Global Epidemics

2003-10-12T22:18:00.000-07:00

India to conduct clinical trials for HIV vaccine

By Gargi Parsai

New Delhi Oct. 11. India is preparing to go in for Phase-I clinical trials in March next year for a preventive HIV vaccine developed by a scientist of the National Institute of Cholera and Enteric Diseases (NICED), Kolkata, in collaboration with a U.S.-based biotechnology company.

With this, India would join the global effort in finding a vaccine that would prevent healthy, unaffected people from being infected with HIV. Trials are on in parts of the world with no breakthrough yet. India is estimated to have about four million people afflicted with HIV at the end of 2002.

The Phase-I trial, involving administration of the MVA (Modified Vaccinia Ankara) HIV-1 subtype C vaccine for the first time to humans in India would be conducted with 13 healthy volunteers in the age group of 18-50 to determine the efficacy of the vaccine. It would be conducted at the National AIDS Research Institute (NARI) Pune, under a tripartite agreement between the National AIDS Control Organisation (NACO), the Indian Council of Medical Research (ICMR) and the International AIDS Vaccine Initiative (IAVI). Other areas would later be Chennai and the north east.

The Union Government would control the use of the vaccine if and when developed. Three vaccine manufacturers have been shortlisted, though the Phase-I trial vaccine has been manufactured by Therion. About Rs. 17 crores has been invested by ICMR so far. IAVI is looking at an investment of $100 million till the marketing of a vaccine.

The Phase-I would determine the safety, immunogenicity (ability to induce strong immune responses in the person to fight HIV) of the intramuscular vaccine, preliminary dose requirement and schedules for immunisation. This phase is expected to last two years.

Participating in a media workshop here on Friday, the Director-General of ICMR, N.K. Ganguli, and NACO experts expressed the confidence that the ethical and regulatory clearances on safety and toxicology and pre-clinical studies will come before March.

There was no clarity, however, on the norm that a vaccine developed in another country — in this case the U.S. — should first undergo Phase-I clinical trial in the country of origin.

Although the India-specific vaccine has been developed with the involvement of the scientist, Shekhar Chakravorty, of NICED and the U.S. Biotech Company, Therion Biologic Corporation in the U.S., there has been no Phase I clinical trials with this vaccine in that country.

According to Mark Chataway of the IAVI, all HIV laboratory research in vaccine development has to be uniform for global acceptability, though bound by the regulatory requirements of each country.

He hoped the Drugs Controller of India would accept the validity of the ongoing preclinical and toxicology studies on animals (mice) under way at the Therion Corporation.

The current status of the trial in India is that a new vaccine trial centre and immunology dedicated laboratory and staff is being set up at NARI. Efforts are on to enrol volunteers who are likely to be from groups of high-risk sex workers, truck drivers, health care workers and adolescents. The scientists said there would be sufficient safeguards for the volunteers to cover risks.

2003-09-14T01:42:00.000-07:00

SARS case confirmed

By P. S. Suryanarayana

SINGAPORE Sept. 9. In the first case of the Severe Acute Respiratory Syndrome (SARS) in recent months worldwide, a 27-year-old Chinese-Singaporean was today diagnosed to have been infected with the virus after a repeat test was found positive. The World Health Organisation, which was duly notified, said that the current case ``does not fulfil the case definition for SARS as per the new WHO guideline in the post-outbreak period'', the Ministry noted.

2003-08-17T06:11:00.000-07:00

AIDS and the public health challenge

SOUTH AFRICA HAS taken a historic decision to begin treatment in public hospitals of the five million citizens who are infected with HIV. Now that the country with the world's largest HIV population has decided to provide medical care for the affected, can there be hope that India, which has the world's second largest population infected with the virus, will follow in the leader's footsteps? AIDS treatment in the form of active retroviral therapy (ART) offers no cure for the disease. Prevention is the only way to contain the spread of the virus that causes AIDS. India is doing poorly in prevention, with the recent estimates by the National AIDS Control Organisation showing a 15 per cent increase in just one year in the number of new infections. Much more has to be done in the area of prevention. However, society also has a responsibility to care for those infected with HIV. ART provides the infected with an opportunity to lead a normal life, delays the onset of full-blown AIDS, and reduces the transmission of HIV, especially by infected mothers. The only AIDS care now available in India is in private hospitals. The irony is that while Indian pharmaceutical companies caused an upheaval in the global market by offering anti-AIDS generic drugs at just 3.5 per cent of global prices ($350 versus $10,000 for a year), the Government has refused to take advantage of the achievements of Indian industry.

Three kinds of arguments are advanced against the provision of ART through public health programmes. None of them can stand critical scrutiny. One argument is that AIDS care requires adherence to a difficult regimen of intake of toxic drugs and this is not possible in a poor country. The best answer to this objection is provided by the success story of Brazil. In the mid-1990s, this developing country put in place a universal, free AIDS care programme, backed by community programmes that monitored drug consumption. The result has been extremely good standards of adherence, which have led to a stabilisation of the HIV/AIDS population at half a million, a dramatic reduction in AIDS-related deaths, and a control of transmissions. A second argument is that a poor country cannot afford universal care. ART is expensive and the cost of drugs, testing and monitoring can go up to Rs. 35,000 a year for a patient. The answer to this is that at any point only 20 to 30 per cent of the infected need treatment. This means that universal care in India would not cost more than Rs. 4,000 crores a year. This is equivalent to 0.5 per cent of annual GDP and is by no means unaffordable. The third argument against State-provided care is that AIDS is not the only public health priority in India. The number of Indians suffering from and not receiving treatment for tuberculosis, malaria and diabetes is many times the number affected by HIV/AIDS. These populations cannot be ignored.

AIDS cannot be the only illness receiving close attention, but the absence of a cure makes it a unique kind of challenge today. What is required is public health action of a kind that has been lacking: Government provision of medical services that care for Indians suffering from all the major illnesses. The Government of South Africa has decided to provide medical care for its HIV population after maintaining for years that ART would not make a difference. The Government of India has been involved in denial of a different kind; it has simply refused to acknowledge that it is confronted with a major public health crisis. This cannot continue any longer.

