdong's bustling southern boomtown Shenzhen, reports of the outbreak in February sparked panic buying of medicines, food and traditional folk remedies including vinegar, said to ward off the new mystery illness.

 

"During the worst time in early Febuary, there was much panic. Some people drank so much vinegar that their stomachs hurt," Zhou Linyan, 27, a Shenzhen bank clerk, told Reuters.

 

"Others had stocked up on rice and salt, after hearing rumours that the city might be closed to visitors," she said. Her office reeked of vinegar for days.

 

"Now everything is back to normal. I am not as worried as before. People have become more sensible after experiencing the worst," she said.

 

In Guangzhou, streets, supermarkets and restaurants are crowded and few people wear masks -- unlike Hong Kong where half the population dons them and everything from karaoke parlours to dimsum restaurants are emptied out.

 

And city officials stress the two-week Guangzhou Trade Fair is still scheduled to begin on April 15.

 

Cai, the banker, said: "I still find it very difficult to book seats at good restaurants. I was baffled when friends told me that their companies had banned travel to Guangdong."

 

"We still talk about SARS often and watch its development closely. But we're no longer afraid like in February," he said.

 

China's media have been barred from reporting freely on the outbreaks, and their latest reports have accentuated the positive. Last week, stories focused on the outbreak being "under effective control", and buried a dramatic rise in cases.

 

Aside from concerns about losing foreign investment, China's Communist Party has long prided itself in eradicating epidemics after sweeping to power in 1949. Being blamed for a global epidemic would be a tremendous loss of face, analysts said.

 

China has a long track record of suppressing bad news and fudging figures. A man-made famine in the late 1950s and early 1960s claimed about 30 million lives, but China still calls it "three years of natural disasters".

 

Health Minister Zhang Wenkang was adamant it was "safe to work, travel and attend meetings" in China, and told a news conference he had just returned from Guangzhou, where a WHO team is visiting to investigate the disease.

[tonado]

http://asia.news.yahoo.com/030404/ap/d7q6q2k00.html

 

Friday April 4, 11:14 PM

China Apologizes for Handling of SARS

 

China apologized Friday for not doing a better job of informing people about severe acute respiratory syndrome as an international medical team went to the city where it believed the mystery illness may have first broken out.

 

The admission, extraordinary for a government that rarely acknowledges fault, came after escalating criticism abroad _ and one day after the health minister explicitly said China had followed its own rules in dealing with the problem.

 

"Today, we apologize to everyone," said Li Liming, director of the Chinese Center for Disease Control.

 

"Our medical departments and our mass media suffered poor coordination. We weren't able to muster our forces in helping to provide everyone with scientific publicity and allowing the masses to get hold of this sort of knowledge."

 

In Foshan, a city in China's southern Guangdong province, World Health Organization investigators worked with local authorities to isolate data from a few people believed key to the emergence of SARS.

 

At the top of their list: a Foshan man believed by investigators to be the first known person infected. The man, who was not identified, is suspected of having passed the virus to four people _ but, mysteriously, not to his four children. He survived and was released from the hospital in January.

 

"It's going to be a tricky task to find out what went on," said Powell, a spokesman for the WHO team, who said investigators had not met the man. "It's going to be a long job, a long epidemiological study to try to find out exactly how the infection was transmitted."

 

SARS has killed at least 82 people in Asia and Canada _ 46 in mainland China _ and sickened at least 2,200 in more than a dozen nations as infected travelers board planes and reach other continents in hours. Forty of those deaths happened in Guangdong province.

 

Singapore's Health Ministry reported the island nation's sixth SARS death _ a woman who died Friday. Health Minister Lim Hng Kiang said all visitors arriving in Singapore beginning Monday must sign a declaration saying they do not have SARS.

 

Anyone caught lying will be fined $2,800.

 

No cure for SARS has been found, although health officials say most sufferers recover with timely hospital care. Symptoms include high fever, aches, dry cough and shortness of breath.

 

The WHO team met Friday with provincial health officials, who have given them information about SARS patients in Guangdong, including how they got sick and their treatment. The team plans to stay through Tuesday in the provincial capital, Guangzhou.

 

Increasingly, investigators are looking at Guangdong as the place where SARS began _ something China's health minister, Zhang Wenkang, insists is premature and possibly inaccurate. Twenty-four cases, including some of the earliest, have been traced to Foshan, though five of them show no actual "trace of transmission" to others.

 

"So this is a real mystery, and it's something they're going to try to have to solve," Powell said.

 

WHO says aggressive pamphleteering helped stem the disease in Foshan, a bustling city brimming with traffic and modern buildings. It has reported no new cases, and few here were wearing masks Friday.

 

"People die from other infectious diseases, so what's the difference with this one. If you can prevent it, prevent it. If not, what's the point of being scared?" said Liang Lan, a shop owner in Foshan. "We need to keep living our lives."

 

The WHO team, which arrived Thursday from Beijing, received government data indicating that numbers of new SARS cases were diminishing in Guangdong, which has reported 40 deaths, Powell said.

 

Overnight, officials in Canada confirmed the country's seventh death from SARS, a 57-year-old woman who also had other health problems.

 

On Thursday, a 56-year-old man died in Hong Kong, bringing its toll to 17.

