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About EINet
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Vol. VI, No. 07~ EINet News Briefs ~ March 26 , 2003
****A free service of the APEC Emerging Infections Network*****
The EINet listserv was created to foster discussion, networking, and collaboration in the area of emerging infectious diseases (EID's) among academicians, scientists, and policy makers in the AsiaPacific region. We strongly encourage you to share their perspectives and experiences, as your participation directly contributes to the richness of the "electronic discussions" that occur. To respond to the listserv, use the reply function. In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION Below is a semimonthly summary of AsiaPacific emerging infectious diseases. ASIA & AMERICAS URGENTSARS MORTALITY, CONTAGION Moderator: News wire stories suggest that the virus, tentatively identified as a Coronavirus, may be more contagious than presented in bulletins from authoritative sources last week. Given the school closures in Hong Kong and Singapore and quarantines in Ontario, Canada, we urgently suggest that APEC member countrieswith strong travel ties to affected countries review the information on this epidemic situation. Additional technical information is available at the WHO (http://www.who.int/csr/don/2003_03_26/en/), CDC (http://www.cdc.gov/ncidod/sars/) and Hong Kong Health Department (http://www.info.gov.hk/dh/ap.htm) Health Canada (http://www.hcsc.gc.ca/pphbdgspsp/sarssras/index.html) websites. With probable droplet persontoperson transmission advising the public with messages about hand washing, remaining at home when coughing and sneezing and other measures is more important than ever to avoid spread within our communities. As always EINET is pleased to accept comments from the many authoritative members on our network about the accuracy of these reports, or other information carried through this network. Below are three news wire accounts: Reuters: Hong Kong March 26, 2003 Singapore, which has quarantined 861 people with flulike symptoms and reported
on Wednesday its first two deaths from severe acute respiratory syndrome (SARS),
said all schools would be closed until April 6.
A top Hong Kong official issued a chilling warning to the city's seven million
people, saying the killer disease was spreading among the public.
"We can see the trend of the figure climbing. People from all walks of
life have been infected,'' Hong Kong Deputy Director of Health Leung Pakyin told
a news conference. ``If you are on the plane and an infected person is sitting
either behind or in front of you and he coughs, you can get infected.''
Eleven people have died from the illness in Hong Kong since the outbreak began
in February. Leung said infections had risen to 319 from 290 on Tuesday, with
316 suffering severe pneumonia.
Hong Kong officials had said the illness was mostly confined to hospital staff
and relatives of infected patients.
China said on Wednesday 34 people had died and about 800 had been infected
by a mystery pneumonia, up from a previously reported five deaths and 305 infections.
In Beijing, health officials said three people had died of the disease and
five more had been infected but said the illness was not spreading in the city
of 14 million. Health officials had previously denied any deaths in the capital.
SEVERE PNEUMONIA
World Health Organization officials believe SARS, spreading swiftly across
the world, is linked to a disease outbreak in China's southern province of Guangdong
that began in November, but they have yet to prove a link. Guangdong borders Hong
Kong.
Symptoms of the disease, which is believed to be spread through droplets by
sneezing and coughing, include high fever, chills, coughing, cold and breathing
difficulty. Many victims quickly develop severe pneumonia. Out of every 100 infected
people, three to five die from the disease, experts say.
Guangdong officials said 31 people had died of atypical pneumonia in Guangzhou
and six other cities in the province by the end of February. A total of 792 had
been infected.
Beijing has put its hospitals on alert and laid out a plan to prevent the disease
from spreading in the city.
SARS has spread to Hong Kong, Vietnam, Singapore, Canada and Germany, infecting
more than 500. Suspected cases have been reported in the United States, Japan,
Britain and Australia.
Four people have died in Vietnam, three in Canada and two in Singapore. More
than 70 people have been infected in Singapore.
Worried parents in Hong Kong and Singapore kept children home from school or
packed them off to class wearing surgical masks.
``Don't worry about how you look. You should feel lucky you have this to protect
you,'' one Hong Kong mother told her son as he fidgeted under his mask.
SCHOOL'S OUT
The Singapore government went further on Wednesday evening. It said it would
halt classes for the city state's 500,000 children to try to alleviate parent
concern, despite saying in a statement there were no medical reasons to close
schools.
The Hong Kong government has ruled out suspending classes, although nearly
100 schools have chosen to shut down. Two more school children fell ill on Wednesday,
bringing the total to 9.
Hong Kong's Central Library and a branch of the Bank of East Asia in the city
were shut for disinfection after a worker in each place was suspected to have
caught the disease.
