SARS Headlines:

• The Straits Times: "The World Health Organization on Monday declared that Vietnam is the first country to successfully contain its SARS outbreak, after Vietnam's health ministry announced that it had brought the epidemic under control.
  
  Vietnam's Health Minister Tran Thi Trung Chien said at a press conference in the capital that the Sars outbreak, which killed five and infected 63 people in the country, had been brought under control after 20 days with no new infections."


• India is relying on unproven diagnostic tests for SARS, defying WHO recommendations, and missing its chance to block the spread of SARS.


• Dr. David Heymann, WHO's Executive Director of Communicable Diseases said that WHO was not confident that the worldwide SARS virus spread could be stopped, although "We are hoping." He said that there was still time, if the affected countries took appropriate actions, such as travel warnings, airport checks and quarantines.


The complete 4/28 SARS Update is here.

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Vietnam
NYNewsday: HONG KONG -- The World Health Organization announced today that Vietnam has become the first country to contain SARS, even as other East Asian nations quarreled over increasingly draconian measures to halt the spread of the pneumonia-like illness.

The progress in Vietnam came after the country sealed off the Hanoi hospital where its main outbreak occurred. A total of 63 people have become ill with SARS in Vietnam, and five have died, but no new case has been reported there since April 12.

WHO doctor Carlo Urbani, who was based in Vietnam, quickly recognized the danger of the disease and health officials sealed off the Hanoi hospital, including its medical staff. The Italian doctor later died of the disease in a Bangkok hospital...

Health officials cautioned that Vietnam — which borders southern China — must remain vigilant and not allow new cases to enter the country undetected.

Taiwan reports that a Vietnamese coming from Hanoi, brought a suspected case of SARS on April 19. That might ruin the Vietnamese hopes to have the WHO lift the travel advisory, which named Hanoi.


India
1 case reported, as of April 21. No more recent reports have been made to WHO.

News reports from rediff.com indicate 7 'confirmed' SARS cases, and 20 suspected.

Indian medical authorities are diagnosing SARS by using lab tests. This is unfortunate since all currently available lab tests are inaccurate and are suited for research purposes only. The current tests fail to diagnose many cases.

Because of the Indian reliance on lab tests, 'false-negative' cases could be (wrongly) diagnosed as SARS-free and be released into the public, spreading SARS infection. The World Health Organisation (WHO) recommends:

"In the absence of a reliable diagnostic test, national authorities are strongly advised to continue to base decisions concerning what constitutes both a suspect and a probable case of SARS on the present clinical and epidemiological case definition, and not to rely on the results of diagnostic tests. WHO advises that all suspect and probable SARS cases be placed in isolation and managed according to strict procedures of infection control."


Speaking to The Times of India, a former director of the National Institute of Communicable Diseases, Dr K K Datta said, "SARS will spread. We cannot avoid it. As time passes, the mortality will come down...There is nothing like an infected or an affected country anymore. It's just that some have reported and some have not."

[ In the absence of official statements, I suspect Datta's nihilistic attitude is prevalent. India is apparently going to miss the chance to control SARS -- docbear ]

MumbaiNewsline has another story about SARS cases, in India, which also demonstrates the non-standard and very dangerous Indian reliance on SARS blood tests.

AFP: Air India has suspended a total of 27 pilots, for refusing to fly to SARS-infected countries. An Air India spokesman said that, worldwide, WHO knows of 5 people who contracted SARS from being on an airliner with an infected person.

From ProMED mailing list, issue #71:
"We have stressed in prior postings the need to maintain consistent clinical and epidemiological criteria for case reporting, pending more information on the sensitivity and specificity of currently available laboratory tests."

The Financial Express asks, "Has India Got Its Act Together On SARS?"


Dr. Heymann on controlling SARS
Dr. David Hemann, WHO's Executive Director of Communicable Disease, was also interviewed by Reuters:

Asked if he was confident that the worldwide spread of the Severe Acute Respiratory Syndrome (SARS) virus could be stopped, Heymann said: "No we are not. We are hoping."

"China is the key and it's the unknown question in the whole formula, because if China cannot contain it then it can't be removed," he said....

Heymann said there were a lot of things scientists and doctors needed to learn about the virus, before its spread could be brought under control.

"We don't understand whether it is occurring in an asymptomatic form, which may be already spread around the world as occurred in AIDS, with a long incubation period."


The complete 4/28 SARS Update is here.

Posted by docbear @ 04/28/2003 08:48 AM | TrackBack