 

Health officials raised concerns of a new outbreak at Hong Kong's United Christian Hospital, where at least 10 health workers have been infected.

 

In Washington, the State Department authorized the departure of nonessential personnel and family members from its embassy in Beijing and from five consular offices in China because of concerns about SARS.

 

The State Department noted that commercial airlines and most air ambulance services in China will not transport SARS patients. Consulates affected _ in Chengdu, Shanghai, Shenyang, Guangzhou and Hong Kong _ will remain open.

 

The WHO team in Guangdong comprises four doctors from the United States, Wales, Germany and Bangladesh.

 

The Chinese moves toward openness come after foreign criticism of the communist government's reluctance to release information about SARS. Li's apology came at a news conference to which foreign news organizations were not invited.

 

On Thursday in Beijing, Zhang, the health minister, insisted it is "safe to live in China." He implored people who canceled travel to China to reconsider _ contradicting a WHO advisory to avoid Guangdong.

 

Some in southern China, though, were unhappy with the government's tight hold on information about SARS.

 

"They should have told us how to prevent it," said Chen Mao, a 67-year-old retiree in Guangzhou who has been taking medicine he hopes will ward it off. "You must observe prevention _ eat healthy, keep exercising. Don't be scared _ there's no point."

[tonado]

HK mask fashion

 

 

http://wwwi.reuters.com/images/mdf248353.jpg

[AZwolfman]

Good grief! Who woulda thunk it

 

Some of them are kinda cute, though. Major designer label masks could be next?

[AZwolfman]

© Associated Press

 

- Federal researchers said they are beginning work toward a vaccine that could eventually help control SARS. They are already courting private pharmaceutical companies that might manufacture the treatments down the road.

[rocksplit]

from the NYTimes April 4, 2003

 

http://www.nytimes.com/2003/04/04/business...ess/04CHIN.html

 

 

China Yields Data on Mystery Illness Reluctantly

By ELISABETH ROSENTHAL

 

 

BEIJING, April 3 — In early March, when a new mystery illness started hopscotching around the globe, Chinese health officials looked on in silence, as if to say, "This has nothing to do with us."

 

At that point, China was already four months into an outbreak that officials later acknowledged was the same disease, severe acute respiratory syndrome, or SARS. Yet they insisted that the situation was fully under control, shared none of their data and declined to join international investigations.

 

Only in the face of intense international pressure are the Chinese now releasing valuable information to scientists from the World Health Organization, who were allowed in the country just a few weeks ago.

 

This week, the Chinese government announced its count of new SARS cases for March, bringing China's caseload to 1,190, with 46 deaths — the highest figures for any nation. It also announced that the W.H.O. team had permission to travel to the southern city of Guangzhou, the epicenter and origin of the epidemic.

 

But once again, China's penchant for burying bad news and manipulating statistics for political ends has increased human suffering.

 

In the late 1950's and early 60's, historians estimate, tens of millions of farmers starved in the aftermath of Mao Zedong's disastrous experiment in collectivized agriculture during the Great Leap Forward. The policy continued unchecked because local officials, eager to please their superiors in Beijing, reported only bumper harvests.

 

Today, SARS has presented these same kinds of officials with a similar choice — to save people or save face with their bosses — and until recently they chose the latter.

 

By January, Chinese doctors in Guangdong Province already understood a lot about the disease's spread and how to control outbreaks. If three months ago, they had shared that experience or allowed international experts in to aggressively look for the germ responsible, would so many be dying from Canada to Vietnam today?

 

World Health Organization officials greeted China's decision to now share such information with elaborate praise, although Robert Breiman, the team leader, acknowledged that "earlier is better" for disease investigations.

 

But many Chinese have been disappointed in a statistical cover-up that seems more suited to the Mao-era China of three decades ago.

 

"I would have expected that with so much international pressure, the government would have quickly released more information — they are sensitive to this — but this time they've still been tardy," said Prof. Mao Shoulong, a public administration expert at People's University in Beijing. "The government's general attitude about public disclosure is that when there's a problem, unless there's a rule that requires disclosure, you don't speak out."

 

Statistical legerdemain is part of Chinese practice and is widespread. Economic indicators are routinely inflated and disease cases or protest statistics are conveniently rounded down.

 

The lack of openness about the epidemic here was particularly confounding, experts said, because when the Chinese released their data this week, the figures were encouraging in many respects. The number of cases in Guangdong Province decreased throughout March, suggesting that SARS outbreaks might burn themselves out.

 

But old habits die hard and Chinese officials' secretive attitude on sensitive health matters stems, in part, from their longstanding emphasis on not wanting to cause panic among citizens or allow chaos in society. And local and provincial officials do not want bad news occurring on their watch, since promotion depends almost entirely on pleasing their superiors. To this end, statistics are often massaged or collected halfheartedly if the results are likely to be negative.

 

For example, the government has never collected good figures on the number of poor farmers with H.I.V. in rural China, who were infected through unsanitary — though officially sanctioned — blood-selling schemes in the 1990's. Government estimates are in the tens of thousands, though most researchers put the number at a million or more.

 

The problem is particularly serious with new or emerging medical problems, where reporting is not mandatory.

