Posted 9:34 PM by Dr. Kay

SARS situation stabilises

By P. S. Suryanarayana

SINGAPORE May 2. There was no sign of any respite from the Severe Acute Respiratory Syndrome (SARS) epidemic in China, although the health authorities in Beijing today underlined that the new disease might have "stabilised'' or hit a "platform'' of neither improvement nor deterioration.

According to the Deputy Director of the Beijing Health Bureau, Liang Wannian, the spread of the dreaded disease had now entered "a stable period, with the upward trend contained''. However, there was no real cheer on the SARS front in China as a whole. The overall death roll was put at 181 by Friday morning, as against a global figure of 391 dead by Thursday. The total number of confirmed SARS cases in China today stood at 3,799 (the global figure as on Thursday being 5,865 across 27 countries and territories).

The latest number of suspected SARS cases in China was put at 2,459 over and above the probable or confirmed cases. The situation in China's Hong Kong Special Administrative Region remained a matter of serious concern for yet another day, with some researchers at a university there saying that the "coronavirus'', believed to be the cause of the disease, showing signs of "mutating'' at a "rapid'' rate. This aspect might make the fight against the disease that much more formidable, it was emphasised. There was still no authoritative word from China on how the disease originated last November.

On the wider regional front, the recent accord between China and the Association of South East Asian Nations (ASEAN) on ways to combat the SARS and contain its spread would be implemented through practical measures to be decided upon at a meeting in the Philippines by the middle of this month.

The Chinese President, Hu Jintao, and his South Korean counterpart, Roh Moo-hyun, discussed the SARS situation over phone today, with Seoul expressing solidarity with Beijing on this score.

The two leaders also exchanged views on the North Korean nuclear issue.

No SARS case in India as per WHO definition: Minister

NEW DELHI MAY 1. The World Health Organisation and the Central Government today declared that India had no case of the Severe Acute Respiratory Syndrome (SARS) as on date since not a single person in the country fitted the case definition formulated by the WHO for the disease.

Addressing a joint press conference, the Union Health Minister, Sushma Swaraj, and the WHO representative in India, S.J. Habayeb, said that as per WHO definition, a person could be considered as SARS-affected only if he or she met all the three following basic conditions: should have a fever more than 100.4 degrees Fahrenheit, should have difficulty breathing or other respiratory problem, and should either have travelled to a SARS-affected country or should have been in contact with a known SARS patient.

In India, none except one person in Goa had so far satisfied all the three conditions and the condition of that person had also improved and he had been discharged. Consequently, the WHO has even removed India from the list of countries reporting SARS cases as of today, they said.

Asked how then was the Government announcing detection of SARS cases from different parts of the country now and then, Ms. Swaraj clarified that what was being announced was only the results of tests on samples collected from suspected cases and they were made public "only with a view to tell the people that the Government was transparent and had nothing to hide".

The test results, she and Dr. Habayeb emphasised, had no meaning unless the cases also had clinical symptoms.

The tests were only supportive in nature and by themselves were not enough, particularly since the exact nature of the virus was yet to be known fully and subsequently the tests, which were based on knowledge available so far, were not totally reliable.

In this context, Ms. Swaraj noted that in India a large number of persons were carriers of the Tuberculosis virus but only those who showed clinical symptoms were considered TB patients and not others.

The WHO had, in fact, been asking the Centre to stick to its definition ever since the Government began announcing the test results and the WHO website had also been maintaining that there was only one case in India.

But the Government went ahead and kept making its announcements.

A turning point came on Wednesday, after two doctors and seven para-medical staff treating a family of suspected cases in Pune tested positive raising serious concern among medical professionals.

Ms. Swaraj announced that hereafter only the samples of persons who met the three WHO pre-requisites would be sent for laboratory analysis. However, the country would remain in a state of high alert for SARS as a measure of abundant caution.

As regards the status of persons currently under isolation in hospitals or under home quarantine without fulfilling WHO definition completely, she said they would be discharged as and when they completed 10 days of isolation or quarantine if they did not show symptoms in the meantime.

SARS virus genome sequenced

WASHINGTON MAY 1. Two nearly identical sequences of the SARS virus genetic structure have been reviewed and authenticated by experts.

The publication of the virus genome, which is being rushed into print by Science journal, should help researchers find drugs to treat the deadly respiratory illness and to develop a vaccine to prevent the infection. Science is one of the world's leading scientific journals.

A team of Canadians first sequenced a strain of the virus that causes Severe Acute Respiratory Syndrome, or SARS, using specimens taken from a patient in Toronto, journal officials said on Thursday. Another form of the virus, called the Urbani strain, was sequenced shortly afterward by a U.S.-led team. The Urbani strain was earlier linked to a lung disease by Dutch researchers. The sequences were posted on the Internet on April 15 but are only now being peer-reviewed, a scientific step that lends credence to the accuracy of the work. ``Both research teams produced these genomic sequences quickly and efficiently, in a model of cooperation among various groups,'' said Don Kennedy, editor-in-chief of Science. ``Because this information is crucial to the public health, Science is making it immediately available following an important and promptly conducted peer review.''

Experts said the authenticated gene sequences will enable researchers to more quickly develop diagnostic tests and vaccines to combat the rapidly spreading, highly contagious respiratory disease. Researchers, however, said they found key differences in genetic sequences, suggesting that SARS is a novel form of coronavirus and not a recent mutation of a known variety.

Both of the sequencing studies have identified genetic pieces of the virus that may contain instructions for protein production, along with genes that enable the virus to infect cells and to reproduce. ``These findings set the stage for further investigation into the viral proteins' functions, possibly uncovering new targets for therapies or vaccines,'' the journal said in a statement. — AP

Posted 5:12 AM by Dr. Kay

SARS: `no need for panic'

By Our Staff Reporter

THIRUVANANTHAPURAM April 30. There is no room for concern over the occurrence of Severe Acute Respiratory Syndrome (SARS) even though the State is not adequately equipped to counter it, according to the participants at a discussion on this disease, organised here today by the Thiruvananthapuram branch of the Indian Medical Association (IMA).

Various aspects of the disease that has by now caused a scare in society were discussed by a panel of experts from different fields.

It would be advisable to take necessary steps to prevent the disease rather than to begin treating a patient after it has been contracted. The situation was not alarming and it could be hoped that the change in climatic conditions would result in the disease itself dying down as in the case of any epidemic caused by virus. Isolated cases could be managed effectively, but on a large scale there would be serious problems containing the disease, the speakers observed.

Among the speakers were V.C.Velayudhan Pillai, A.Marthanda Pillai and Sreejith N.Kumar.

AI claims return of some striking pilots

By Our Special Correspondent

MUMBAI APRIL 30. Air India today claimed that some of the striking pilots had ignored the directive of their union, the Indian Pilots' Guild, and had reported for duty and said that it was restoring some flights in the Gulf sector.

The AI spokesman, however, refused to give the number of pilots who had come forward to operate flights. The Mumbai-Delhi-Mumbai-Jeddah-Mumbai flight was reinstated today, while three more flights in the Mumbai-Bangalore-Dubai-Mumbai and the Mumbai-Kozhikode-Dubai-Mumbai sectors would be operated from tomorrow.