2003-07-10T13:55:00.000-07:00

WHO Predicts World Will Be Free of Human SARS Cases in a Few Weeks

BANGKOK (Reuters) Jun 27 - The World Health Organization said Friday the world population should be SARS-free within the next two to three weeks, but warned the disease could emerge from animal reservoirs in China again next winter.

David Heymann, director of the WHO's communicable diseases division, told Reuters he expected Taiwan and Toronto--the only two areas still regarded as zones where the disease could be transmitted--to be given a clean bill of health by the first week of July.

"It appears we've had the peak of the epidemic in all countries," Heymann said in an interview ahead of a meeting of Asia Pacific health ministers in Bangkok Saturday.

"All countries are probably now going to be SARS-free within the next two to three weeks. SARS will be gone, we believe, from human populations."

Severe acute respiratory syndrome (SARS), which is believed to have jumped from animals to humans in southern China late last year, has killed more than 800 people worldwide, infected some 8500, trimmed economic growth forecasts and cost billions of dollars in lost business.

Hong Kong and China, which were the most severely affected, were given the all-clear by WHO this month and Taiwan and Toronto, Canada, are expected to follow soon.

"If these two countries have no reintroduction or no new cases then by the first week of July all countries should be off the list and therefore we can say that transmission has been interrupted in human populations," Heymann said.

He said the WHO was still clarifying with the Taiwanese government when health officials there had isolated their most recent case.

Countries are removed from the WHO's list of areas of SARS transmission when they have gone for 20 consecutive days without reporting a new case, twice the time it takes for the disease to develop in humans.

The WHO says that Taiwan's last SARS patient was isolated on June 15. "This is the period of the greatest danger as was shown in Canada, which exited the list of affected countries and then had another peak. The word now is vigilance," Heymann said.

He however said there was a risk the disease could once again be transmitted to human populations from animals in southern China in November or December of this year and that China's efforts at future prevention would be a major focus of attention at the weekend heath minister's meeting in Bangkok.

"The one thing we don't know is whether it will be cyclical, whether it will occur seasonally," Heymann said.

2003-07-09T21:36:00.000-07:00

'Taiwan free from SARS'

By Our Diplomatic Correspondent

NEW DELHI JULY 9. The seven-year-old Taipei Economic and Cultural Centre (TECC), New Delhi, held its first-ever press conference today to announce that Taiwan was free from the Severe Acute Respiratory Syndrome (SARS). The invitation mentioned that this was the first press conference of its kind that the TECC was organising. K.T. Chen, TECC Representative in New Delhi, who met the press at his office, read out a statement but added that he was not prepared to answer questions.

India and Taiwan have maintained low-key, non-Government contacts and the TECC opened in 1995. A similar Indian entity began functioning in Taipei as well. There are obvious sensitivities involved, with India holding steadfast to its "one China'' policy.

"The Indian side recalled that India was among the first countries to recognise that there is one China and its `one China' policy remains unaltered. The Chinese side expressed its appreciation of the Indian position,'' the recent joint declaration issued by the Chinese and Indian Prime Ministers in Beijing said.

Mr. Chen said the World Health Organisation (WHO) formally removed Taiwan from its list of areas with local transmission of SARS while the travel advisory against the island was lifted on June 17.

Declaring that Taiwan was a "safe and healthy'' place to visit, he said the island stood ready to welcome friends from abroad for business and pleasure. Mr. Chen, however, used his statement to pitch for Taiwan's association with the WHO. "The outbreak and spread of SARS, which had brought illness, death and economic peril to Asia and the rest of the world, has also drawn attention to Taiwan's exclusion from the WHO.'' ``The time has come for the members of WHO to acknowledge that the exclusion of Taiwan's membership or even observer status in the organisation is unjustified, and that this exclusion creates a gap in the global defence against diseases...'' According to Mr. Chen, it was, therefore, "imperative'' that the WHO invites Taiwan to participate, as an observer, in achieving the comprehensive objectives of the organisation.

Twins die on operation table

SINGAPORE July 8. The brave new surgery that an international team of medical professionals carried out in Singapore to separate two adult conjoined twins ended in failure today, as both women died, one after the other, during the marathon operation itself.

The shared wish of the Iranian twins was to become ``separated in all circumstances'' and, in a tragic twist, they died due to heavy loss of blood that followed a clinically "successful'' separation surgery, it was announced here.

The high-risk operation, first of its kind in the world as regards an attempt to separate grown-up twins joined at their heads, began on Sunday morning after a long period of careful assessments of the surgical possibilities and preparations, including counselling of the generally-cheerful twins themselves.

As the surgery proceeded, the doctors reported cautious optimism before they felt inclined to consider suspending the operation in the context of some complications late on Monday.

However, the complex operation was not halted in deference to the stated pre-surgery wishes of the twins to become separated and lead independent lives.

They had reportedly agreed to take the massive risks involved in the unprecedented surgery.

With a suspension of the surgery ruled out, it finally ended by late afternoon today.

2003-07-05T21:29:00.000-07:00

SARS contained, says WHO

Geneva: The World Health Organisation on Saturday said the pneumonia-like illness SARS had been contained worldwide after it declared Taiwan, the last country on its watch list, free of new infections. But it warned the world was not SARS-free and continued vigilance was needed. ``Today the World Health Organisation is removing Taiwan ... from the list of areas with recent local transmission of Severe Acute Respiratory Syndrome (SARS),'' the United Nations agency said in a statement. ``Taiwan is the last area to be removed from the list. It has been 20 days, or two consecutive 10-day incubation periods, since the last case on June 15. ``Based on country surveillance reports, the human chains of SARS virus transmission appear to have been broken everywhere in the world.'' (In the picture, Taiwanese are seen celebrating the WHO's announcement in Taipei on Saturday.)

— AFP

Continue alert against SARS, says WHO

By Our Special Correspondent

NEW DELHI July 5. Even as the SARS scare has become a thing of the past, a meeting of experts convened by the World Health Organisation has emphasised the need to continue the alert against the disease to prevent it from returning.