Hong Kong is trying to track down 78 foreigners who stayed on the same hotel
floor as an infected mainland Chinese doctor suspected of starting the Hong Kong
outbreak in February.
The hotel guests from mainland China, Britain, the United States, Singapore,
Canada, Australia, Malaysia, Japan, the Philippines, Netherlands, Germany and
Taiwan stayed on the ninth floor of the Metropole Hotel between February 21㪮.
The Chinese doctor is believed to have infected at least seven strangers
probably in the hotel lift or lift lobby who then spread the virus in Hong Kong,
Singapore, Vietnam and Canada. The doctor and two of those he infected have died.
Hong Kong is looking for 245 passengers on board two Air China flights CA
112 from Hong Kong to Beijing on March 15, and CA 115 from Beijing to Hong Kong
on March 19 after nine tourists from Hong Kong on those two flights fell ill.
The nine were likely to have caught the disease during the March 15 flight
from an infected Chinese passenger, who was returning to Beijing after visiting
a sick relative in Hong Kong.
______________________________________________________________
World Health Organization links China illness outbreak to others Chinese authorities said the disease has killed at least 34 people in China
since November 31 in the south and three in Beijing. Hundreds have been infected.
Previously, they said only five had died in southern Guangdong province. World
health officials later said the symptoms of the Chinese illness are consistent
with those for severe acute respiratory syndrome, or SARS, which has sickened
nearly 500 people and killed 18 elsewhere 10 in Hong Kong, four in Vietnam,
three in Canada and one in Singapore.
A second person suspected of having the disease died in Singapore late Wednesday,
officials said, and all schools were ordered shut as a health precaution. More
than 700 people in the citystate have been ordered to stay home under quarantine
or face fines.
"Everything we've seen so far indicates it's the same disease," said
Dr. Meirion Evans, a member of a WHO team that has studied the cases in southern
China, but not yet those in Beijing.
"We're getting a more complete picture," Evans told The Associated
Press. "It's certainly been one of the objectives of the mission to clarify
whether the outbreak in China was the same disease as what's been seen outside
of China.
"It's not good news for the patients, but it's helpful in our understanding
of the disease."
The WHO has called on Beijing to be more cooperative. Taiwan also urged China
on Wednesday to be more forthcoming.
"Because the mainland is not sharing information, the source of the contagion
has not been clear and the period of risk for the outbreak has been lengthened,"
said a report from Taiwan's Mainland Affairs Council, which handles the island's
relations with rival China. "This hasn't helped us protect ourselves from
an Singapore's closure of schools, from day care centers to junior colleges, will
keep a halfmillion students temporarily out of class.
"On purely medical grounds, there are currently no strong reasons for
closing all schools," said Teo Chee Hean, Singapore's education minister.
"However, principals and general practitioners have reported that parents
continue to be concerned about the risk to their children in schools."
In Hong Kong, where numerous citizens are going about town in masks, media
reported that about 60 schools have been closed as a precaution.
The Hong Kong Education and Manpower Bureau would confirm only five closures
after eight students were infected by sick relatives or health care workers
but officials acknowledged some schools were closing at their own initiative.
Health officials said Tuesday they had quarantined about two dozen possible
carriers of SARS in Canada after the number of probable cases in Ontario jumped
from 10 to 18. The disease is believed to have spread to Singapore, Vietnam and
Canada by people who caught it while spending time last month on the ninth floor
of the Metropole Hotel in Hong Kong, where an infected mainland Chinese medical
professor was a guest.
The South China Morning Post in Hong Kong reported early Wednesday that the
professor had been treating atypical pneumonia patients in the mainland before
he came to Hong Kong. The professor died here in early March. Chinese officials
said previously that 305 people were sickened in the atypical pneumonia outbreak. Ye said 31 people in Guangdong had died by the end of February. Three others
died in Beijing this month, the city said Wednesday. Hoping to avoid any SARS
cases in the Philippines, officials in Manila on Wednesday urged travelers from
countries hit by the disease to stay at home for a week in voluntary quarantine.
Foreign Secretary Blas Ople also cautioned Filipinos to limit travel to countries
with known cases of SARS. Tens of thousands of Filipinos work in Hong Kong and
Singapore, many as domestic helpers. Philippine officials also convinced the parents
of a Filipina maid, Adela Dalingay, who is believed to have died of SARS this
week in Hong Kong, to have her remains cremated to avoid difficulties of transporting
the body home, Ople said. No official cause of her death has been given.
Ontario warns of 'health emergency' Health minister says SARS must
be stopped A police spokesperson said police were providing protection for a helicopter
about to land at Scarborough Grace Hospital and would not immediately confirm
that the measures taken were linked to SARS.