It was planning to operate two more flights from Friday. The AI is considering the hiring of pilots of Indian origin working for other international airlines and now laid off. Expediting the training of the trainee pilots is also being contemplated to induct them by May-end instead of June-end.

Meanwhile, 27 of the 45 suspended SARS-scared striking pilots filed a petition in the Mumbai High Court today challenging their suspension. The petition, expected to come up for admission on May 2, calls the AI action of illegal and rejects the management view that the pilots had breached the service conditions by refusing to operate flights unless the management certified that the cabin crew had not travelled to the SARS-affected sectors in the previous 10 days.

PTI reports:

The Indian Pilots Guild president, Capt. Kenneth Khan, has been issued a suspension notice by the AI for refusing to operate a flight from London. "Capt. Khan was issued with a suspension notice last night for refusing to operate the Boeing 747 flight out of London last week after he was denied a certificate that none of the accompanying crew had not travelled to SARS-affected region for the last 10 days," AI sources said today.

Hospital staff quarantined in Pune

By Our Special Correspondent

MUMBAI April 30. Nine hospital staff members in Pune who came into contact with Maharashtra's first SARS patient, Stanley D'Silva, have tested positive, it was announced here today.

The D'Silvas — two of whom came in from Indonesia — themselves have now been discharged from quarantine, "having recovered.'' A second confirmatory test outcome is awaited.

The nine — two doctors and seven para medical staff — "however did not show any abnormal symptoms.

They were either in quarantine at the hospital or confined to their homes.''

This, sources concede, points to "the possible initial inability to cope with the needs of barrier-nursing.''

Those who have tested positive are among the 36 staff members at the private hospital and have been under surveillance since the first instance of SARS. Mr. D'Silva's mother and sister as well as the taxi driver who had ferried them from near here to Pune were also infected.

This updating came moments after the Maharashtra Chief Minister, Sushilkumar Shinde, said the State had "only 13 suspects and only six were confirmed so far.''

The Health Minister, Digvijay Khanvilkar, as well as the Director-General of Public Health, Subhash Salunkhe, have rushed to Pune for an "on the spot'' evaluation.

Following an outcry from people living near houses of SARS-affected people about their own vulnerability, Mr. Salunkhe had announced three days ago that "Pune was SARS free.''

Now the Government has opted to keep the identity of the victims under wraps and no names are being released.

The location of the patient, the place of quarantine and the possible point of origin alone are being indicated.

SARS 'remains severe' in Beijing, says Mayor

BEIJING april 30. Beijing's SARS outbreak ``remains severe'' and hospitals handling the disease don't have enough beds for all suspected cases, the city's new Mayor said on Wednesday.

The Mayor, Wang Qishan, acknowleged residents were frightened and that there had been some panic. But he denied speculation that the Chinese capital would be sealed off, saying enough precautions were in place. ``I think the coming week will be of critical importance in monitoring the trend of development of this disease,'' Mr. Wang said at a news conference. He called for calm and said ``the panic and fear factor among the general public is a really big issue for us.''

The Health Ministry reported nine new fatalities in Beijing and two elsewhere, raising the capital's death toll to 75 and the total for the mainland to 159. The Ministry said there were 101 new infections in Beijing, raising its total to 1,448.

``The situation in Beijing remains severe for SARS prevention and treatment. Infections have not yet been cut off. Numbers of confirmed and suspected SARS cases remain high,'' Mr. Wang said in a written statement. ``Due to a shortage of berths at designated hospitals, not all suspected SARS patients can be hospitalized there in a timely manner.''

The city has designated 21 hospitals to handle SARS cases, Mr. Wang's statement said. It didn't say how the suspected cases that weren't hospitalised were being handled.

A new 1,000-bed SARS facility north of Beijing was to receive its first 195 patients on Wednesday, he said. The official Xinhua News Agency said the facility — built in eight days by an army of 7,000 construction workers — would be staffed by 813 military medical personnel.

The rising number of infections has prompted urgent steps to stem the spread of the virus. The Beijing Government has closed public schools and ordered cinemas and other entertainment sites to close. Thousands of people have been quarantined, companies have closed temporarily and many families are staying at home.

Man of Indian origin dies of SARS

By P. S. Suryanarayana

SINGAPORE April 30. A taxi driver of Indian origin taxi driver is among the 23 who have died of Severe Acute Respiratory Syndrome in Singapore. The cause of the taxi driver's death, first thought to have been a viral fever, was later determined to be SARS.

The Health Ministry, which announced this, has not disclosed the name of the person. Singapore has so far had 201 probable cases of SARS, of whom 139 have been discharged from hospital. Another 3001 are under home quarantine.

SARS: 9 test positive

New Delhi April 30. Nine more persons in Pune have been confirmed to be positive for the dreaded SARS virus and preliminary tests revealed that a 65-year-old man in Punjab has tested positive in preliminary tests, Health officials said here today. ``Nine contacts of Stanley D'Silva in Pune have tested positive. Majority of them are hospital staff,'' the officials told reporters. All of them were under home quarantine. — PTI

Kerala allocates Rs 75 lakh for SARS control

Thiruvananthapuram: The Kerala Government on Wednesday set apart a sum of Rs 75 lakh for taking immediate steps to prevent the spread of the dreaded Severe Acute Respiratory Syndrome (SARS).

Chief Minister A K Antony, talking to newspersons after a meeting of the state Cabinet here, said though no confirmed case was reported from anywhere in the state, the government wanted to take all possible measures to prevent the disease.

Kerala, which has a huge expatriate population, has already constituted a high-level committee to deal with the situation. All the three suspected cases reported in the State so far have been tested negative for the deadly flu-like SARS virus.

Official sources said medical teams are posted on rotation round the clock at all the three international airports in Thiruvananthapuram, Kochi and Kozhikode. An ambulance is stationed at airports to shift SARS patients. Special isolation wards have been opened at the General Hospitals at Thiruvananthapuram and Ernakulam and the Medical College Hospital at Kozhikode.

SARS treatment facility in three hospitals in Kerala

04/30/2003New Delhi: Special treatment sections have been started for SARS in four hospitals in Kerala, the Union Health Minister, Sushma Swaraj said in the Lok Sabha on Wednesday. The facility is now available in the general hospitals in Thiruvananthapuram and Ernakulam and in the Medical College in Kozhikode.

SARS treatment facility is available in the Kasturba Hospital, Mumbai, V.N. Desai Hospital, Chennai, Madras Medical College Hospital, Chennai, Epidemic Disease Hospital, Bangalore and the Medical College, Coimbatore.

'Eat papaya, tulsi leaves to prevent SARS'

CHENNAI: SARS would spread through human saliva and not through air quickly as feared by people, Tamil Nadu Chief Minister J Jayalalithaa told the House on Wednesday while responding to a BJP member who wanted the government to supply masks for the MLAs.

As a preventive measure, she advised the people to eat papaya and tulsi leaves.

Quoting the doctors, who treated the SARS patient at Vellore, Jayalalithaa said none of the 15 members of his family who had called on him were affected by the disease.

