Hotspots cool down but stay alert!

The known global death toll due to the new virus (as of 1 July) was 811. Total number of cases 8447.

Cases reported in Europe were: one case each: United Kingdom, Switzerland, Spain, Finland and Romania; 3 cases Sweden; 5 cases Italy; 7 cases France and 10 cases Germany.

China, Hong Kong, Macao and Taiwan had a combined total of 7761 reported cases as of June.
Towards the end of May, the World Health Organisation lifted its warning about travel to Guangdong, China. This month the organisation removed the warning about four more Chinese areas - Hebei and Shanxi provinces, Inner Mongolia and Tianjin city.

However, the WHO has not raised the warning about non-essential travel to Beijing, which had reported about 2,500 cases and just under 200 deaths, out of China’s 5,300 cases 347 deaths. WHO Executive Director for Communicable Diseases, David Heymann, has travelled to China to assess the level of control of the Sars epidemic, indicating doubt on the decline in reported numbers of new infections. His team are investigating whether cases are being missed, or that patients with suspected Sars are being turned away.

Both China and Taiwan are lobbying the WHO to lift warnings against travel to their areas.
New infections and deaths caused by the respiratory disease have been reported as lower in all affected countries except Canada over recent weeks, but China and Taiwan reported the highest success rate in reduction of cases, despite a large surge of cases in Taiwan in April and May. The figures logged in had dropped to such a level that the WHO pointed out that it is unlikely that the SARS virus has suddenly become less virulent - or that China’s isolation and quarantine procedures are more successful than those of other nations. (The WHO had already warned that facilities for monitoring and treating the virus are inadequate in China, and it was concerned that the virus could spread to rural areas from Beijing).

In Taipei, over 150 doctors and nurses quit their jobs in protest at the lack of safeguards and two hospitals were fined for covering up the spread of the disease. Taipei’s top health official, Chiu Shu-ti, resigned in late May. Just prior to this, the island’s record number of new infections in one day reached 65, at which point the WHO extended its travel warning about Taipei to cover the whole of Taiwan.

That outbreak prompted an offer of help from Mainland China to combat the disease. Taipei refused this and demanded that China stop blocking the island’s efforts to join the WHO.
Meanwhile, Singapore was removed from the list of SARS-affected countries at the end of May. There, 31 people had died due to Sars out of 206 cases. Singapore took stringent measures to prevent the spread of the disease, which include isolating all Sars patients and suspected cases in one hospital; the thermal-imaging of air passengers to detect any with high temperatures; issuing digital thermometers to thousands of primary school children for daily temperature checks; and the city state has now announced that it will fine and imprison patients who lie on new health forms distributed at health clinics and Chinese medicine halls. The country also recently implemented mandatory temperature checks for workers at construction sites, factories and shipyards.

Hong Kong was also taken off the non-essential travel list in June, although this area had more Sars cases per capita than any other.

Meanwhile in Canada, which had apparently eliminated Sars, doctors were recently investigating whether a new cluster of pneumonia cases at a hospital near Toronto is Sars-related.
Health authorities were criticised for easing up on precautions too soon, when it was also reported that some quarantined people had ignored isolation orders.

The authorities appealed to health workers in Toronto to go voluntarily into quarantine.
Meanwhile, health authorities in the USA reinstated advice to those visiting Toronto to take precautions against infection.

Many countries won praise for their approach to reporting and controlling the disease; these include Canada, Singapore, Vietnam, and the Philippines. Most have not only suffered the disease but economically due to the drop in tourism.

The Sars epidemic is now possibly tailing off. Gro Brundtland, Director General of the WHO, said the number of new Sars cases logged in daily was declining, but has advised that countries remain on the alert. ‘We have several examples where we have seen the figures drop in one country before seeing a new wave,’ she said during a press conference in Oslo. She also warned of a possible surge when winter arrives in the Northern Hemisphere.

Why is there so much concern about Sars? Because other contagious diseases, such as influenza (which kills 1% or less of those with the illness) do not all show the very high mortality rate that Sars has achieved.

‘We’re so used to there being an answer to everything, that there is either a medicine or a vaccine,’ said Gro Brundtland, but this time the world had to rely on old-fashioned ways of isolating cases to combat this disease.

01.07.2003

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