Taiwan:
April 25: 49 probable SARS cases (increase of 8 cases, or 19.5%, in past 24 hours)
April 28: 66 probable cases, “0” deaths according to WHO.
April 29: 66 probable cases, 85 suspected cases, 79 ‘pending’ cases ( in negative-pressure rooms), 2286 remain in quarantine.
May 1: 89 probable SARS cases, 3 deaths.
May 2: 100 probable SARS cases, 8 deaths.

The first Taiwanese death from SARS occurred on April 27. The outbreak has grown substantially in the past 10 days. It seems that most of the new patients are hospital staff, but details are lacking.

Taipei Times: Community spread may be underway, although most recent cases seem to be amongst health care workers. "Some taxi drivers and hairdressers have been suspected of being infected with the disease even though they have no contact history with SARS patients..."

AP:Taiwan to Jail Knowing SARS Infectors

NYTimes: "SARS appears to be spreading in Taiwan as fast or faster than anywhere except mainland China, prompting the World Health Organization to prepare to send a team there despite the risk of creating diplomatic tensions with Beijing."

New WHO standards for SARS case definition, an excerpt:
Suspect case
1. A person presenting after 1 November 20021 with history of:
- high fever (>38 °C)
AND
- cough or breathing difficulty
AND one or more of the following exposures during the 10 days prior to onset of symptoms:
- close contact2 with a person who is a suspect or probable case of SARS;
- history of travel, to an area with recent local transmission of SARS
- residing in an area with recent local transmission of SARS

2. A person with an unexplained acute respiratory illness resulting in death after 1 November 2002,1 but on whom no autopsy has been performed
AND one or more of the following exposures during to 10 days prior to onset of symptoms:
- close contact,2 with a person who is a suspect or probable case of SARS;
- history of travel to an area with recent local transmission of SARS
- residing in an area with recent local transmission of SARS

Probable case
1. A suspect case with radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS) on chest X-ray (CXR).
2. A suspect case of SARS that is positive for SARS coronavirus by one or more assays. See Use of laboratory methods for SARS diagnosis.
3. A suspect case with autopsy findings consistent with the pathology of RDS without an identifiable cause.

New WHO standards for SARS diagnosis, assisted by laboratory findings, an excerpt

PCR testing
Laboratories testing for SARS by PCR should already have experience with PCR testing. They should adopt quality control procedures and identify a partner laboratory in their country or among the WHO collaborating research laboratories listed in Multi-centre Collaborative Network: Laboratories testing for SARS to cross-check their positive findings.

Laboratories performing SARS specific PCR tests should adopt strict criteria for confirmation of positive results , especially in low prevalence areas, where the positive predictive value might be lower.

A PCR-kit for SARS is commercially available, including internal controls. PCR primers and procedures have been published and can be adapted by laboratories. Positive control RNA is available from the Bernhard-Nocht Institute in Hamburg, Germany.

The sensitivity of PCR tests for SARS depends on the specimen and the time of testing during the course of the illness. This may result in real cases of SARS testing negative by PCR (false negative results). Sensitivity can be increased if multiple specimens/ multiple body sites are tested.

The specificity of PCR tests for SARS is excellent if technical procedures used follow quality control guidelines. False positive results may arise as a result of technical problems (e.g. laboratory contamination), so every positive PCR test should be verified.

Antibody testing

ELISA and IFA tests are being developed by research laboratories.

Because SARS a new disease in humans, SARS-CoV antibodies are not found in populations that have not been exposed to the virus.

An antibody rise between acute and convalescent phase sera tested in parallel is very specific.

WHO switches "affected areas" classification to "Areas with recent local transmission of SARS":

With the classification change, the US and UK were dropped from the list, since it has been over 20 days since the last local transmission in those countries.

Here are the countries / areas with recent local SARS transmission:
(The number of + signs estimates the extent of local SARS transmission as low, medium, or high).

Canada: Toronto/ ++
China: Beijing/ +++
China: Guangdong/ +++
China: Hong Kong SAR/ +++
China: Inner Mongolia/ Uncertain
China: Shanxi/ +++
China: Tianjin/ Uncertain
China: Taiwan Province/ ++
Mongolia: Ulaanbaatar/ +
Singapore: Singapore/ ++

To read the complete May 3 SARS Update, click here.