Posted 1:48 PM by Dr. Kay
High-level panel to combat SARS

By Our Special Correspondent

THIRUVANANTHAPURAM APRIL 29 . Vigilance against the Severe Acute Respiratory Syndrome (SARS) has been intensified in the State as new cases of this dreaded disease are surfacing elsewhere in the country.

The State Government today set up a high-level committee, chaired by the Chief Secretary, to coordinate the efforts to prevent the disease being carried into the State and contain it if, by any chance, it makes an appearance here.

Announcing this at a press conference here, the Health Minister, P. Sankaran, said the high-level committee would have the Principal Finance Secretary, the Secretaries of various other departments like Health, Local Self-Government and Urban Affairs, the Director of Health Services, the Director of Medical Education and the head of the Airport Authority as its members.

``This committee will have full powers to decide what should be done to combat the threat,'' he said.

Mr. Sankaran said the Health Department had requisitioned a sum of Rs. 60 lakhs for the anti-SARS campaign. This amount was expected to be released soon, he added.

"As the State that accounts for the largest number of Indians working abroad, including in the SARS-affected countries, Kerala is quite vulnerable to the threat of the disease. There is no room for complacency," Mr. Sankaran said.

No case of SARS has been reported from the State so far. Three persons, admitted to the hospital with symptoms similar to the disease, were later cleared of suspicion following tests conducted on their serum samples at the National Virology Institute in Pune.

Mr. Sankaran said the present situation had exposed the need for a competent virology institute in the State. The institute set up in Alappuzha a few years ago was still not having either the required staff or the facilities to be of any assistance in a contingency like the present one.

``The Health Department has decided to provide Rs. 50 lakhs to this institute from its allocation under this year's State Plan. We will be appointing a special officer at this institute immediately. It would be made a full-fledged virology institute with its own building, expert staff and all the necessary equipment within two years,'' he said.

Listing the measures taken by the Government to combat SARS, Mr. Sankaran said all passengers disembarking at the international airports in the State were being screened by special medical teams posted there. Three medical teams were working on rotation round the clock at each of the three international airports--Thiruvananthapuram, Kochi and Kozhikode.

"So far, we have screened 17,628 international air passengers. An ambulance with driver is posted at the airports to shift suspected SARS patients to the nearest hospital designated to handle the disease. Special isolation wards are kept ready at the Government Hospitals in Thiruvananthapuram and Ernakulam and the Medical College Hospital in Kozhikode, fully equipped with oxygen sets, ventilators etc., in addition to the medicines recommended under the protocol for treating the disease,'' he said.

The Minister said that 50 `N-95 masks' to give protection against contracting the disease had been received by the State from the Centre. These had been distributed to the airports and the hospitals where the special isolation wards had been opened. The State was also importing 1,000 more such masks from the United States, he said.

The medical staff across the State has been alerted on SARS and the protocol of management of the disease has been communicated to them. An `epidemic cell' has started functioning in the Directorate of Health Services(DHS). (Ph: 0471-2302160, 2302490 and mobile 94472 04987).

China, ASEAN plan to fight epidemic

By P. S. Suryanarayana

SINGAPORE April 29. China and the Association of South-East Asian Nations (ASEAN) today pledged to act in concert in battling the Severe Acute Respiratory Syndrome (SARS) by pooling resources and sharing their skills.

At an unprecedented summit in Bangkok, the Chinese Prime Minister, Wen Jiabao, and the leaders of all the 10 ASEAN member-states agreed to set up a China-ASEAN fund to fight the new disease on various fronts, ranging from the scientific-medical zone of action to the political-legal spheres. It was announced tonight, at the conclusion of the China-ASEAN summit, that Mr. Wen had pledged a contribution of 10 million yuan (over $1 million) towards the Anti-SARS Fund. This would be China's contribution for the present at least, and some individual ASEAN member-states also announced their immediate financial commitments.

As the host to the conference, Thailand announced a contribution of $250,000. Cambodia, the current ASEAN Chairman, also specified its contribution, while other members, too, would follow suit.

The other major decision taken was that relating to what the Singapore Prime Minister, Goh Chok Tong, described as a policy of keeping borders "open'' so that people could freely travel across the frontiers of SARS-hit countries. The idea was to safeguard the economies of the SARS-afflicted countries by allowing free movement of people and goods under some guidelines of health checks at the exit and entry points.

The idea of safeguarded "open borders'' was recommended to the summit leaders by the Health Ministers of the ASEAN countries as also China and Japan, besides South Korea. These Health Ministers had met in Kuala Lumpur a couple of days ago. However, the latest Bangkok summit was attended only by China and Hong Kong (as part of the Chinese delegation) in addition to the ASEAN member-states, the reason being the acute seriousness of the SARS crisis in China.

First case in South Korea

While Japan has so far reported no SARS cases, South Korea today indicated that the first SARS case might have occurred within its territory. The Prime Minister of Thailand, Thaksin Shinawatra, took the initiative for this summit and sought to make it more meaningful by inviting the leader of China, which is reckoned to be the epicentre of the SARS disease.

Mr. Thaksin underlined that the summit was aimed at winning back the international community's confidence in the ability of the SARS-affected countries of East Asia to combat the disease. In this sense, the latest confidence-building exercise was likened to similar efforts that were launched in this region in the wake of a "financial melt-down'' in the 1990s and the more recent terrorist inroads into East Asia. To induce confidence in the global community in the present context, Mr. Wen said in Bangkok today that he would be willing to let the World Health Organisation inspect any hospital or any place in China to determine the causes of the outbreak of the disease and to work out remedies.

Mr. Wen's assurance followed certain China-specific comments that the WHO's executive director for communicable diseases, David Heymann, made on the sidelines of the summit. Mr. Heymann, who briefed the summit leaders on the WHO's perspectives, noted that the global SARS control efforts would depend on the efforts of China, which was at present fully engaged in the battle against the disease. According to the latest WHO assessment, SARS was still raging in China, while the worst of the disease might either be over or nearing the end in places like Vietnam and Singapore and perhaps even Hong Kong. China's latest SARS death toll was 148 against the total confirmed cases of 3,306.

Facts about SARS

The Severe Acute Respiratory Syndrome (SARS) has worried health officials across the world, with more than 4,000 infected, mostly in Asia but also in 20 other countries. More than 300 people have died. Here is what is known about the disease so far:

Question: How does one get SARS?

Answer: Scientists believe the main way SARS spreads is by person-to-person contact, such as touching the skin of an infected person or objects that are contaminated by them — through sneezes or coughs — and then touching your eye, nose or mouth. It may also spread through contact with infected people's faeces. It is also possible that SARS can be spread through the air or by other ways not yet known.

Q: Can you get it by travelling by plane?

A: Most cases of SARS are found among people who have had direct close contact with an infected person, such as a family member or a health-care worker who treated an ill person. SARS also has occurred among air travellers, primarily travellers to and from Hong Kong, Hanoi, Singapore and mainland China.

Q: Where is SARS appearing?