The three-day consultation, organised by the organistaion's Southeast Asia Regional Office, called for strengthening the mechanism for the surveillance of SARS and other atypical pneumonia and improve upon the facilities for the treatment of such highly infectious diseases.

Besides, the experts underlined the importance of health authorities being `pro-active' in sharing information with the media not only when such an epidemic occurred but also in normal times to ensure a rapid dissemination of correct information for public awareness.

Apart from experts from the 10 countries which were covered by WHO's SEARO, the meeting was attended by specialists from WHO headquarters.

2003-06-30T11:05:00.000-07:00

China SARS case sparks WHO concern

Beijing June 25 . A day after being declared SARS-free, China today reported a new case of Severe Acute Respiratory Syndrome in Guangdong province, sparking concern from the World Health Orgaisation.

One death was also recorded, in Beijing, the Health Ministry said.

``This does not affect our decision and the emergence of another case stays within our guidelines,'' a WHO spokesman, Bob Dietz, said.

``We are concerned, but our concern would be greater if this was a new emerging case and not a case that has developed from an already identified suspected case.

``We know there are people suspected of having SARS, a person not diagnosed as suspected who emerges as a probable case would be a matter of greater concern.

``We do not want to see SARS re-emerge in the general public at large.''

The WHO yesterday lifted its travel advisory against Beijing, the world's most SARS-hit city, and pronounced the country free from the chain of local transmission.

Celebrations

Earlier, with flying confetti and clanging gongs, Beijing celebrated the lifting of the World Health Organization's SARS travel warning over the city, reopened discos and Internet cafes and sought to resuscitate its battered tourism industry.

Banner headlines in Chinese newspapers cheered WHO's yesterday's announcement giving a clean bill of health to the capital of the nation where the outbreak began and lifting the last remaining SARS warning anywhere in the world.

``Our wish is finally fulfilled, we smile again,'' the popular Beijing Youth Daily said above a photograph of city residents posing in front of a banner reading, ``We win!''

``Beijing returns to normal,'' the China Youth Daily said on its front page.

Beijing was simultaneously removed from a WHO list of places with recent local transmissions of the disease — a move recognising the passage of more than 20 days since the last SARS case was isolated.

City travel bureau officials and representatives of tour agencies rallied at the Beijing Exhibition Hall to relaunch the city's tourism industry. Hotels, tour agencies and transportation companies are reported to have suffered 16 billion yuan ($1.9 billions) losses during the outbreak. An estimated 10 million fewer visitors came to the city during the first half of the year due to domestic travel restrictions and foreigners heeding the April 23 WHO advisory, which urged people to delay any non-urgent trips.

``We've taken the opportunity of this suspension to move the Beijing travel industry up a step,'' said Ding Changjiang, director of the Beijing Travel Bureau. — AP/AFP

2003-05-28T13:51:00.000-07:00

An invader from space?

Cardiff May 26. SARS may turn out to be an alien invader from outer space, some scientists believe.

Chandra Wickramasinghe, from the University of Cardiff, says there is already evidence that the virus which causes Severe Acute Respiratory Syndrome (SARS) is extraterrestrial.

He warned it could still be circulating high in the atmosphere, and might fall anywhere on Earth without warning. The microbiologist, Milton Wainwright, of Sheffield University agrees.

Mr. Wainwright says the evidence that SARS came from space is the virus's unique character, the fact it was first detected in China, the low rates of infection except through close contact, and the failure to restrict the epidemic. The idea is not as fanciful as it sounds. A small group of respected astrobiologists, led by Prof. Wickramasinghe, believe the idea of bugs and viruses arriving on Earth from space is plausible. They point to ancient and modern major epidemics which appear suddenly and spread in a way that cannot easily be explained.

Examples include the plague of Athens and the devastating influenza pandemic of 1917-19 that killed more people than the First World War. Samples of air taken from 26 miles up in the stratosphere have yielded many microbes, but whether or not they are extraterrestrial is open to question.

Bacterial material

Prof. Wickramasinghe's team estimates that a tonne of bacterial material falls to Earth from space daily — equivalent to 20,000 bacteria per square metre of the Earth's surface. The theory is that extraterrestrial organisms are carried around the solar system by comets or meteorites. — DPA

WHO lifts Hong Kong travel advisory

HONG KONG MAY 23. The fight against Severe Acute Respiratory Syndrome (SARS) in Hong Kong took two big steps forward on Friday as the World Health Organisation lifted a travel warning and local researchers announced the disease came from civet cats — a delicacy eaten by some Chinese.

University of Hong Kong researchers said that to prevent more outbreaks of SARS in people, the cats and other game food animals should be raised, slaughtered and sold under careful monitoring. The researchers had previously said SARS came from animals but they had not been sure which kind. Hong Kong had been lobbying for removal of the WHO travel advisory, which has devastated local airlines, hotels and other businesses, and WHO officials said early on Friday in Geneva they had lifted it.

The Chief Executive, Tung Chee-hwa, praised the ``effort of all the people of Hong Kong'' as instrumental in bringing the territory out from under the advisory.

``What we've achieved so far has not been easy,'' Mr. Tung said, adding that Hong Kong needed to redouble its efforts in the continued fight against SARS.

AP

2003-05-23T01:41:00.000-07:00

Sharp rise in Taiwan SARS cases

TAIPEI (Taiwan) MAY 22. Taiwan reported 65 new SARS infections — the island's biggest daily jump in cases — on Thursday as a U.S. health expert assisting the island developed symptoms of the deadly virus.

The official with the Centre for Disease Control and Prevention reported having a fever and muscle pain — common SARS symptoms — this week while staying at the Sheraton Hotel in Taipei, said Su Yi-jen, chief of the island's Centre for Disease Control.

The man, who wasn't identified, was taken to a hospital for an examination and the hotel was temporarily sealed off, Mr. Su said.

Earlier Thursday, Mr. Su reported 65 new cases — the island's sharpest daily increase. The island now has 483 infections. He also said there were eight more fatalities, raising the death roll to 60.

