WHO: Vietnam may defeat SARS, and world has chance to follow suit

Apr 25, 2003 (CIDRAP News) – World Health Organization (WHO) officials today said Vietnam has not had a new SARS (severe acute respiratory syndrome) case in 17 days and could soon become the first country to contain the epidemic, even as the cumulative global case count took another sizable jump.

In addition, WHO officials said the world still has "a narrow window of opportunity" to eradicate SARS, though the chance could be lost if the disease spreads to countries with weak public health systems.

Meanwhile, Canadian officials protested the WHO warning not to travel to Toronto because of the SARS outbreak there, saying the outbreak there is ebbing. And in Beijing, officials ordered thousands of people quarantined at home.

A WHO statement today said no new SARS cases have been detected in Vietnam in the past 17 days, despite good surveillance. "If no new cases are detected by 30 April (a date which marks the end of two incubation periods), Viet Nam could become the first country to be taken off the list of SARS-affected countries," the statement said. "This achievement would also make Viet Nam the first country to successfully contain its SARS outbreak."

Vietnam was the second country, after China, to face SARS. The most recent probable case there was detected Apr 8, WHO officials said. SARS was first identified by the WHO's Dr Carlo Urbani, who investigated an outbreak in French Hospital in Hanoi after a Hong Kong man was admitted there Feb 26, WHO officials noted. They said Vietnamese officials took the proper infection control actions very quickly after the disease was identified.

The optimistic comments about Vietnam came as the WHO reported another 210 cases worldwide, bringing the cumulative total to 4,649 cases in 25 countries, with 274 deaths. Eleven deaths—five in China and six in Hong Kong—were reported today. Of the new cases, 180 were in China, with 103 in Beijing and the rest scattered among eight provinces. Thirty-eight of China's new cases were among healthcare workers, indicating that hospitals need to strengthen infection control practices, WHO officials said. China reported 125 new cases yesterday, WHO officials said, though it was unclear how many were old cases just coming to light and how many were newly detected.

In a news briefing today (a transcript of which was published online), Dr Mike Ryan, coordinator of the WHO's Global Outbreak Alert and Response Network, said, "We have an opportunity to control this disease, but we must control it now or we will be dealing with the disease for the next 20 years. This is a key issue. We have a window of opportunity that must be grasped." Later he added, "We do believe that this disease can be controlled and can be eradicated. But we are in a very narrow window of opportunity."

David Heymann, director of WHO's communicable diseases programs, concurred with Ryan. So far SARS has occurred in countries with "reasonable systems" for dealing with infectious disease outbreaks, he said, adding, "Our fear is that it will enter into a country where those systems are not so good, a country in sub-Saharan Africa or somewhere in Asia, where the systems are not good to detect it, and that it will spread widely before we know it is occurring."

Ryan said the only three countries that currently have active transmission are China, including Hong Kong; Singapore, and Canada.

In Hong Kong today, the former head of the US Centers for Disease Control and Prevention said eradication is probably not possible, according to an Associated Press report. The world can hope for "suppression and minimization," but the hope of eradication is "very unrealistic," Dr Jeffrey P. Koplan was quoted as saying.

Meanwhile, Canadian officials were protesting the WHO warning, issued Apr 23, against traveling to Toronto because of the SARS outbreak there. Today, according to the AP, Canadian Prime Minister Jean Chretien said WHO Director Dr. Gro Harlem Brundtland had promised him that WHO would review the travel advisory next week, instead of waiting 3 weeks, as announced earlier.

A report in today's Toronto Globe and Mail said Toronto's outbreak is tapering off. No new cases have occurred in the community in 19 days, and the Ontario case count dropped yesterday for the first time, to 257, 10 lower than the day before, the report said.

The Canadians received support yesterday from CDC Director Julie Gerberding. As announced earlier this week, the CDC is not echoing the WHO warning against travel to Toronto, though it is suggesting that visitors there stay out of hospitals, she said. "We can predict so far in Toronto where the patterns of transmission are leading us, and there is no evidence that travelers to that area 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 travelers," she said.

In other developments, Beijing ordered home quarantine for 4,000 people who had had close contact with suspected SARS patients, and three hospitals in the city were sealed in the containment effort, according to AP reports. Also, a hospital in Taipei, Taiwan, was sealed after more than 25 suspected SARS cases were discovered there; more than 1,100 patients and staff were expected to be confined for up to 2 weeks.

Elsewhere, the Philippines reported its first two SARS deaths today, and Bulgaria reported its first case yesterday.

See also:

Apr 25 WHO statement on Vietnam

Transcript of Apr 25 WHO news briefing

Transcript of Apr 24 CDC news briefing

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