A: Primarily in Asia — China, Hong Kong, Vietnam and Singapore. But also in Toronto and more than 20 other countries, including the United States, Germany, Brazil, South Africa and Australia.

Q: How does one know if he/she has got it?

A: The illness usually begins with a fever, with temperature higher than 100.4 Fahrenheit (38 degree Celsius), and sometimes chills, headaches, a general feeling of discomfort and body aches. Later, patients may develop a dry, non-productive cough.

Q: How long does it take to get it?

A: It usually takes between two and seven days for symptoms to appear after exposure, though some reports have said it can take as long as 10 days.

Q: What should one do if one thinks he/she has the disease?

A: Contact your doctor or a health care provider. Explain any recent travel to regions where SARS has been reported and whether you were in close contact with someone who had these symptoms.

Q: How can one keep oneself from getting it?

A: Since SARS is an infectious disease, traditional methods of avoiding such illnesses are advised — with careful and frequent washing of hands with soap and water. Alcohol-based rubs are a good alternative. It is also advisable to avoid contact with large numbers of people.

Q: Do masks over the mouth help?

A: The routine use of masks while in public areas is not recommended. If you have to be in close proximity to an infected person, a doctor will advise you on what mask to wear.

Q: How deadly is it?

A: So far, 5.9 per cent of people who got sick worldwide have died. Hong Kong health officials revised their rate to 7.2 per cent of all reported cases from about 5 per cent earlier. Some Chinese health officials say the rate is higher.

Q: What treatment is there?

A: Scientists are trying anti-viral drugs as well as steroids. But so far, patients are given the same supportive treatment as they would for any serious pneumonia of unknown cause, which involves good diet and medication to ease chest pain.

Q. What causes SARS?

A. Experts say the cause is a previously unknown coronavirus, one of a family of viruses that ordinarily causes colds in people and more serious diseases in animals.

Q. Is there a cure?

A. None has been found yet. — AP

AI pilots to move court

By Our Special Correspondent

MUMBAI April 29. Air-India today took a series of measures to subdue the agitating, SARS-scared pilots — it derecognised their union, the Indian Pilots' Guild (IGP) and suspended 18 more pilots, taking the total to 45.

The airline also filed caveats in the Mumbai and Delhi High Courts to ensure that the courts granted no stay or ex-parte decision without hearing the AI. The step followed the IPG's threat to challenge the suspension and other actions.

The IGP denounced the action and its general secretary, Vikrant Sansare, called it unlawful and unilateral. The union would soon move the court.

Toughening its stand, the AI indicated that it may wet-lease aircraft (chartering the plane with the operating service) for maintaining its schedule. Its spokesman said that in view of the global recession in the air travel industry, even premier airlines had such capacity to spare.

Meanwhile, the Regional Labour Commissioner here, Shiv Kumar, heard both the sides at length and concluded that no agreement could be reached. He is expected to send his report to the Central Labour Commissioner in New Delhi, S.K. Mukhopadhyay. The AI spokesman said that derecognition was an extreme step, because the IGP violated the agreement of September 1998. The management had also withdrawn the privileges given to the IPG office-bearers, such as convenient duty roaster and even on-duty free tickets to travel abroad to attend meetings.

However, the AI has not burnt its bridges with the guild. None of the office-bearers figures among suspended pilots and the airline has excluded even its executive committee members from the disciplinary action. The spokesman could not say if they were included and could not explain why the leaders spearheading the "unjust and illegal" agitation were being spared. Kennil Khan, one of the senior flight commanders and among the makers of the IGP directives who abandoned the flight, is facing no action. He is the president of the IGP. The IGP has directed its member-pilots not to take off if the management did not certify that the cabin crew had not flown the SARS-affected routes in the previous 10 days.

The management stand is that such a certificate is unwarranted and that the pilots have no business to ask for it because health is the responsibility of the health officer of the airport of origin. Only two countries — Japan and the U.S — ask for a health certificate for the crew covering injury, incapacity, influence of alcohol and drugs and that is also the responsibility of the flight commander and not the co-pilot. Most of the flight commanders are executive pilots who are not members of the IPG.

SARS news doesn't shock CMC patients

VELLORE: The CMC hospital here was as usual busy on Tuesday evening, even as the news about the first SARS case in Tamil Nadu got confirmed after some delay amid speculation.

The patients already admitted in the hospital and those who came for treatment did not seem to be really bothered about a SARS suspected patient being in the isolation ward.

The hospital sources confirmed that the number of patients in the last three days had not dropped due to any SARS scare.

Dr Kurien Thomas, of the Department of Medicine, told this correspondent on Tuesday over telephone that the test sample of Elumalai, the SARS suspected patient, admitted in the hospital, flown to the National Institute of Virology (NIV) Pune on Friday, had indicated the presence of SARS virus.

He said the patient was responding to treatment very well. He was being given antibiotics. Though he had mild fever, cough and sugar condition (and no problem with his breathing) when he was admitted, his condition was much better now, he added.

Possibly, he had initial symptoms of the disease and the treatment could have helped him get over the viral attack. The doctor said the patient would be kept in the hospital for another two days before being discharged. He would be kept in quarantine in his house for the next ten days, he added.

Asked about how the doctors and the other staff members who were attending on Elumalai reacted to the confirmation of SARS, he said there was panic among them. The staff had good awareness of the disease.

A cross-section of the paramedical staff ruled out the possibility of getting afflicted since many of them said that the virus was virulent only in short distance. Moreover, the heat conditions of the Vellore town might not help the virus to survive.

They said that protective masks, gowns and gloves had been provided to the staff attending on the patient and there was no chance of the virus spreading.

They also said that they would involve themselves in educating the patients as well as the general public in the hospital about the safety aspects of SARS management.

The shop owners in the Ida Scudder Steet opposite to the hospital were unnerved on hearing about the SARS case in the town. They said the media was making a much ado about nothing.

India's SARS count climbs to 10

IANS

NEW DELHI: India's SARS count climbed to 10 on Tuesday and more suspected cases came to light, even as the government warned against panic and insisted the situation was under control.

Even so, the authorities were drawing solace from the fact no deaths from the killer pneumonia had been reported so far in India.

"Even in Goa, where India's first case was reported, there have been no reports of further spreading of the virus," said an official of the health ministry here who did not want to be named.

"We have stepped up measures to screen for SARS at airports and ports and deployed more doctors. We are determined to prevent the spread of SARS," he said.

After Pune's D'Silva family survived a scare, it was the turn of a family in Tamil Nadu's Vellore to be quarantined as the disease was confirmed in a man working in Singapore who had arrived in India on a holiday.

The patient was admitted to hospital on Friday after he complained of ill health. Fourteen members of his family have been quarantined.

The family of Stanley D'Silva in Pune in Maharashtra was released from quarantine after being declared free of SARS.

D'Silva had returned from Indonesia carrying the SARS virus and infected his sister, mother and uncle as well as the driver of the taxi in which the trio had travelled.

In Kolkata, the confirmation of the second SARS case on Monday night triggered a scare as a third of doctors and paramedical staff at the state-run Infectious Diseases Hospital (IDH) shunned work on Tuesday for fear of contracting the virus, which has claimed around 300 lives worldwide and infected 5,000.