The official said the sharp increase in cases was largely due to improvements in Taiwan's SARS confirmation process. Mr. Su noted that the WHO and America's CDC have complained that Taiwan had about 400 cases awaiting confirmation and that officials were taking too long to sort out the patients.

Many of the new cases on Thursday were from that backlog, he said. ``We are now at the peak of the new wave, and we're at the stage when we're about to come down,'' he said.

The new numbers were announced one day after the WHO warned travellers to avoid the entire island. Originally, the U.N. health agency only advised people against making non-essential visits to Taiwan's capital, Taipei. Following the WHO's lead, Britain issued a new travel warning about Taiwan, strongly advising its citizens not to go to the island, about 160 km off China's south-eastern coast.

The outbreak has already forced Taiwanese to change their daily routines and cancel several important events. On Thursday, the elite National Taiwan University announced that it called off its June 7 graduation ceremony.

China reopens schools

Meanwhile, in China, thousands of students went back to class on Thursday as Beijing began to reopen public schools that were shut down at the height of the Chinese capital's SARS outbreak.

``I'm really excited to see all my friends again. I can't stop smiling,'' said Qing Zhu (18), who was chatting with a classmate at Beijing No. 80 High School.

School closures on April 24 sent home 1.7 million students. Most spent the past month at home, often in tiny apartments, told by schools not to see classmates to avoid possibly spreading the virus.

Classes for students planning to take university entrance tests resumed on Thursday. Lower grades were to return later. Some schools will stay closed longer, holding classes on the Internet or television.

The measures were part of sweeping efforts to contain SARS in Beijing, the world's hardest-hit area with 156 deaths reported and nearly 2,500 people infected.

Throughout China's mainland, the disease has killed at least 296 people, with more than 5,200 cases reported.

AP

2003-05-18T10:29:00.000-07:00

WHO blames it on leaky pipes, ventilation fans

HONG KONG MAY 16. Leaky sewage pipes and bathroom ventilation fans carried contaminated droplets through parts of a Hong Kong apartment complex, causing one of the world's worst outbreaks of SARS, World Health Organisation investigators said on Friday.

More than 300 people came down with the illness at the Amoy Gardens apartment complex in late March, and 35 people died. The speed of the infection amazed health experts, who at the time believed the disease was spread mainly by person-to-person contact.

Hong Kong reported four new SARS deaths on Friday but only three new infections, the lowest number since officials began releasing daily statistics in March. SARS has now infected 1,706 people here and killed 238.

A report written by a team of WHO investigators blamed an `unlucky' combination of circumstances — a patient with diarrhoea, seeping pipes and drafty air shafts at Amoy Gardens. The findings largely confirm an earlier report by Hong Kong officials.

"It's just an accumulation of events," an official said. There was no way to guarantee against a repeat, but that another such outbreak seems `unlikely', he said. When the WHO investigators went to Amoy Gardens to collect samples, they found no live coronaviruses — the family of virus believed to cause severe acute respiratory syndrome — and no remaining genetic material from the virus, th official said.

The WHO team is still conducting lab tests on samples collected from another housing development, the Tung Tau Estate, that suffered a minor outbreak. Preliminary findings showed the sewage system did not appear to be the cause there, but he did not elaborate. — AP

Out of hospital

BEIJING MAY 16. An Indian citizen, who had to spend over three weeks in isolation in a SARS-only hospital here, was discharged today after recovering from typhoid fever. — PTI

2003-05-15T11:55:00.000-07:00

SARS: scientists claim breakthrough

PARIS MAY 14. Dutch researchers say they have carried out the last three lab tests needed under a venerable scientific benchmark to confirm that SARS is caused by a coronavirus. A test procedure known as Koch's Postulates is traditionally used by medical scientists to establish whether a specific virus has caused a disease.

The goal is to cross-check: to ensure that the disease can be clearly pinpointed to that virus and not to other pathogens that may lurk in samples taken from patients.

The first three criteria — isolating the virus from diseased hosts; cultivating it in host cells; and proving that the agent passes through a lab filter that traps bacteria, which are bigger than viruses — have already been met.

Scientists in Rotterdam say they have now successfully carried out the three other Koch tests.

These are: inducing the disease in the same or comparable host; re-isolating the pathogen from the sick animals; and detecting a specific response to the virus from the body's immune system.

The Osterhaus team used macaque monkeys as a close relative to human species to carry out the trio of experiments.

The research could be the final blow to early lab work in the Severe Acute Respiratory Syndrome (SARS) outbreak that suggested another agent was to blame - a paramyxovirus, which is related to the virus that causes mumps and measles. — AFP

Fight against SARS: anti-cold drug raises hopes

By N. Gopal Raj

THIRUVANANTHAPURAM MAY 14. An anti-cold drug, currently in clinical trials, could probably be modified so that it is effective against the SARS virus, say researchers in Germany.

The German group, which includes two Indians, has studied the structure of the "Main proteinase'' (Mpro) enzyme which plays an important role in the replication of coronaviruses and is therefore attractive as a potential drug target. Their findings are published in the journal, Science.

Kanchan Anand and her colleagues have examined the crystal structure of the Mpro enzyme from a human coronavirus (HCoV) which causes the common cold. They had earlier studied the structure of a pig coronavirus' Mpro. Based on the close similarity of the SARS virus' Mpro to those of the HCoV and the pig virus, the researchers were able to construct a reliable three-dimensional model for the SARS-CoV enzyme.

They then looked at the binding between the pig coronavirus' Mpro and a chemical which inhibits it. Combining this information with their structure of the SARS-CoV Mpro, the German group has suggested that AG7088, a drug currently in clinical trials against the human rhinovirus (one of the causes of the common cold), could be suitably modified to effectively block the SARS virus enzyme.

As there were "some minor clashes'' between AG7088 and the structure of the SARS coronavirus enzyme, the inhibitor was unlikely to be suitable in its present form as a drug against SARS, observes Rolf Hilgenfeld, senior author of the paper from the University of Leubeck in Germany. But since AG7088 is already in clinical trials and there were no cellular enzymes with which it was interfering, the prospects for developing a broad-spectrum antiviral drug were good, the paper noted.