"This is a temporary stopgap measure until this helicopter comes in,"
said Sgt. Jim Muscat.
"Because there is no launch pad for a helicopter we are putting a perimeter
on the hospital so this helicopter could facilitate a safe landing."
The dramatic scene unfolded hours after Health Minister Tony Clement announced
he had activated an action group under Ontario's emergency powers legislation
to try to stop the spread of SARS, or severe acute respiratory syndrome.
Dozens of households have already been quarantined and a school and a hospital
emergency room has been closed.
"We're taking this very seriously," Clement said.
"By characterizing it as a health emergency, we are giving ourselves the
powers that we need and the information that we need at the most appropriate time
to ensure that we can contain this disease as soon as possible."
A command centre will be set up and staffed 24 hours a day to coordinate all
information from hospitals and health workers on SARS, also known as atypical
pneumonia.
The government has already designated the illness a reportable, communicable
and virulent disease under the Health Protection and Promotion Act, which lets
officials quarantine people against their will.
About 25 Toronto residents showing symptoms of SARS, many of them health care
workers, have been quarantined, some in hospital isolation rooms. Their family
members have been told to stay home for at least 10 days. They must wear facemasks
while interacting with other family members, sleep in separate rooms and are forbidden
to leave their home or hospital room.
Public health officials warn the total quarantine count could be in the hundreds.
The outbreak has dominated the front pages of local newspapers, sending some
Torontonians straight to a surgical supply store first thing this morning.
"Before we even opened there were three people at the door and I think
they cleaned us out at that point," said Jim Garde, general manager of Starkman's
Home Healthcare.
"It's gone crazy, we're trying to keep up with it right now. ... It seems
that about every second person that's coming in is buying a box of these masks."
Garde's store provides masks wholesale to several pharmacies, as well as to
Toronto's ambulance service, public health office and police force. But many of
the customers he's seen in recent days have been regular citizens, fearful they
could soon fall ill.
It's made for huge sales for a business that generally sells one case of masks
per month.
"We've picked up 30 cases this morning, we've got another 125 cases tomorrow,"
said Garde.
Health officials urged the public not to panic, pointing out that only people
who have been in close contact within about one metre, over a period of some
time with a person sick with SARS have become infected.
Clement said he held a rare evening meeting with Ontario's chief medical officer
Tuesday to discuss taking extraordinary measures to deal with the pneumonialike
illness.
"(The) Health (Ministry) has an emergency situation, it recognizes that,"
he said. "We felt that because there were new suspect cases that this was
warranted."
On Tuesday, eight more probable cases emerged in Ontario, marking a substantial
jump in suspected cases in Canada. There are now 19 probable cases; 18 in Toronto
and one in Vancouver. Three people in Toronto have died.
Clement said the ministry action group would make it easier to track the disease's
spread.
"It provides a central depository of this kind of information so that
we can act as swiftly as possible," he said.
Fears over the spread of SARS closed an eastend school until Monday after
three kindergarten students fell ill with undiagnosed fever. The board stressed
the fevers were not consistent with SARS symptoms and that the closure of the
elementary school was a precaution.
Other schools have sent notes home urging parents to watch for symptoms such
as dry coughs and soaring temperatures and to keep sick children home.
The closed school is a short walk from Scarborough Grace Hospital, which shut
its emergency room earlier this week after treating three people who died from
the disease.
Clement noted that SARS posed a distinct threat from the West Nile virus, which
is not as easily spread.
"(SARS) is a potentially airborne disease," Clement said. "The
degree of spread could be quite exponential if nothing is done."
West Nile is spread by mosquitoes that have bitten an infected bird, not through
persontoperson contact, such as coughing, sneezing or drinking from a shared
cup.
The SARS outbreak started in China, where it sickened hundreds. It was carried
to Toronto by Suichu Kwan who was returning from Hong Kong. Kwan died of the
disease March 5.
Health Canada has urged Canadians planning trips to the most affected parts
of Southeast Asia to defer travel for the time being. Those areas are Hanoi, Vietnam,
Hong Kong, Guangdong province in China and Singapore.
Grover Hayashi of Elite Orient Tours said about 20 people have cancelled flights
with his company in recent days, likely because of the Health Canada warning and
anxiety over the war with Iraq.
2. JOIN THE ELIST AND RECEIVE EINet NEWS BRIEFS REGULARLY The APEC EINet listserv was established to enhance collaboration among academicians and public health professionals in the area of emerging infections surveillance and control. Subscribers are encouraged to share their material with colleagues in the AsiaPacific Rim. To subscribe (or unsubscribe), contact apecein@u.washington.edu. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious. |
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© 2003, The University of Washington |