WHO to lift Toronto SARS travel advisory

By STEVE MITCHELL, UPI Medical Correspondent  |  April 30, 2003 at 8:52 AM
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WASHINGTON, April 30 (UPI) -- The World Health Organization said Tuesday it will take Toronto off its list of places travelers should avoid over concerns about SARS because the city seems to have the disease under control.

Toronto still is classified as an "affected area," however, because it still has cases of severe acute respiratory syndrome. Previous WHO travel advisories for areas of China and Hong Kong also remain in effect.

The decision to lift the Toronto travel advisory -- which becomes effective Wednesday -- was made because the city has not had any community transmission of SARS for 20 days and no cases of the disease have been exported from the city to other areas, WHO Director-General Dr. Gro Harlem Brundtland said in a statement from Geneva.

In addition, Canadian authorities have assured WHO officials they will implement screening measures for SARS at airports, Brundtland said.

"The streets of Toronto are safe from SARS. They're as safe as the streets of London, Paris or Washington," Dr. James Young, commissioner of public security for the government of Ontario, Canada, testified during a Tuesday hearing on SARS held by the U.S. Senate Health, Education, Labor and Pensions Committee.

Young noted, however, "It only takes one case to start a new breakout and therefore we must be vigilant."

To date, Canada has reported 146 cases of SARS, including 20 deaths from the illness.

Dr. Paul Gully, senior director-general of the population and public health branch of Health Canada, agreed with Young about the need to stay prepared for new cases.

"We don't think (SARS is) going away," Gully testified before the Senate committee. "We hope transmission internally in Canada will go away but we think we will continue to have to deal with imported cases" from other countries, he said.

Indeed, several Asian countries still are struggling with SARS, and the Association of Southeast Asian Nations met in Bangkok Tuesday and endorsed a set of procedures designed to contain the SARS outbreak in that region.

The procedures, which include standardizing screening of all travelers, isolating and treating SARS cases and sharing information in a timely manner, were agreed to by the governments of Indonesia, Malaysia, Singapore, the Philippines, Thailand, Myanmar, Brunei Darussalam, Cambodia, Lao PDR, Vietnam, China and Hong Kong.

The action by the Asian nations comes as China reported 202 new SARS cases and nine more deaths, bringing its total to 3,303 people infected and 148 deaths. Approximately 152 of the cases and all of the deaths occurred in China's capital city Beijing, which now has a cumulative total of 1,347 people infected and 59 deaths.

Probable or suspected cases of SARS have been reported in 25 of China's 31 provinces and there is concern from health officials the country will be unable to contain the disease.

"There is very little suggestion right now that (SARS is) going to go away anytime soon in China," Dr. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention in Atlanta, testified before the Senate committee.

Gerberding said it is "highly unlikely" containment efforts being used by the Chinese government will be successful in stopping the spread of the disease.

"The rapidly growing number of new cases in Beijing imposes a heavy burden on the healthcare system and particularly its hospital capacity," WHO said in a written statement.

In addition, the situation in western China -- where 30 new cases were reported Tuesday -- "continues to be of concern," WHO said.

The United Nation's health agency said it "is working with local health authorities in Beijing to review and improve the data needed to better monitor the SARS situation and assess the success of current control strategies."

Gerberding said the "most likely scenario" for the United States is cases of SARS will continue to occur in the country due to global travel. Health officials "will have to work hard at containment (and) hope this will prove to be a seasonal virus," she said.

SARS continued to spread to new areas of the globe Tuesday as South Korea reported its first case of the disease. To date, 5,462 SARS cases and 353 deaths have been reported in 27 countries.

Hong Kong reported 12 additional deaths from the disease, bringing its total to 1,572 cases and 150 fatalities. Singapore also reported another death and that country has now seen 201 cases and 24 deaths.

Young said the disease appears to be most severe in the elderly as all 20 of the Canadian deaths except for one occurred in people who had significant health conditions or were elderly. Other reports have indicated children might be less prone to contract the illness.

Gerberding dismissed both of these notions as inaccurate. "Children are not immune," she said, noting there have been reports of infants and older children who may have contracted the illness.

The elderly are not the only ones to succumb to SARS, she noted. "I think we thought early on this might be more severe in the elderly ... but as we see the outbreak unfold we're seeing severe disease in all age groups."

The CDC still is developing a test for diagnosing the disease in people and Gerberding said the agency expects to get one to physicians "very soon."

"We're very close to a reliable diagnostic test ... (within) weeks, not months or years," she said.

Medications to treat the illness and vaccines that could prevent infection may be much further off, she added.

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