Meanwhile, an international team of researchers has conclusively established that SARS-CoV is indeed what causes the SARS illness. Robert Koch, founder of modern bacteriology, had laid down four conditions, which had to be satisfied to prove that a bacterium was the causative agent of an illness. Two more conditions were subsequently added in the case of viruses.

Three of these conditions have already been satisfied in the case of SARS-CoV, namely isolation of the virus from the diseased hosts, cultivation in host cells and proof of filterability.

A paper being published in the coming issue of Nature says that the remaining three conditions have now been fulfilled. Macaque monkeys infected with the SARS virus derived from a cell culture became ill. The same virus later could be isolated from the monkey's respiratory tract excretions. The monkeys also developed antibodies against the virus.

The SARS coronavirus, therefore, fulfilled all the Koch postulates as the primary cause of SARS. "But this does not exclude the possibility that other pathogens, including human metapneumovirus (hMPV) and Chlamydia pneumoniae, may have exacerbated the disease in some patients,'' the paper added.

2003-05-12T19:52:00.000-07:00

China reports drop in SARS cases

BEIJING MAY 12. Highlighting the potential of SARS to become a global problem, Canadian officials angrily rejected any suggestion that a Finnish man contracted the disease in Toronto, which says its outbreak is under control.

In China, the likely place of origin, the officials maintained strict measures as infection rates continue to drop.

The international death toll from SARS was at least 538 on Monday, when Taiwan reported two new deaths. One victim was a dentist in southern Kaohsiung, an indication that the illness has spread from the north of the island. The location of the other death was not disclosed.

In Taipei, people were complying with a Government order to wear masks on the city's subway. Also Taiwanese authorities are keeping a watch over about 8,000 people quarantined in their homes in case they have contracted the illness. So far, 184 people have been infected in Taiwan, and 21 have died.

In Finland, the University of Turku Central Hospital said a Finnish man who had been on vacation in SARS-hit Toronto in late April had contracted the illness.

It said the patient was recovering well, and that no one who had been in contact with him had shown any of the disease's symptoms.— AP

SARS-free Indian patient stuck in Beijing hospital

BEIJING MAY 12. An Indian national, who was admitted to a hospital here after showing some SARS-like symptoms, is stuck in the isolation ward, even though doctors have diagnosed that he has not contracted the deadly disease.

After initially treating him as a suspected case of the disease, doctors at the Peking Union Medical College (PUMC) have now diagnosed that he is suffering from typhoid fever, a rare bacterial infection not found in China. However, since he was admitted to the PUMC, a SARS-designated hospital for foreigners here, he cannot be shifted to a regular hospital for routine treatment of typhoid fever. ``Though I don't have SARS, I am stuck in the isolation ward which is designated for SARS patients,'' the Indian man, who did not want to be identified, told PTI over phone. ``Since my family in India would be horrified to know that I am stuck in a SARS-designated hospital, I don't want to be named,'' the man, who hails from North India, said.

2003-05-11T20:54:00.000-07:00

Anti-viral agents developed

Beijing May 11 . A team of scientists in Hong Kong and the United States today claimed to have developed synthetic peptides — anti-viral agents — that are expected to block the entry of coronavirus into human cells, promising a new treatment for SARS patients world-wide.

The team of scientists from the University of Hong Kong and David Ho, an international expert on HIV treatment, said initial lab results indicated that the synthetic peptide was quite effective in blocking the Severe Acute Respiratory Syndrome (SARS) virus from entering into cultured cells.

Peptides are groups of amino acids that have been used in AIDS treatment.

However, Hong Kong scientists stressed that the development of the synthetic peptide represented only initial results and much more had to be done before its clinic use.

Zhang Linqi, Aaron Diamond AIDS Research Centre Staff investigator who is also a member of the research team, said protein sequencing indicated that the SARS virus and HIV virus were similar in space structure and ways of attacking human cells.

Mr. Zhang said by blocking the SARS virus from entering into the human cells, the synthetic peptide can be applied for either treatment of patients or prevention of SARS from inflicting ordinary people if tests on animals and human beings proved effective, Xinhua news agency reported from Hong Kong.

Meanwhile, the Communist Party secretary for Beijing is calling for ``total victory'' against SARS, warning officials not to relax disease-fighting efforts despite falling numbers of new cases in the hard-hit Chinese capital, newspapers reported on Sunday.

``We can't allow the slightest relaxation in the fight against SARS in May,'' the party newspaper People's Daily quoted Liu Qi as telling Beijing officials on Saturday in a video conference. — PTI/AP

15 tested for SARS in Manipal

Manipal May 9. Fifteen people who came in contact with a CEO of an Indo-Malaysian joint venture, whose blood samples tested positive for the SARS virus, have been subjected to medical examination here.

``Over 15 persons including doctors and nurses who attended a conference in which the CEO participated have been tested for SARS virus,'' the Udupi District Health Officer, Chandramouli, told PTI today.

The CEO, who arrived from Malaysia last month, was the first person to test positive.

SARS shadow over Cannes fete

By Gautaman Bhaskaran

PARIS MAY 9. The Cannes International Film Festival, beginning next week, is facing a typically French menace: a nationwide public workers' strike on May 13.

After the battered Franco-American relations over Iraq and the still hot SARS scare, the strike will undoubtedly be a major irritant for thousands of people from across the globe sitting on Cannes-bound trains and planes just a day ahead of the Festival's opening night on May 14. The strike, which is bound to affect the French national railway company (SNFC) and even private firms such as Air France, is a protest against the Government's move to add three more years to one's working life.

Although one is not sure how widely the strike will be observed, the Festival's managing director, Veronique Cayla, has a word of advice for participants: "Try and travel on May 12 or 14... Avoid May 13."

This is a typical French reaction. Although strikes occur frequently in France, admittedly with varying impacts on everyday life, the people here tend to be over cautious. They stay at home, away from work, rather than be harassed by delays on road, on rail or in air as well as by overcrowded public transport systems.