Radheshyam Gupta, who returned from Bangkok, is Kolkata's second SARS victim after Asitava Purakayastha. Due to the shortage of staff, the hospital could not complete the diagnosis on another suspected patient, Jamil Ahmed.

A Chinese crewmember from a ship that arrived at Mangalore has been kept under observation. Ching Chung Huang's ship had come from China, where the maximum number of people had died of the virus.

Amid more cancellations and rescheduled flights across the country, Air-India Tuesday de-recognised the Indian Pilot's Guild (IPG) for "anti-organisation activities" by refusing to fly to SARS-hit countries.

The airline accused the IPG pilots of tarnishing its name and moved against 18 more pilots for refusing to operate flights to Southeast Asia, taking the total number of suspended pilots to 45.

Several flights from New Delhi and Mumbai to destinations in the U.S. and the Middle East were cancelled or rescheduled Tuesday even as executive pilots and retired pilots were being pressed into service to tide over the temporary crisis.

The government has also augmented measures across the country for quicker detection of the virus.

While only the National Institute of Communicable Diseases (NICD) here and the National Institute of Virology (NIV) at Pune were testing for the virus till now, facilities would soon be available at four more institutes in Chennai, Kolkata, Mumbai and Pune shortly.

Medical experts warned that health authorities needed to do more to tackle the disease as SARS had entered the "local transmission" phase in which Indians who had returned to the country carrying the virus were now infecting fellow citizens.

"The cases in Pune (D'Silvas) were an instance of local transmission, and with this we have entered the second phase in the spread of infectious diseases," said K.K. Agarwal of the Indian Medical Association (IMA).

Matters have been compounded by an apparent lack of coordination between health authorities in New Delhi and other states.

Though the number of SARS cases in India is low compared to other South Asian countries, health workers are worried that any complacency on the part of the authorities could have disastrous consequences for the world's second most populous country.

Suspected SARS cases tests negative

THIRUVANANTHAPURAM: The two suspected Severe Acute Respiratory Syndrome (SARS) cases in the State have been tested negative at the National Institute of Virology, Pune.

Chief Secretary Chandrashekharan Nair has convened a high-level meeting of health officials here tomorrow to review the steps taken by the Health Department to tackle the SARS threat.

According to a Health Department release here on Monday, the test reports of Somakanthan and S.L.Varghese arrived here this evening. The suspected cases had been under the surveillance of the Health Department.

Medical College Hospital superintendent Dr. Mathew Thomas told our website owned newspsper that Somakanthan was likely to be discharged tomorrow after getting the clearance of the authorities concerned.

A meeting of the district medical officers was held at the office of Additional Director of Health (SARS incharge) Dr. P K Sivaraman on Monday to discuss the threat posed by SARS in the State. ``We have instructed the DMOs to keep a strict vigil on all passengers coming from the SARS-hit countries for at least 10 days,'' Dr. Sivaraman said.

Posted 8:50 PM by Dr. Kay

Air India hardens stand, suspends 15 more pilots

By Arunkumar Bhatt

MUMBAI April 27. Promising to be harsh and tough, the Air India management today suspended 15 more pilots raising the total to 27 even as the Indian Pilots Guild prepared to move the High Court here to challenge the management. The airline has accused the pilots of using the SARS scare for demanding more remuneration. But the IPG maintains that it is only concerned with the risk of infection to its members and passengers.

The trouble began two days ago when the IPG directed its members not to operate the flights unless the management certified that the cabin crew onboard had not been to the SARS-affected sectors in the past ten days.

The AI spokesman, Jitendra Bhargav, who announced more suspensions said the action was taken under Clause 21 (1) (A) of the Certified Standing Orders in view of the pilots' refusal to operate flight.

The airline which is operating all its six flights bound for western Europe and the United States, has chalked out a contingency plan "to ensure stability of the flight schedule" assuming that the `unionised' pilots are not on its rolls.

The new schedule not only uses the services of 159 executive pilots but also those of five pilots who retired 30 to 60 days ago but are medically fit and hold valid licences.

The spokesman said the Director-General of Civil Aviation had allowed the airline to increase the pilots' duty hours from nine to 10 hours. But this would not jeopardise the passenger safety for the pilots would get the prescribed rest hours.

The new schedule that would come into effect from tomorrow morning provides for 100 per cent maintenance of the West-bound flights to destinations such as London, Paris, New York, Newark and Chicago — using Boeing 747 aircraft for which the executive pilots are licensed.

The majority of the agitating pilots fly Airbus 310 aircraft and their non-availability would reduce the flights to the Gulf and South East Asia to the extent of 25 per cent.

These passengers would be transferred to Indian Airlines wherever the sister airline is flying or to other airlines.

The airline will use all means of communication to inform the passengers about the changes. Details of the flight can be had by calling telephone no. 9892230010.

Govt. warning

Vinay Kumar reports

from New Delhi:

Meanwhile, the Government has hardened its stance asking the pilots to withdraw their stir unconditionally and warned that action would be taken against all those who refuse to fly.

"The Government is determined that the striking pilots withdraw their instructions unconditionally and resume flying," the Civil Aviation Secretary and chairman of the AI Board, K. Roy Paul, said here.

The Government had asked the IPG to withdraw its "unlawful, illogical and irrational" directive to its members, he said adding that the demands would be considered only after the pilots ended their strike.

Meanwhile, Indian Airlines has stepped in to lift stranded AI passengers in the Gulf sector by operating additional flights. India's domestic carrier is operating all its scheduled flights to SARS-hit Singapore from Delhi, Chennai and Bangalore.

On a request from AI, the domestic carrier operated an additional flight yesterday on the Delhi-Dubai-Delhi sector to clear the 142 stranded AI passengers.

* * *

Fernandes, team screened

PTI reported that Defence Minister George Fernandes and the official delegation which returned here tonight after a week-long visit to China were screened at the Indira Gandhi International Airport for SARS. Although reporters were not allowed inside the VIP lounge at the airport, Fernandes told them later he was screened for SARS. He said he was also checked for SARS at Shanghai before leaving for India.

Reports of 13 SARS cases awaited

By Aarti Dhar

NEW DELHI APRIL 27. Even as the number of confirmed SARS cases in the country stood to seven, the pathological results of 13 suspected cases are awaited.

One suspected case, who was discharged from a Mumbai hospital and advised home quarantine while his blood and urine test reports were awaited, got himself admitted to the Infectious Diseases Hospital here after learning that he had tested positive for the disease by experts at the National Institute of Virology, Pune.

The Health Ministry was ascertaining the details of his travel and the possibility of his having spread the infection.

Meanwhile, two new cases were reported from Bhatinda and one each from Amritsar, Kolkata, Thiruvananthapuram and Cochin.

One person has already tested positive for SARS at Kolkata and is being treated at the Amri Apollo Hospital.

The new case had come to Kolkata via Dhaka and complained of chest congestion, though doctors at the ID Hospital there said he was afebrile and unlikely to spread the infection.