 

SARS has now been placed in a category that requires daily reporting, the W.H.O. team said.

 

With information captive to politics, the magnitude of a problem sometimes only emerges after years of denial: In a 1975 disaster that only recently came to light, vast floods on the Huai River killed tens of thousands when poorly constructed dams proved inadequate to contain floodwater. To prevent news of the devastation from spreading, province officials diverted planes from the affected region, not wanting to upset or anger the ailing Chairman Mao.

 

Of course, in a country now teeming with cellphones and computers, it is increasingly difficult to suppress bad news fully. While the Chinese press today started to run articles on the subject, until now such articles had been rare and appeared only in the English-language editions.

 

Most Chinese learned of the epidemic not from their government but from cellphone messages. In Guangdong, cellphone users learned about a patient who had spread it to doctors as well as an ambulance driver.

 

"Phones are a mechanism of trust," Professor Mao of People's University said. "A friend passes on information and the friend believes it because of trust that he is a credible source of information," then adding, "But another big reason why the people trusted their phones is the inadequacy of public information."

 

In the economic sphere, a result is that investing in China is a risky business. As a health matter, poor statistics mean that serious unreported public needs are often ignored.

 

With SARS, China's initial lack of openness means that the World Health Organization researchers on the way to Guangzhou are playing catch-up — though they are grateful to have made what progress they have.

 

"We are hoping to be a conduit to the rest of the world, which is anxiously awaiting to learn about China's experience," Dr. Breiman said.

[tonado]

Still spreading

---------------------------------------------------------

Sunday April 6, 8:37 PM

SARS gloom deepens as China, Hong Kong reveal new deaths

 

HONG KONG (AFP) - The high-profile death of an International Labour Organisation (ILO) official in Beijing and another two deaths from SARS in Hong Kong provided a gloomy backdrop to efforts to find a cure for the killer disease.

 

As the first suspected case of infection by the Severe Acute Respiratory Syndrome (SARS) virus was detected in Kuwait, World Health Organisation (WHO) experts continued to search for the cause of the mystery illness in the epidemic's epicentre, southern China.

 

The death of the ILO's Pekka Aro from Severe Acute Respiratory Syndrome was announced at a Chinese health ministry press conference in Beijing. He was the highest profile casualty of the outbreak since WHO expert Carlo Urbani -- who first identified the disease -- died in Bangkok last month.

 

Finnish official Aro was among 19 new cases announced in the capital, bringing the number of deaths in Beijing to four.

 

At least 51 deaths from SARS have been reported in China and 1,247 people have been infected, according to official figures released Sunday.

 

WHO experts continued their probe into the killer pneumonia as China went into damage control mode to repair an image badly tarnished by its foot-dragging in handling the outbreak.

 

WHO investigators held meetings with Chinese health and disease control officials on Sunday, their fourth day in Guangdong province, where the virus has killed more people than anywhere else.

 

In an effort to staunch criticism of China's handling of the outbreak, state-run media carried reports by the WHO praising China for its handling of the crisis the authorities put a gag on Internet jokers mentioning SARS online.

 

China's new premier Wen Jiabao also stepped into the fray, saying his government was "fully capable" of controlling SARS' spread.

 

"The Communist Party and the government pays much attention to SARS, have adopted a series of timely measures and achieved obvious results," he said according to Xinhua news agency.

 

"The Chinese government is fully capable of controlling the spread of SARS," said Wen during an inspection tour of a center for disease control.

 

In neighbouring Hong Kong, hopes that the rate of infection has slowed were dashed as another two people died on Sunday and another 42 cases were detected. It followed the death of three people and the admission of another 39 cases into hospital on Sunday.

 

Despite assurances from health authorities and Chief Executive Tung Chee-hwa last week that the rate of infection had stabilised, the sudden weekend surge raised the death toll to 22 and infections to 842.

 

The latest figures brought the worldwide death toll from SARS to 93 and 2,705 the number of confirmed or suspected infections.

 

Citizens and organisations who had begun shedding surgical masks in belief that the disease was under control, stepped up precautionary measures on Sunday.

 

Among them, the Roman Catholic diocese removed basins of holy water from its churches and ordered clergy to wear masks and gloves.

 

Worshippers were told not to attend mass if they were ill and were urged not to hold hands during prayers. The measures will remain in place during Easter, which falls on April 20 this year.

 

Panic set in throughout much of the rest of Asia, as governments continued to urge citizens to stay away from infected areas, and in the rest of the world as the virus reached newer shores.

 

In Singapore, where six people have died and 103 cases have been confirmed, Prime Minister Goh Chok Tong set up a cabinet-level task force to help beef up the city-state's defences.

 

It was also suggested that the government take the opportunity provided by the siege under which the virus has the city to test Singapore's much-vaunted bio-terrorism security shelters.

 

In Malaysia, acting Prime Minister Abdullah Ahmad Badawi called for calm after the country's first probable death from SARS was announced overnight.

 

Australia, taking no chances after four children who recently arrived in the country were identified as suspected carriers, SARS has been categorised as quarantinable, allowing authorities to detain anybody entering the country with suspected symptoms.

 

On the other side of the Pacific, an eighth person died in Canada's Ontario province and a ninth was suspected. Canada remains the worst-hit country outside Asia with 187 infections. More than 3,500 people are in voluntary quarantine in Ontario.