In addition to the planned strike nuisance, there is this medical test. Ms. Cayla said moviemakers and others from SARS-hit Asian countries would have to undergo health checks before they could attend the Festival.

Teams from China, Hong Kong and Taiwan have agreed to the examination for their own peace of mind, and that of the others.

Some such as the Chinese actor, Jiang Wen, who is on the main international jury, will travel to France early so that the medical test can be completed well in time.

Ms. Cayla felt that the final number of Asians at the Festival could go down because of the fear of the impending inconvenience.

Although press reports here talk of medical tests at the French airports, this correspondent who arrived from New Delhi the other day found nothing of the kind happening at Paris' Charles de Gaulle terminal. Was it all because of the WHO's clean chit to India? One can never tell.

The same press reports also talk about such checks being in place at Nice, the airport for Cannes, though no flights from Asia arrive there non-stop. This "scare" may well be yet another classic case of media-hype.

2003-05-08T20:42:00.000-07:00

SARS: India back on list

NEW DELHI MAY 8. India is back on the WHO list of countries reporting ``probable cases'' of SARS after being declared SARS-free by the world body on May 1. The WHO's website on SARS mentions one SARS-probable case in India. The WHO had modified the definition of probable cases on May 1.

All the cases reported in the country earlier, despite testing positive for the new corona virus in samples, did not fall into the WHO's previous case definition of ``SARS-probable''. ``We have taken into account one case in Kolkata, who is a SARS-probable according to the WHO's revised definition,'' N. Kumara Rai, WHO's representative here, said.

PTI

SARS epidemic: China closes some border points

By P. S. Suryanarayana

SINGAPORE May 8. China today announced that it has closed its borders with neighbouring countries at certain points and also imposed restrictions on the flow of passengers and goods across some other border crossings.

These measures have been taken in an attempt to control the spiralling crisis following the spread of Severe Acute Respiratory Syndrome (SARS) in the country. According to the Chinese Foreign Ministry spokesperson, Zhang Qiyue, restrictions on the movement of people and freight had been imposed in respect of the Democratic People's Republic of Korea (or the North), China's strategic ally, besides Kazakhstan, a key member of the Shanghai Cooperation Organisation. As for Pakistan, which is China's "all-weather friend and ally'' (in Beijing's parlance), the opening of the Khunjirap point had been "postponed'', she said at a news conference in Beijing today.

Some seasonal border posts between China and Mongolia had been "temporarily closed''.

She underlined that the action had been taken in line with the international practice of closing border points during times of an epidemic or any other catastrophe.

On a separate but related front, even as the Chinese Prime Minister, Wen Jiabao, enunciated a new policy of placing the country's rural areas under the laser beam of anti-SARS efforts by his Government and the Communist Party, the World Health Organisation (WHO) too turned its attention in the same direction. A team of WHO experts arrived today at Baoding, a city in the Hebei province in northern China, to inspect the hospitals designated for SARS patients, it was officially announced by the Chinese authorities.

The team would "investigate'' a whole range of parameters about how the province, said to be on the frontline of rural China's potential SARS crisis, could cope with a possible danger at this stage, it was said on behalf of the WHO.

The organisation also included Taipei (in Taiwan, which China claims as its own) in the list of places to avoid non-essential travel.

Beijing's latest fact sheet on SARS read as follows: the total number of confirmed or probable cases: 4,698; the cumulative total of suspected cases: 2,648; and the death roll: 224.

Mr. Wen, who has been following a hands-on approach in facing the SARS crisis for the past several weeks, on Wednesday ordered all-out efforts to try and prevent the spread of the epidemic.

The ruling Communist Party of China began deploying its cadres in the rural areas in a big way to undertake preventive measures.

First SARS case in Russia

By Vladimir Radyuhin

MOSCOW MAY 8. Russia appears to have become the world's 30th country to have been hit by SARS virus as the first "almost certain'' case of the disease has been detected on the border with China.

A 25-year-old man hospitalised four days ago in Russia's Far East has been tentatively diagnosed as having SARS, pending laboratory tests, the Russian Health Ministry said on Thursday.

The young man did not travel to China, but has been working in a hotel popular with Chinese traders in the border town of Blagoveshchensk. His condition has been described as grave but stable. So far there have been no confirmed cases of the killer pneumonia in Russia, though more than 20 suspected cases have been reported in regions bordering China. Russian authorities have partially closed the border with China, only allowing Chinese and Russian citizens to return home, and the Government is considering total closure of the gigantic 4,000-odd km border if the situation gets out of hand.

Hundreds of thousands of people do brisk trade under visa-free regime. The Russian Civil Aviation Authority has ordered all airlines to stop selling tickets to China and South-East Asia and be ready for a ban on air links.

Moscow has started disinfecting the metro and other public transportation and is distributing millions of SARS-education brochures to residents to prevent the deadly disease from creeping into the capital.

Medical scientists to discuss SARS strategy

By Our Special Correspondent

NEW DELHI May 8. The Centre has proposed to hold a meeting of medical scientists soon to work out a strategy to tackle the new threat posed by SARS — Severe Acute Respiratory Syndrome.

The meeting is being held in the backdrop of fears expressed by public health experts that even if the present epidemic has not had much of an impact in India, one could not remain complacent as the virus causing the disease has been found in the country and outbreaks could not be ruled out.

The Secretary, Department of Biotechnology (DBT), Manju Sharma, said it would particularly focus on a work plan to develop techniques for early diagnosis. It was likely to be held in about a fortnight.

Ms. Sharma said her department was also taking up a major initiative to promote research in mental health, with a particular focus on age-related degenerative disorders, considering that the proportion of the aged in the population was growing steadily.

Among other things, emphasis is being laid on validating the ayurvedic cures using modern scientific tools. "The Department was trying to tap the rich knowledge base of the traditional medicine systems such as ayurveda."

She was speaking to reporters after a brief ceremony where the Director, National Brain Research Centre, under the Department, Vijayalakshmi Ravindran, and the Director, National Institute of Mental Health and Neurosciences under the Union Health Ministry, D.N. Nagaraja, signed a memorandum of understanding for joint research on brain-related disorders.