Four positive cases are already being treated at Pune's Naidu Hospital while reports of three others under home quarantine are awaited.

Reports of two cases in Mumbai, and two in Delhi are also awaited, though the Health Ministry believes they could be mere carriers.

The confirmed case from Mumbai is now being treated at ID Hospital.

On the other hand, the Centre has taken a serious note and sought details from the Karnataka Health Department following the discharge of a 17-year-old SARS suspect who was allowed to go home even without taking his blood samples for testing.

He has been advised home quarantine.

SARS: Crisis management cell set up in district

KOZHIKODE: District collector T O Sooraj on Saturday said that the administration had taken precautionary measures to prevent the spread of SARS in the district.

A crisis management group has been formed with the collector as chairman.

A special ward has been kept ready at the Institute of Chest Diseases at the medical college here and it will be manned by a separate group of doctors.

Another group of doctors will be deployed at the Karipur Airport to monitor the passengers.

Ambulances will be kept ready at the Airport for the quick transfer of persons suspected to be infected with virus.

Those arriving from SARS affected countries like Canada, China, Hong Kong, United States, England, Belgium and Spain must undergo medical check up.

Fever, cough and difficulty in respiration are the symptoms of SARS. This disease, which spreads through air, is not fatal.

Collector also requested the public to refrain from travelling to the SARS affected nations for the time being.

SARS crisis: Potential threat to Asian economy

People walk under infra-red fever-detecting scanners, seen overhead, as they cross the border into mainland China at Hong Kong's Lo Wu border crossing. Health authorities began using the scanners last weekend to screen out any traveller who may have SARS-related fever. They also started random temperature checks of passengers at all land border crossings and ferry terminals. — AP

THE LAST time Asia was engulfed in crisis, during the financial cataclysms of the late 1990s, China was on the sidelines. As regional financial markets and currencies collapsed and millions slipped back into poverty, the Chinese economy chugged ahead. This time, China's leaders are the ones being put to the test.

The outbreak of severe acute respiratory syndrome, or SARS, could wreak political as well as economic havoc on a scale rivalling the 1997-98 Asian financial crisis if not brought under control soon, some believe.

"This event is having a negative impact on this region. Last time, there was a bad impact on the economy, but now it's having a bad impact overall: economically, socially, politically and psychologically,'' said Zheng Yongnian of the East Asian Institute at the National University of Singapore.

Unlike the earlier crisis, there has been no massive flood of investment out of the region, no collapse of regional stock markets, no bloodletting of currency values. Instead, it's death by a thousand cuts.

Region's vitality sapped

Though each successive cancellation of package tours, flights and business trips does not amount to a catastrophe, added together, they are sapping the region of its economic vitality, depriving workers of their livelihood and chipping away at investor confidence.

SARS has made itself felt in myriad ways, from empty airports and surgical masks worn on the streets of Hong Kong to the ten-day closure of Singapore's biggest fresh produce market because of SARS cases there.

So far, most economists see the impact of SARS as limited to short-term damage to tourism and retail businesses. But it will add up. The World Bank forecast last week that SARS would chip 0.3 percentage point off Asian economic growth in 2003.

Taking into account the war in Iraq, a global electronics slump and SARS, it lowered its 2003 regional growth forecast to 5 per cent from an earlier 6 per cent. Thus far, the spread of SARS throughout the region has been limited. Mainland China, Hong Kong and Singapore account for roughly nine out of ten cases worldwide, shielding most Asian economies from the brunt of the outbreak.

Despite temporary stoppages due to SARS on some production lines, manufacturing and trade have continued with little disruption.

Overall, the region is in better shape than it was when the Asian financial crisis hit in mid-1997. Indonesia, South Korea and Thailand have scaled back foreign debt. And after the high-tech bust and the bear markets of the past several years, there are no financial or real estate bubbles left to burst.

Still, SARS has already cost Asia billions in terms of lost tourism, retail sales and other consumer spending. The World Health Organization recently put the cost of SARS at $30 billion.

The earlier Asian crisis, by contrast, is believed to have cut world economic growth by up to $800 billion, according to one estimate by the Asian Development Bank.

Alarmed by massive closures of restaurants, shops and travel agencies, the Hong Kong government has pledged an 11.8 billion Hong Kong dollar ($1.5 billion) package of tax, utility and rent cuts and bank loans to help alleviate the strain of SARS on the already ailing economy. China's own economy looks certain to slow from the sizzling 9.9 per cent growth recorded in the first three months of the year. Citigroup recently lowered its 2003 growth forecast for China to 6.5 per cent from 7.6 per cent, following similar revisions by other banks.

An economist with the Geneva-based World Trade Organization, Michael Finger, warns that given China's growing importance as an engine of growth for the global economy, world trade could suffer if SARS is not brought under control soon. "It will be quickly felt throughout the economy. The biggest problem will be if it creates some panic reactions,'' Mr. Finger said.

Some signs of panic were seen last week, as anxious Beijing residents stocked up on food and other supplies after the city government announced measures to quarantine people exposed to the deadly virus.

Insulated by restrictions on its trade and financial markets, China weathered downturns in foreign investment and export demand during the last crisis by keeping its currency steady and spending heavily to stimulate its domestic economy.

How well other Asian countries fared depended greatly on how they responded to the need for political and economic reforms.

Andy Xie, a managing director for the investment bank Morgan Stanley, says the SARS emergency highlights the struggle of China's communist leaders to reconcile their secretive, authoritarian politics with the needs of an increasingly international, market-driven economy. Accustomed to putting economic growth first, China's leaders alerted the public to the urgency of the SARS outbreak only after realising they had overestimated their ability to control it, says Mr. Zheng.

"China's Communist Party once ruled a simple society,'' he says. "Now, with globalisation and the market economy the whole society is mobile and the old methods don't work anymore.'' — AP

ARS wars

THE SARS THREAT has placed India on a red alert even as reports of a few people testing positive for this flu-like disease have emerged from different parts of the country. The fresh measures announced by the Union Health Ministry include the provision of masks (to airport employees, doctors and paramedical staff) and the isolation of any passenger arriving at an international airport who exhibits symptoms of the virus (until blood tests and other examinations prove negative). Since it is impracticable to screen every international visitor and since those who catch the infection may take up to a week or more to develop SARS, there can be no foolproof measure — in this age of international travel — to prevent the virus from entering the country. The best that can be done is to create a mechanism to continuously monitor the incidence of SARS in the country as well as create the conditions for inhibiting its transmission. The first task has been vested with a special joint action group, with representatives from the States and the Centre, that is expected to keep the Health Ministry advised about what needs to be done to tackle the disease from time to time. Screening and isolating international visitors is an important measure towards inhibiting the transmission of the virus, but the real fear is over how India will cope with SARS in the event of an outbreak of it.