 

Kuwait brought the tally of potentially affected countries to as many as 32 when it announced its first suspected case. An expatriate woman who returned to Kuwait from southeast Asia is being tested.

 

The SARS fallout continued to batter the world's tourism industry. In Taipei, travel agents appealed for government assistance to ease the worst crisis in 30 years and Australian analysts said the virus scare would dash hopes of an Asian-sourced resuscitation of the nation's flagging tourism industry.

 

Hong Kong's Airport Authority also reported that 119 flights, or 22 percent of Sunday's total, had been cancelled amid fears over the virus and the Iraq war adding to woes after airlines like Qantas, Continental and British Airways had slashed services to the territory.

[tonado]

Monday April 7, 9:03 AM

UPDATE 1-Killer virus sparks discrimination in Hong Kong

 

By Carrie Lee

 

HONG KONG, April 6 (Reuters) - Besides killing more than a score of people and infecting hundreds, the spread of the deadly SARS virus in Hong Kong is also leading to discrimination.

 

Some hotels are refusing to check in people from the city and mainland China. Doctors will not treat patients suffering from high fever unless hospitals certify they are free of SARS. A funeral parlour refused to allow the funeral of an SARS victim to be held there.

 

"Discriminatory acts and concerns about possible discrimination are on the rise," Anna Wu, chairwoman of the Equal Opportunities Commission, said in a recent statement.

 

By Friday, the commission had received 105 enquiries about SARS, which revealed discrimination against patients and their friends and families.

 

"Initial enquiries include a hotel employee asking if it was discriminatory to reject Hong Kong ID (identity) card holders who want to stay," the commission said.

 

The commission did not elaborate. But some hotels are apparently rejecting guests from the city and mainland China.

 

SARS, or Severe Acute Respiratory Syndrome, broke out in southern China late last year, before Hong Kong reported infections this year. So it is widely thought that the disease originated in China and then spread to Hong Kong, but Chinese officials have repeatedly denied such allegations.

 

The pneumonia-like disease has killed more than 90 people worldwide and infected about 2,600. In Hong Kong, a city of about seven million people, 22 have died and 842 have been infected. The city is the worst-hit area apart from mainland China.

 

WHO and Hong Kong experts say the virus spreads through droplets from sneezing or coughing and such direct infection can usually occur within a radius of about a metre (three feet).

 

But health experts have not ruled out the possibility of the virus being airborne, which would dramatically raise its contagiousness and would make it far harder to contain.

 

NO GUESTS FROM CHINA, HK

 

"To be straightforward with you, we are not taking guests from Hong Kong or mainland China," a receptionist of an unidentified Hong Kong hotel told a television reporter who pretended to book a room. The dialogue was broadcast on television.

 

The television station also showed another hotel turning down a reporter who claimed to be a resident of a housing estate, Amoy Gardens, in the east of the crowded Kowloon peninsula.

 

More than 200 people from Amoy Gardens have been found to be infected by SARS. The worst-hit residential block there has been sealed off and many of its residents have been quarantined.

 

But some residents had managed to flee the block before quarantine was imposed last week and refused to respond to the government's appeal to turn up for medical checks. They told newspapers they feared discrimination and infection if they visited government clinics crowded with possible SARS patients.

 

Some in Kowloon are giving the complex a wide berth.

 

"I need to walk past the estate every day. But now I'd take care to stay at a distance," said a woman wearing a face mask.

 

In another apartment block in eastern Kowloon, a SARS patient refused to go to hospital and had a stand-off with police negotiators for about 14 hours before backing down and agreeing to be taken to hospital on Sunday.

 

Some of his neighbours wasted no time in packing up and moving out.

 

"I'm moving to live with my father temporarily," a man, who would only identify himself as Mr Lee, told reporters as he left the building.

 

The Equal Opportunities Commission said an employer asked an employee to quit his voluntary service to those at risk of contracting the disease, and a funeral parlour refused to stage the funeral of an SARS victim.

 

The Apple Daily reported some private doctors had put up notices outside their clinics to say people suffering high fever should go to hospital and only those confirmed not to have contracted SARS should come back.

 

The more health-conscious are wary of those who do not wear masks.

 

"I discriminate against those who don't wear masks in public places. If they don't care about themselves, they should care about the others. How can they know they are not sick?," said Ming Lee, an information technology professional.

[shi2tou5]

Since we are quoting news sources.

Original document at:

http://www.msnbc.com/news/885653.asp?0cv=CB20

 

 

SCIENTISTS CLOSE IN ON DEADLY VIRUS

 

 

MSNBC NEWS SERVICES

 

April 6 — Scientists may have identified the deadly respiratory virus that has killed more than 90 people, and that could help control its spread, the head of the World Health Organization said Sunday. But scientists said they were unsure how long it would take to control the outbreak, which has infected thousands in a dozen countries.

 

 

LABORATORY TESTS indicated the virus behind Severe Acute Respiratory Syndrome belonged to the corona family, which also causes the common cold, Gro Harlem Brundtland, secretary-general of the U.N.’s health agency, told Reuters.