2003-05-07T22:15:00.000-07:00

Clinical Course of SARS Less Aggressive in Children

NEW YORK (Reuters Health) Apr 29 - Young children appear to develop a milder form of SARS than adolescents or adults, according to report in April 29th online issue of The Lancet.

Severe acute respiratory syndrome (SARS) has killed more than 350 people and affected 5500 in nearly 30 countries. Although pediatric cases have been reported, so far no children have died from SARS--suggesting that the clinical course is less severe in younger patients.

Dr. T. F. Fok, from the Chinese University of Hong Kong, and colleagues describe the clinical presentation and outcome of the first 10 children who were diagnosed with SARS during the outbreak in Hong Kong. The children included 5 who were no older than 12 years and 5 who were adolescents.

All of the children had contracted the disease after being in close contact with infected adults, the authors note. All of the patients presented with persistent fever and cough.

Nine of the children presented with abnormal chest x-ray findings--usually air-space opacification. The remaining child demonstrated focal consolidation in the right lower lobe on chest CT. Mild progressive consolidative change was noted on follow-up radiographs in all patients, but complete resolution of disease was observed within 2 weeks of presentation.

All of the patients had lymphopenia, but it was usually more severe in the adolescents, the investigators note.

The children were treated with ribavirin, oral prednisolone, or IV methylprednisolone. No short-term adverse effects were observed and such therapy was generally effective in eradicating the disease. Four adolescents required oxygen therapy, including two who needed assisted ventilation. None of the younger children required respiratory assistance.

The findings indicate that the clinical course of SARS in adolescents differs from that seen in younger children, the authors note. Teenage and adult patients present similar symptoms, including malaise, myalgia, chills, and rigor. In contrast, younger children usually present with just cough and runny nose. Radiologic and laboratory abnormalities are also less severe in younger children and resolve more quickly.

Another difference between children and adults with SARS may relate to infectivity. In adults, SARS is associated with a very high infectivity rate. In contrast, in the current study, 8 of the 10 children were attending school at the time of presentation, yet none of their classmates appear to have developed the disease.

Lancet 2003;April 29th online issue:000-000.

2003-05-07T22:06:00.000-07:00

CDC Adds Laboratory Criteria to Case Definition for SARS

NEW YORK (Reuters Health) May 01 - The Centers for Disease Control and Prevention has updated its interim U.S. surveillance case definition for severe acute respiratory syndrome (SARS) to include laboratory evidence of infection with SARS-associated coronavirus (SARS-CoV).

Under the new laboratory criteria, a SARS case is laboratory-confirmed if one of the following criteria is met:

Detection of antibody to SARS-CoV by indirect fluorescent antibody (IFA) or enzyme-linked immunosorbent assay (ELISA).

Isolation of SARS-CoV in tissue culture.

Detection of SARS-CoV RNA by reverse transcriptase-polymerase chain reaction (RT-PCR), which must be confirmed by a second PCR test.

The CDC emphasizes that a negative PCR, viral culture, or antibody test for SARS-CoV obtained within 21 days of illness does not rule out coronavirus infection. "In these cases, an antibody test of a specimen obtained more than 21 days after illness begins is needed to determine infection," CDC officials note in a statement.

The CDC has also revised the clinical criteria for SARS "to reflect the possible spectrum of respiratory illness associated with SARS-CoV." These clinical criteria include:

Asymptomatic or mild respiratory illness.

Moderate respiratory illness: temp > 100.4 degrees Fahrenheit with one or more of the following: cough, shortness of breath, difficulty breathing or hypoxia.

Severe respiratory illness: Same as above, plus radiographic evidence of pneumonia, or respiratory distress syndrome, or autopsy findings consistent with pneumonia or respiratory distress syndrome without an identifiable cause.

As of April 30th, 289 SARS cases have been reported in the U.S. from 38 states. Of these, 233 (81%) were classified as suspected cases and 56 (19%) were classified as probable SARS cases (more severe illness with pneumonia or acute respiratory distress syndrome).

Of the 60 cases in which laboratory testing is complete, 6 have laboratory-confirmed SARS-CoV and 54 are negative for SARS-CoV infection.

The vast majority of U.S. cases of SARS have been linked to international travel to affected areas. There have been only two instances of secondary transmission to household contacts or healthcare workers.

More information about SARS case definition, travel advisories, and numbers of cases worldwide can be found at the CDC Web site at http://www.cdc.gov.

MMWR 2003;52:388-393.

SARS Virus Found in Recovered Patients

HONG KONG (Reuters) May 01 - Hong Kong physicians have discovered for the first time traces of the SARS virus in the stool and urine of patients thought to be free of the virus and discharged from the hospital, officials said on Thursday.

The news came after physicians in Hong Kong found evidence of permanent lung scarring and possible cases of relapses in patients with severe acute respiratory syndrome (SARS).

"Recovered patients have the virus in their stools and urine," David Hui, a doctor treating SARS patients, told Reuters.

Hong Kong's Director of Health told a news conference experts here were now trying to ascertain how long recovered patients in the territory may be passing the virus in their stool and urine. "Most patients spend at least 3 weeks in hospital, they must be clear of any symptoms for 5 days before they can be released," said Margaret Chan, adding that those discharged must remain at home for another 14 days.

Tests were being done to see if recovered patients with the traces of the virus were still infectious.

Authorities said the disease killed another 5 people in the city and infected 11 others on Thursday, bringing the death toll to 162 and cumulative cases to 1600.

Drug Companies Collaborating to Develop SARS Vaccine

LONDON (Reuters Health) Apr 30 - GlaxoSmithKline said on Wednesday it is collaborating with other companies and France's Institut Pasteur to accelerate development of a possible vaccine against SARS.

"We had a high level meeting with the US government that asked the main vaccine companies to come to the table and give their plans for how to deal with this issue," Chief Executive Jean-Pierre Garnier told reporters. "We committed to accelerate our development of a possible vaccine for SARS."