In a country where awareness is relatively low and medical infrastructure relatively poor, there is a considerable risk of a killer disease (which spreads in a way similar to the common cold) causing havoc. The good news so far is that only a few cases have tested positive and that every one of them has caught the infection abroad. Moreover, there have been no deaths, no transmission from patient to close family members and the natural remission of the disease in a few cases. Does this mean that the risk of SARS becoming an epidemic is very low in India? It is much too premature to rush to such optimistic conclusions. India may have done well to act ahead of time against the SARS threat but there is room for neither apathy nor overconfidence against a disease that is infecting more and more people by the day. The worldwide incidence of SARS continues to throw up a confusing pattern, with the virus re-emerging when there was hope that it had exhausted itself, with evidence that those infected in China could be much greater than admitted and with no clear picture at the moment about which prevails in the ongoing battle against the disease: the virus or the global medical establishment.

The agitating pilots who threw Air India schedules into disarray by refusing to fly to SARS-hit destinations or alongside cabin crew that had recently been in these places have focussed attention on the fear the disease has triggered in the country. In this era of economic interdependence, cancellation of international flights to all SARS-affected countries, which now number a great many, is simply not an option. But travel to South East Asia, which constitutes an estimated 30 per cent of the travel out of India, has already been badly affected, with both holiday-makers and businessmen preferring to stay at home. Places such as Hong Kong and Singapore, which have announced stimulus packages to offset the impact of SARS, have been made painfully aware that the virus has the potential to wreak economic havoc. Even Canada, where 16 persons have succumbed to the disease, has expressed fears that the disease — which recently provoked the WHO into issuing a controversial travel advisory for Toronto — could significantly retard economic growth. The possible economic impact of the disease on India is something that will need to be assessed with bodies such as industry chamber FICCI estimating that the Asian economy is likely to suffer a loss of up to $50 billion following the SARS outbreak. To what degree this will impact on India will depend, among other things, on how effectively the country is able to control the spread of the virus.

SARS: U.S. offers China help

By P. S. Suryanarayana

SINGAPORE April 27. The United States has promised to extend "support and assistance'' to China in the battle against the Severe Acute Respiratory Syndrome (SARS).

The offer was made by the U.S. President, George W. Bush, in a telephonic conversation with his Chinese counterpart, Hu Jintao. According to the Chinese side, the conversation took place at Mr. Bush's initiative and he evinced interest in the manner in which China was trying to combat the SARS crisis. No details about the U.S. help were indicated, though.

On the wider Asia-Pacific diplomatic front, the rise and spread of SARS in China remained a matter of serious concern, although there was no definitive view on the circumstances in which the deadly disease first hit southern China last November. With the death roll continuing to rise in mainland China, the latest official figure being 131, the Beijing municipal authorities today ordered the suspension of activities at all public places of entertainment. The order covered Internet centres and cinema halls.

The total number of confirmed SARS cases across China, excluding Hong Kong, was today placed at 2,941.The Chinese Health Ministry, now under the supervision of the Vice-Premier, Wu Yi, today issued an emergency notice that asked hospital authorities to guard against the spread of SARS through cross-infections at the places of diagnosis and treatment.

Hong Kong registered no signs of abatement of the SARS crisis and toll in the territory remained as high as in mainland China. In a dramatic development, Taiwan today took steps to ban, for an unspecified period, the arrival of travellers from designated SARS-afflicted countries or territories — China, Hong Kong, Singapore and Canada.

The move followed the first fatality in Taiwan on account of SARS. Taiwan sought to tighten its system of penalties in a bid to contain the disease. With the crisis becoming a pan-regional issue, the Health Ministers of the member-states of the Association of South East Asian Nations drew up recommendations, at their meeting in Kuala Lumpur, for discussions by the ASEAN summit leaders in Bangkok on Tuesday.

A closer monitoring of the passengers across inter-state boundaries is believed to be among the proposals expected to be discussed at the summit. The main challenge before the ASEAN leaders would be to clinch an accord that could put in place some scientific restrictions on the international travellers without infringing national sovereignty.

The Philippines President, Gloria Macapagal, floated the idea of a regional fund to meet the SARS emergency.

Isolation of SARS suspects 'not up to the mark'

By Our Special Correspondent

MUMBAI April 27. Maharashtra, which has seen the largest number of positive cases of the Severe Acute Respiratory Syndrome so far — three of them certainly `imports' and two locally acquired infections from them — may need to better manage the quarantining of the patients.

An element of compulsion in quarantining, despite the claims that each district hospital is equipped with an isolation ward for SARS cases, is clearly missing. SARS patients have treated this requirement quite lightly, at least in two cases.

Julia D'Silva, who tested positive in Pune, was allowed to marry because she threatened officials with dire consequences if the wedding was put off. Helpless, they allowed it to be solemnised and then `closed down' the church; those who attended the marriage, including the priest, were later isolated.

Then came the case of Bhaskara Murthy, a Hong Kong-based businessman. He reported to a hospital in Mumbai, was found positive and after being isolated, "he left against medical advice". He stayed with friends before leaving for Delhi where he was pushed back into isolation in a hospital.

Some doctors say that if "isolation is mandatory to contain a disease not yet understood fully, it has to be enforced meticulously. Even patients have to understand that they should submit to such quarantine" in the interest of everyone. The Government cannot "take it lightly" because patients "acted against advice".

In Julia D'silva's case, she was first treated as an out-patient and when she asked to submit to the test by Virology Institute at Pune, she was not in a hospital. Only when she tested positive was she sought to be isolated. That too after allowing her to get married. Later, her husband was also quarantined.

That the infection spread to her from her brother or mother who came to her wedding is evident because they travelled from the Far East on the aircraft on which a SARS suspect travelled. He got off at Singapore. Her uncle, who travelled with them in a taxi from Ambernath near Pune, also tested positive.

Two taxi drivers involved in transporting them were found and isolated. In Pune, where the largest number of people came into contact with a SARS-positive patient, most of them were asked to remain indoors instead of being moved to another place. This created some panic among the residents of the building.

It is being argued that the crucial aspect of isolating the suspects till they test either positive or negative leaves a lot to be desired.

In the beginning, patients flying into India via Mumbai's Sahar International Airport were asked to fill a questionnaire stating whether they had any symptoms including fever, cold and cough and it was expected that the detection procedures would be strengthened.

3 more SARS cases, total 7

By P.Sunderarajan

NEW DELHI April 26. In a significant development, the Centre today announced that three more cases of the Severe Acute Respiratory Syndrome had been confirmed in the country, taking the total to seven. The new cases have been reported from Pune, Mumbai and Kolkata.

Briefing reporters, a spokesperson of the Union Health Ministry said here that efforts were under way to trace those who had come in contact with the confirmed cases to try and see whether they had also contracted the killer disease.

No confirmed SARS cases in State

By Our Special Correspondent

THIRUVANANTHAPURAM April 26. No cases of the dreaded Severe Acute Respiratory Syndrome (SARS) have been confirmed in the State so far, though three persons were hospitalised under suspicion of having contracted the disease.

Addressing a press conference here today, the Health Secretary, K. Ramamoorthy, said one of the three suspected cases had been discharged from hospital in the absence of any clinical symptoms of the disease.

The other two patients were also not having the clinical symptoms now. They would be discharged upon receiving the report from the National Institute of Virology in Pune, where their serum samples had been sent.