Scientists have been struggling to identify the virus as a first crucial step toward trying to control its spread.

The outbreak started late last year in China and has spread around the world, killing more than 90 people and infecting almost 2,600.

Brundtland said international cooperation was needed to battle the flulike disease and added that China, which has come under fire for a lack of transparency over the disease, should have shared information much earlier.

“I think we are now seeing good collaboration, but of course it would have been helpful if we had been able at an early stage to gain access and send the WHO team in.”

A team of WHO experts is in the Guangdong province, which accounts for an overwhelming majority of the total number of deaths and infections in China, to investigate the outbreak.

 

CONTROLLING THE DISEASE

Brundtland said it was difficult to say how long it would take to control the disease.

 

“What we can see is that in some of the places where a lot of effort has come in to contain, limit the spread, isolate and deal with the cases the result has been quite positive.”

Symptoms of SARS include a fever above 100 degrees Fahrenheit, aches, coughing and breathing difficulty.

“There could be a number of other people who are really symptomless and who don’t really know,” she said, but added that such people were not likely to spread the virus.

The virus spreads through droplets by sneezing or coughing, according to WHO, but they have not ruled out the possibility of the virus’s being airborne.

On Saturday, a World Health Organization official said that a key to controlling the fast-spreading respiratory illness could lie in identifying highly infectious people.

 

 

- select a question -What are the symptoms?How does the illness spread?What causes it?How is SARS treated?How deadly is SARS?Is it safe to travel?Where have SARS cases been reported?What if I have SARS symptoms?

World health experts are trying to identify the cause of severe acute respiratory syndrome, or SARS, a new form of deadly pneumonia that is spreading rapidly through Southeast Asia and other parts of the world. For more information about the illness, click on a question above.

Most patients start out with a fever greater than 100.4 ° F (38° C) and often have accompanying chills, headache, malaise, body aches and mild respiratory symptoms. In the early stage, many patients have a decreased white blood cell count and may also have diarrhea. After 3 to 7 days, the patient may develop a dry, non-productive cough that increases in severity. As the disease progresses, chest x-rays may show significant congestion in the lungs. Eventually not enough oxygen can get to the blood and, in 10 to 20 percent of cases, patients will require mechanical ventilation. The severity of illness among patients is highly variable, ranging from mild symptoms to death. Only patients who have traveled within 10 days of the onset of symptoms to an area with suspected SARS cases, or have had contact with a person suspected of having SARS, are considered possible carriers of the disease.

SARS appears to spread through close contact, such as between family members or between patient and doctor. Experts believe it is transmitted through coughing, sneezing and other contact with nasal fluids. Researchers are also looking into the possibility that it is spread through the air, but this has not yet been confirmed. Once someone has been exposed to the illness, it takes three to seven days for symptoms to develop.

Researchers are not yet certain what pathogen is behind the illness. CDC scientists recently said the disease may be caused by a new form of the coronavirus, one of a few viruses that can cause the common cold. Other researchers have found signs of another germ family, the paramyxovirus, which causes measles, mumps and other diseases. SARS may be caused by one of those two viruses or it’s possible they are working together.

Patients suspected of having the illness are being quarantined in hospitals. Until health officials learn its cause, there is no definite course of treatment. Some doctors have reported that patients respond well to treatment with antiviral medications and steroids.

The fatality rate among persons with SARS is approximately 3 percent, according to the World Health Organization.

The CDC says travelers should consider postponing trips to countries at risk, including Hong Kong and China. In addition, the U.S. State Department has warned citizens not to travel to Vietnam because the country lacks medical facilities to deal with the outbreak there. The CDC has begun handing out notices to travelers returning from Hong Kong, China and Vietnam warning them to be on the lookout for symptoms of SARS. Americans living abroad are urged to avoid activities, such as visits to hospitals, that might bring them into contact with people who have SARS. Airline crew members are asked to be on the lookout for sick passengers and quickly isolate them from other passengers if possible.

 

Suspected cases of SARS have been reported in China, Hong Kong, Taiwan, Singapore, Thailand, Vietnam, Canada, United States, France, Germany, Switzerland, Italy, Britain and Ireland. So far China, Hong Kong, Vietnam, Singapore and Canada are the only countries with reported deaths from the illness.

In the United States, people who think they may have SARS and have recently traveled to Asia, or have been in contact with someone who has, should contact their doctor for a full evaluation. Health workers who suspect cases of SARS are asked to report them to their state health departments. The CDC requests that reports of suspected cases from state health departments, international airlines, cruise ships, or cargo carriers be directed to the SARS Investigative Team at the CDC Emergency Operations Center (770-488-7100). Outside the United States, health workers who suspect cases of SARS are requested to report them to their local public health authorities.

 

Source: World Health Organization; U.S. Centers for Disease Control and Prevention; Associated Press

Printable version

 

 

’CHINA CAN CURB DISEASE’

Chinese Prime Minister Wen Jiabao said Sunday that his country was capable of curbing the spread of SARS even though the toll nationwide climbed to at least 51 dead and 1,247 infected.

SARS is the first big crisis facing Wen’s fledgling administration, which took office only in March.

Wen declared it was safe to travel to the mainland even though SARS killed a Finn on Sunday — the first foreigner to succumb to the disease in China.

