SARS in Toronto considered contained

Jul 2, 2003 (CIDRAP News) – The World Health Organization (WHO) today removed Toronto from the list of areas with recent local transmission of SARS (severe acute respiratory syndrome), leaving Taiwan as the only place where the disease is not officially contained.

Toronto had a 4-month, two stage SARS outbreak that was the largest outside Asia, with almost 250 probable cases and at least 38 deaths. The city thought it had beaten the disease once before.

"This is a great achievement for public health in what we hope is the final phase of the global emergency," said David Heymann, WHO executive director for communicable diseases, in a news release.

The last probable SARS case in Toronto was detected Jun 12, and the patient was immediately isolated, the WHO said. Twenty days—twice the incubation period—with no new cases have passed since then, signaling that the transmission chain is broken.

Toronto was among the first areas affected when the SARS virus spread out of southern China in late February, WHO officials noted. The agency warned against nonessential travel to the city on Apr 23 but lifted the warning a week later. Toronto was deleted from the list of places with recent local transmission May 14, only to face a renewed outbreak and return to the list May 26.

"We should all pay tribute to the health workers and others in Canada who had their lives disrupted and threatened by this disease," said Heymann. "When the virus returned to start a second outbreak, health workers continued the fight and have now won it."

Canadian Prime Minister Jean Chretien applauded the WHO announcement and expressed hope that it would revive tourist traffic to Toronto, according to a report in the Toronto Star. The city has suffered economically because of SARS.

Dr. Donald Low, a leader in the city's battle with the disease, reacted cautiously to the news. The newspaper quoted him as saying, "We've been told this once before. We're not going to celebrate just yet . . . [but] it's another step forward."

More than 27,000 people were quarantined in Toronto's two SARS outbreaks, one in March and April and the second in May and June, according to the Associated Press. The AP put the number of deaths in the Toronto area at 39, including a nurse who died Jun 30 and was the first Canadian health worker to succumb to the disease. Health Canada currently attributes 38 deaths in Ontario to probable SARS and one death to suspected SARS.

Toronto's initial SARS outbreak was traced back to a guest or guests who stayed at Hong Kong's Metropole Hotel in late February and caught the virus from an infected Chinese physician there, according to the WHO. At the time, no one knew that a new disease had emerged in China, and hospital workers who treated the first patients were unaware of the need to protect themselves. As a result, SARS spread rapidly in hospitals and then to the community.

See also:

WHO announcement
http://www.who.int/csr/don/2003_07_02/en/

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