He said Kerala was observing the highest level of vigilance against the disease. Since April 11, more than 2,000 air passengers disembarking at the three international airports in the State had been subjected to screening. ``Everything possible is being done to prevent people carrying this disease into our State from the affected countries,'' he said.

He said the report on the serum samples of the two persons still in hospital was expected from Pune by Monday. The doctors observing them were of the view that there was nothing to fear.

He said patients would be classified as `suspected' or `probable' based on the following criteria.

Suspected case:

1. Sudden onset of high fever (of more than 100.4 degree Fahrenheit.

2. One or more respiratory symptoms like cough, shortness of breath and difficulty in breathing.

3. History of visit to SARS affected countries within 10 days of onset of symptoms.

4. History of having taken care of, having lived with, having had face-to-face contact with or having had contact with respiratory secretions and body fluids of a persons who has been diagnosed with the disease.

Probable case: A suspect case having X-ray findings of pneumonia, or a suspect case with an unexplained respiratory illness resulting in death, with the autopsy examination demonstrating the pathology of respiratory distress syndrome without an identifiable cause.

He said suspected patients or probable patients would be treated under strict quarantine in designated hospitals in the State. The doctors and other medical staff would be provided with high risk masks. The Union Department of Health would be sending five such masks to the small States and 10 to the big States. Kerala had requested the supply of 10 masks.

He said those with history of having stayed recently in Maharashtra and Goa (from where SARS cases had been reported in India) too should be subjected to screening for the symptoms of the infection.

Information regarding suspected cases was to be reported to the respective District Medical Officers (DMO). If the DMO could not be contacted, the information should be communicated to the Additional Director of Health Services, P. K. Sivaraman (Ph: 0471-2302160, 2331177, or 2302490; mobile 94472 04987).

The Director of Medical Education, K. A. Kumar, and the Director of Health Services, V. K. Rajan, also attended the press conference.

'Tulsi can cure SARS'

By R. Sampath

VISAKHAPATNAM APRIL 26. Tulsi (oscimum sanctum) can serve as a cure and a prophylactic as well for the severe acute respiratory syndrome (SARS), which is currently stalking the globe as a killer epidemic, according to the Kakinada-based social worker and journalist, S.S. Krishnaji.

In a communication, he says: ``The root of the tulsi plant should be crushed and boiled with turmeric powder for a few minutes, after which it should be filtered. Consuming two spoonfuls of this potion twice daily will cure SARS and prevent contracting of the disease.''

Alternatively, chewing two tulsi leaves with pepper for some time and swallowing it every morning can be helpful in combating the disease, he says.

Mr. Krishnaji has served as the convener of the Bharat Sevak Samaj.

SARS shadow over Cannes

By Gautaman Bhaskaran

Chennai April 26. Tens of thousands of people will arrive at the otherwise sleepy seaside town of Cannes in the south of France for the world's most prestigious, most glamorous international film festival beginning May 14.

With celebrities, journalists, movie-lovers and plain hangers-on from all over the world crossing one another's paths during the Festival, fears of the Severe Acute Respiratory Syndrome (SARS) finding the right ambience to thrive and spread are real.

But the Festival's Managing Director, Veronique Cayla, did not appear to be overtly perturbed over the perceived threat. She told a recent press conference in Paris that ``we are in close contact with the French Health Ministry, and we will follow whatever recommendations they make''.

Knowing the French medical fraternity, aggressive that it is in its preventive efforts, one may be reasonably certain that its suggestions can be tough. Big contingents from the so-called SARS-hit regions will be at Cannes, and there has not yet been any indication that they may be asked to stay away.

In the meantime, it is business as usual in the Paris headquarters of the Festival, where the Artistic Director, Thierry Fremaux, said that they had a difficult year. ``It is getting harder and harder, because movies arrive late, from everywhere''.

In all, 908 features and over 1,500 shorts were submitted for possible inclusion in this Festival. Although the total number was up by 10 per cent over last year's submission, fewer features — 30 less than last time — came in this summer.

At the end of the arguably tough, though sometimes strange, selection process, 52 full-length films are in, across the various sections: Competition, Out of Competition, Special Shows and A Certain Regard.

These, according to Fremaux, ``will be a mix of comedy (we need a large dose of this especially this year, given the Iraq war and SARS) and tragedy — a couple of pure comedies, movies that are radical aesthetically, and films that are very serious and sombre''.

The man behind last year's shock entry, Gaspard Noe's ``Irreversible'' (with a long and brutal rape scene), Fremaux hinted of another jolt this May: Lars von Trier's competing ``Dogville''.

A renowned helmer, his some-years-old ``Breaking the Waves'' is considered an all-time high in cinema.

China names Vice-Premier to tackle pandemic

By P. S. Suryanarayana

Reuters

SINGAPORE APRIL 26. China, in its latest effort to contain the Severe Acute Respiratory Syndrome (SARS), entrusted the Vice-Premier, Wu Yi, with the concurrent charge of the Health portfolio, it was officially announced in Beijing today.

The upgrading of the political importance of the Health portfolio was effected following the formal resignation by Zhang Wenkang, who was only a few days ago sacked from his key post in the ruling Communist Party's unit of the Ministry of Health in the context of the global criticism of China's handling of the SARS crisis.

China's political priority at this moment is to address the enormous public health challenge of taming the SARS epidemic. It is in this context that the Chinese leadership briefed key visiting leaders from abroad — the Indian Defence Minister, George Fernandes, and the French Prime Minister, Jean Pierre Raffarin — about the measures being taken by China to combat the menace.

This became doubly important for Beijing in view of France being inclined to associate China with the Group of Eight — seven industrialised countries plus Russia. On a related front, the Chinese Prime Minister, Wen Jiabao, presided over the "founding ceremony" for the National SARS Control and Prevention Headquarters.

Outlining the tasks before China on this front, Mr. Wen called for free medical services to the poor among the SARS patients in the rural areas. He urged the research institutions to utilise the scientific resources at home and abroad to develop anti-SARS medicines and methods. He also called for closer cooperation between China and the World Health Organisation.

154 new cases

The Chinese mainland today reported 154 new SARS cases, which took the total to 2,753. The updated death toll in China was put at 122. There was no sign of any improvement in the situation in Hong Kong, with a grim sentiment defining the mood there.

In Singapore, where a stringent anti-SARS legislation was passed on Friday, Michael Lim, a Member of Parliament with medical qualifications, said he was "in favour of more draconian measures." The new law, in effect an expansion of the existing legislation on infectious diseases, provides for fines and/or jail terms for home-quarantine breakers and others who might endanger the community's health through such actions as going to public places while suspecting that they might have been SARS-infected.

On the overall question of Singapore's "war on SARS," The Straits Times noted in its editorial today that "the home fight has some way to go," especially in the context of the "public apprehension about going for screening at the dedicated SARS centre, ironically for fear of contracting SARS there."

In Kuala Lumpur, the Health Ministers of the 10-member Association of South East Asian Nations (ASEAN) as also China, Japan and Canada met to address the SARS-related issues such as the severity of the health crisis, the need for international cooperation in controlling the new disease, the impact on economies and the possible turbulence in "social tranquillity."