“The Chinese government and people warmly welcome friends worldwide to come to our country for tourism, visits or to engage in commercial activities,” the official Xinhua news agency quoted Wen as saying.

 

Millions of Chinese are due to be on the move over the week-long May 1 Labor Day holidays. China, which counts on three “Golden Week” holidays a year to help fuel consumer spending, appeared eager to keep public concern at a minimum.

Chinese health officials have said hundreds of victims have been discharged from hospital after they were treated with Western and traditional Chinese medicine.

A group of Kenyan runners has pulled out of the Beijing women’s marathon, the Rolling Stones have postponed their first-ever concerts in China and several international business events have been scrapped.

 

SARS IN BRITAIN

SARS has cropped up in places as disparate as Hanoi and Ontario, and on Sunday Britain reported a fifth probable case of the deadly virus, a man who returned from Taiwan last month.

It was the second suspected case of the illness in the country in as many days. Earlier, the Health Protection Agency said a woman who was being treated for the illness in a hospital in northern England was improving.

 

 

 

Britain has advised against non-essential travel to Hong Kong and Guangdong province.

Malaysia has also reported its first likely death from SARS.

In Thailand, which has suffered two deaths, Health Minister Sudarat Keyuraphan said he might call on military medics to help screen airline passengers for SARS.

Singapore, with six deaths, said its number of new infections was dropping. Authorities said people should resume their normal routines and that schools would reopen in the coming week.

Although WHO says the disease is less infectious than influenza, and the death rate from SARS so far has been between 3 percent and 4 percent, experts say patients in areas without good medical facilities face a higher mortality risk.

The disease has squeezed air travel and cut hotel occupancy rates in some Asian hot spots, reached 19 countries or regions and has many governments bracing to meet the threat.

Vietnam, where the spread of the disease was thought to be in check, quarantined a doctor suspected of catching SARS from a patient, along with 43 others with whom he had contact.

Australia posted doctors and nurses at major airports Saturday to monitor travelers for SARS, armed with the power to quarantine people with suspected symptoms.

In the United States, which has 115 suspected cases of SARS, President Bush issued an executive order allowing health officials to use forced quarantine of patients if needed.

Continental Airlines suspended Hong Kong-to-New York flights until the end of May, and the national airline in Mauritius halted flights to Singapore and Malaysia over SARS fears.

 

The Associated Press and Reuters contributed to this report.

[tonado]

http://asia.news.yahoo.com/030407/3/vf1c.html

 

Monday April 7, 4:28 PM

INTERVIEW-WHO sees SARS slowing in Guangdong

By John Ruwitch

 

BEIJING, April 7 (Reuters) - A World Health Organisation expert said on Monday the number of SARS cases was slowing in China's Guangdong province, where the disease first appeared, and there were signs the virus might be weakening there.

 

"It does look like the disease rates are dropping, dropping quite a bit," said Robert Breiman, head of a WHO team investigating the outbreak of Severe Acute Respiratory Syndrome in the southern province neighbouring Hong Kong.

 

"There still are, though, cases," he told Reuters by telephone from Guangdong as China said two more people had died of the mystery virus. The national toll has now risen to 53 people and infections to 1,268 -- all but a few in Guangdong.

 

"The problem isn't extinguished, which would be the nice place to get to. But it's occurring in lower frequency, lower incidence than it was during the peak time in February," he said.

 

The WHO experts' trip to Guangdong is providing clues on the origins of the disease and how Guangdong, where more than half of the world's cases have been, has handled the outbreak.

 

The WHO team, which has met provincial disease control officials, visited hospitals and laboratories and interviewed several of the people with the earliest known cases of SARS, was also gaining insight into how the illness spreads.

 

"We're still not ruling out the possibility that the virus itself could become burned out and become less and less transmittable," Breiman said.

 

"We've seen more and more evidence of subsequent generations of the disease out here being less severe and people, as they move further on in the generation cycle, transmit it less efficiently," he added.

 

Some experts have suggested the SARS virus came from animals and mutated, then jumped to humans, but the team in Guangdong saw no evidence supporting that theory.

 

"No progress has been made" to support the hypothesis, Breiman said. "It's still something that we think is important, though."

 

A SYSTEMATIC, SLOW PROCESS

 

Breiman balked at suggestions the outbreak was under control, as the Chinese government has said publicly on several occasions.

 

"I think that term 'under control' keeps getting people into various kinds of trouble. To me, that's not so much the issue as whether or not people are taking all the appropriate steps that are available to us at the moment," he said.

 

In Guangdong, where the hospital system was thrown into crisis when the disease peaked in February, the right measures appear to have been taken and the system was now getting back to normal slowly, Breiman said.

 

"In February the hospitals were full, especially a few of the main hospitals that were seeing a large number of patients," he said. "I think now, they're sort of in a recovery mode. They still have some patients, but the numbers are way down."

 

Breiman said the team would head back to Beijing on Tuesday pleased with its work in Guangdong, but had not solved the puzzle of how the disease originated and became an epidemic.

 

"It's a systematic and slow process," he said. "We're still gathering, assembling -- collating through lots of data."

 

"I don't think that we, ourselves, during this time will have the answers. Of course, we didn't really expect that we would.

 

"It's too big of a set of questions and it's the people that have the data themselves that have to come up with the answers," he said.

[owenkrout]

It will be clear by the middle of May whether they have really gotten a handle on the disease or not. If it doesn't explode after millions of people travel all over the country during the Labor Day holiday, then they really have managed to contain it.

[Mick]

It will be clear by the middle of May whether they have really gotten a handle on the disease or not.  If it doesn't explode after millions of people travel all over the country during the Labor Day holiday, then they really have managed to contain it.

Now this is really a good point Owen. I wonder if and to what extent this thing will affect holiday travel. From the news reports quoted in this thread, I am cautiously optimistic that this thing is burning itself out.

[tonado]

It seems like the virus is still spreading.

 

----------------------------------------------------------------

 

Tuesday April 8, 9:54 AM

Virus spreads to new part of Hong Kong

 

HONG KONG, April 8 (Reuters) - A deadly virus showed signs of spreading to a new part of Hong Kong on Tuesday and Singapore said six more nurses had been infected, raising fears the flu-like disease was far from being contained.

Despite precautions taken by airports and airlines to screen out sick passengers and stop the spread, India reported its first suspected case of the virus, involving a U.S. citizen who fell ill after travelling to Bombay from China.

 

Severe Acute Respiratory Syndrome (SARS) has been carried around the world by travellers, killing more than 100 people and infecting more than 2,600 in 20 countries.

 

It has devastated tourism and wreaked havoc in the economies of the worst affected places.

 

Continental Airlines joined a growing number of carriers cutting services. It suspended nonstop flights between New York and Hong Kong for nearly two months because of plunging demand.

 

In Hong Kong, the worst-hit area after mainland China, there were signs that the disease was spreading in the district of Tuen Mun, where a hospital is treating dozens of SARS patients.

 

Fourteen people in the town had contracted the disease, up from five late last week, according to the Wen Wei Po newspaper. Government officials were not immediately available for comment.

 

For many people in Hong Kong, it was a chilling reminder of how the disease erupted in another housing estate in Kowloon last month. Victims from that estate account for more than a quarter of all the 883 cases in Hong Kong, where 23 have died.

 

About half of the 278 people infected in the Amoy Gardens estate come from a single block and authorities are still investigating how they were all infected in a matter of days.

 

The disease has mostly hit Asia but it has killed at least 10 people in Canada, where it is concentrated in Toronto's large Chinese immigrant population.

 

In Singapore, the fourth worst hit area, two more people died on Monday, bringing the death toll to eight, and Prime Minister Goh Chok Tong cancelled a trip to mainland China, where the disease first emerged in November.

 

There were signs the deadly virus had spread to a fifth Singapore hospital, after six more nurses contracted the illness at three different hospitals.

 

Citing the blow from SARS, Goh said the government would revise down its forecast of 2-5 percent economic growth this year.

 

Health officials said on Monday they were trying to contain the deadly virus before it becomes a permanent scourge, but complained that valuable time had been lost with China's secrecy over the outbreak in the first few months.

 

World Health Organisation experts are now in China's southern Guangdong province, where the disease first surfaced in November.

 

They said they thought the epidemic there was slowing, although it was far from over.

 

SARS symptoms include high fever, chills and breathing difficulties, and the disease has a mortality rate of about four percent. By comparison, less than one percent of people who contract influenza die from it.

[tonado]

http://www.nytimes.com/2003/04/08/science/...ml?pagewanted=1

 

April 8, 2003

Respiratory Disease Is Found to Be Spreading

By LAWRENCE K. ALTMAN and SHERYL GAY STOLBERG

 

 

World Health Organization officials, who earlier said they were close to containing a mysterious new respiratory disease in many areas, said they suffered serious setbacks yesterday as clusters of new cases appeared in several countries.

 

The officials were particularly concerned because new clusters appeared in Singapore, which had imposed stringent quarantine measures, and in Vietnam, where health officials thought they had broken the chain of person-to-person spread of the disease, known as SARS, for severe acute respiratory syndrome.

 

And in Canada, health officials also had new worries because of several cases that showed that some elderly people with the disease might not be detected because their symptoms seemed milder than those of younger people with the disease.

 

In particular, Canadian health officials are now scrambling to check people who had contact with one elderly man who was not suspected of having SARS when he died on April 1.

 

The man was exposed to the disease in mid-March when he was an outpatient at the Scarborough Grace Hospital in Toronto, where the initial outbreak of SARS in Canada occurred. But officials did not think he had SARS until after his funeral last Thursday, when members of his family started coming down with the disease.

 

Dr. Colin D'Cunha, Ontario's commissioner of public health, said the concern now was that the man himself might have transmitted the disease more widely before his death and that infected family members might have unknowingly transmitted SARS "in a significant manner" to mourners or workers at the funeral.

 

Health officials did not release the man's name and age out of concern for his family's privacy.

 

On Saturday, epidemiologists began tracking down all workers and all the mourners who signed the register at the funeral home. They were asked to stay in isolation for 10 days.

 

Canadian health officials also said that several other elderly patients had a milder fever and their chest X-rays did not show the same degree of pneumonia that many younger patients did, but nevertheless appeared to have SARS. Most of those who have died from SARS have been elderly and most have had underlying medical conditions, Dr. James Young, Ontario's commissioner of public security, said at a news conference yesterday.

 

Dr. Young also said that doctors should consider SARS in any patient with a respiratory problem. Scarborough Grace was one of two hospitals in Toronto that remained closed to new patients and visitors. York Central Hospital, the other institution, , was closed after health officials learned that SARS had spread from a patient to hospital workers.

 

As of last night, Canada reported 226 probable or suspect cases, of which 188 were from Ontario. British Columbia reported 26 cases. The remaining 12 were in Alberta (5), New Brunswick (2), Prince Edward Island (4) and Saskatchewan (1).

 

One SARS patient hospitalized in Toronto is Dr. Allison McGeer, a microbiologist and director of infection control at Mount Sinai Hospital in Toronto and a leader in fighting the SARS outbreak there.

 

Although the United States has 148 suspected cases of SARS, a top federal public health official said yesterday that the number of actual cases was probably far lower because authorities are casting a wide net in looking for those infected.

 

But the official, Dr. Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention in Atlanta, warned that it was far too early in the epidemic to predict whether the United States, which so far has suffered no deaths from SARS, would escape its worst effects.

 

"We don't want to alarm people unnecessarily, but we do want to express the fact that this is the beginning of a problem," Dr. Gerberding said. "We're learning as we go. It has the potential to spread very quickly, and we've seen that. And it has the potential to spread globally — we've seen that."

 

Testifying before the Senate Committee on Health Education, Labor and Pensions, Dr. Gerberding said that fewer than half the identified patients in the United States have pneumonia. That suggests these patients do not have SARS, and also helps explain why there have been no deaths in this country.

 

Because the cause of SARS is unknown and no diagnostic test exists, officials have issued a case definition that doctors use to report cases. But there are variations in the case definitions. The W.H.O. definition includes pneumonia, whereas the one from C.D.C. does not. The typical signs and symptoms include a fever of 100.4 degrees Fahrenheit or higher, malaise, chills, dry cough and, as the disease worsens, difficulty breathing.

 

Worldwide, about 4 percent of patients infected with SARS die from it.

 

"The main reason for the low death rate in the United States is probably that we have a much broader case definition in this country," Dr. Gerberding said, adding, "We're including people who are not as sick to make sure that we know who they are and that we are doing everything we can to contain the spread."

 

SARS is believed to have emerged in China in November.

 

Officials have said that the leading hypothesis is that SARS is caused by a previously unknown coronavirus — a type of virus that is best known as one cause of the common cold — that may have mutated or jumped into humans from animals.

 

While SARS has spread easily to health workers in China and Hong Kong, Dr. Gerberding said the patterns have been different in the United States. In this country, only three health workers appear to have contracted SARS from patients. One important reason is that hospitals quickly put isolation precautions in place after the W.H.O. issued a global health alert on March 15.

 

But Dr. Gerberding said experts were still especially worried about so-called hypertransmitters, or superspreaders, of SARS.

 

"Some individuals may be especially infectious, they're especially contagious," she said, adding, "It's always the chance that we'll be seeing a further spread of the infection here in this country just as it's been observed in Canada and elsewhere in the world."

 

Dr. Gerberding was joined at yesterday's hearing by Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, and Dr. David L. Heymann, executive director in charge of communicable diseases for the W.H.O., who testified via video from its headquarters in Geneva.

 

At the National Institutes of Health, research has already begun on a vaccine to combat SARS, he said. While an effective vaccine is probably years away, Dr. Fauci predicted that by this time next year, researchers will have conducted animal experiments demonstrating that, in principle at least, a vaccine could work in humans.

 

The W.H.O. said there were at least 2,601 SARS cases, including 98 deaths, reported from 18 countries and Hong Kong.

 

Dr. Heymann, the W.H.O. communicable disease expert, said an unusual cluster of 29 SARS cases in Singapore was "particularly worrisome" because its source was unknown. Singapore health officials classified 4 cases as probable and 25 as suspected; all were health workers from two wards of one hospital where there had been no known SARS cases.

 

The clustering seems to have occurred on March 29. Dr. Heymann said his agency was concerned about that finding because it would be highly unusual for so many workers to have caught SARS from one patient on the same day. No SARS patient was transferred to the new hospital from another one that had cared for earlier cases, Dr. Heymann said.

 

So, he said, epidemiologists investigating the cluster are focusing on the possibility that the SARS agent had somehow contaminated an object in the hospital to which the 29 workers were exposed.

 

"We haven't figured it out yet," Dr. Heymann said.

 

Dr. Heymann also said that the W.H.O. was concerned about the recent spread of SARS in Vietnam.

 

Health officials thought they had stopped the chain of spread in the outbreak in Hanoi because 10 days had passed since the 58th and last case was reported there. The 10-day period represents what health officials have said is the longest incubation period of the disease — the time from exposure to the SARS agent to the onset of symptoms.

 

But on April 3, a new case was detected in a provincial hospital about two hours from Hanoi. The man had been a visitor to the hospital in Hanoi where the first case had transmitted SARS to a large number of health workers.

 

Now SARS has spread to at least two workers at the provincial hospital, Dr. Heymann said.