But Garnier warned this would take time. "This is not a matter of weeks or months, it is matter of years," he said. "It is better to start now because this infection might come back even if it gets contained in the short term. We need to be ready for the next wave, which could be more serious."

He said GSK normally competes against other companies but this time is collaborating to tackle the SARS threat. "We have at least exchange of some of the science. The Institut Pasteur is at the core of this."

Top scientists from the US Centers for Disease Control and the National Institutes of Health called companies to the meeting earlier this month.

The other companies included Merck, Wyeth, Chiron, Baxter, Johnson & Johnson, Aventis, Vical, Avant, PowderJect and Berna Biotech.
Of these, 43 patients were discharged from hospital on Thursday, bringing the total number of discharged patients to 834. The government also said 102 recovering patients were in convalescence and were about to be discharged.

The disease has spread to more than 25 countries in the last 2 months, infected more than 6000 people and killed nearly 400 of them since first emerging in southern China in November.

While daily numbers of new infections have fallen over the past week in Hong Kong, news on Wednesday that 12 people had to be readmitted to hospital brought fresh concerns. Six remain in hospital.

It was not clear if the 12 had experienced relapses.

Some physicians told Reuters these patients may not have fully recovered when they were first discharged, or that that their weakened immune systems may have left them vulnerable to secondary infections.

Chan said experts were still trying to pinpoint the cause of the relapses but she stressed that hospitals in Hong Kong were extremely cautious when handling SARS patients.

2003-05-07T20:43:00.000-07:00

SARS Updates

For all the updated information on SARS, please check the following sites as well

SARS Attack - The Hindu

Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

Christl A Donnelly, Azra C Ghani, Gabriel M Leung, Anthony J Hedley, Christophe Fraser, Steven Riley, Laith J Abu-Raddad, Lai-Ming Ho, Thuan-Quoc Thach, Patsy Chau, King-Pan Chan, Tai-Hing Lam, Lai-Yin Tse, Thomas Tsang, Shao-Haei Liu, James H B Kong, Edith M C Lau, Neil M Ferguson, Roy M Anderson

Summary

Background

Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong.

Methods

We included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients' age and the time from onset to admission.

Findings

After the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6·4 days (95% CI 5·2-7·7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13·2% (9·8-16·8) for patients younger than 60 years and 43·3% (35·2-52·4) for patients aged 60 years or older assuming a parametric g distribution. A non-parametric method yielded estimates of 6·8% (4·0-9·6) and 55·0% (45·3-64·7), respectively. Case clusters have played an important part in the course of the epidemic.

Interpretation

Patients' age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quarantine.

Indian patient in Beijing 'SARS-free'

By P. S. Suryanarayana

SINGAPORE May 7. An Indian patient in Beijing, who figures in China's list of foreigners with suspected Severe Acute Respiratory Syndrome (SARS), has successfully cleared the ``Quick Test''. According to official sources in Beijing, the Indian national, who remains unidentified for reasons of privacy, is still in hospital, pending the results of another diagnostic test that takes about 14 days to complete. The Indian had arrived in Beijing on a visit from North America.

China deploys cadres to check disease

Beijing May 7. China deployed communist party cadres and investigators to monitor the spread of SARS while WHO decided to send a team to a province surrounding Beijing to prevent a rural outbreak of the epidemic as the countrywide toll rose to 219 with five deaths and 159 new cases today.

In a desperate bid to check the spread of Severe Acute Respiratory Syndrome 30,000 investigators were deployed in Haidian district of Beijing to check businesses and residences to look for patients and ensure that measures are being taken to improve hygiene, district official, Zhou Liangluo said.

Each household in the district of 2.2 million people has been issued a thermometer and emergency contact numbers, while offices and businesses were directed to install temperature- monitoring systems.

Reports that migrant workers had ignored government calls and travelled to their rural homes raised concerns over the disease spreading to the hinterland.

``All entry and exit points in rural Beijing are now controlled by cadres who have been assigned the task by the ruling Communist party,'' Cai Fuchao, the director of publicity department of Beijing Municipal Committee of the Communist Party of China said.

Meanwhile, the World Health Organisation said on Wednesday it will send experts to China's northern province of Hebei to investigate a spreading SARS outbreak, while Premier, Wen Jiabao, called for urgent efforts to stop the disease in poor rural areas.

The reports came amid growing worries that severe acute respiratory syndrome, still largely an urban disease in China, might be spreading into the countryside.

— AP, PTI

SARS: new method gives hope

HONG KONG MAY 6. Even as doctors said some SARS victims responded well to a treatment of antibodies from recovered patients, the World Health Organization outlined conditions on Tuesday for removing a warning against travel to Hong Kong.

Hong Kong desperately wants to see WHO lift the advisory that has hit the territory's airlines, hotels, restaurants and retailers with millions of dollars in losses.

Toll 193

Hong Kong reported six more deaths on Tuesday, people in their 70s and 80s, pushing its toll to 193. There were nine new SARS cases, keeping figures in the single digits for a third consecutive day. The Geneva-based WHO told Hong Kong officials in a video conference that the number of new cases needed to come down further before the travel advisory could be eliminated. Hong Kong now has more than 400 people hospitalised with SARS, but the WHO said it wants to see only about 60 active cases, sources said. The WHO also wants to see the number of new cases average no more than five a day over a period of three consecutive days, and Hong Kong needs to stop transmission of the disease in the general population. — AP

Hong Kong has reported 1,646 SARS cases, but 958 people have recovered and been discharged. The hospitals have typically given SARS victims a combination of the anti-viral medicine Ribavirin and steroids, but physicians at the hard-hit Prince of Wales Hospital have tried other treatments on those who kept deteriorating. The doctors divided 40 such patients into two groups and gave about half of them serum containing antibodies from recovered victims, while the rest got a higher dose of steroids.

— AP

Indian in Beijing SARS list

By P. S. Suryanarayana

BEIJING MAY 6. ``One person from India is now receiving medical treatment'' in Beijing as a ``suspected case of the Severe Acute Respiratory Syndrome'', according to an official of the Communist Party of China, Cai Fuchao.

Briefing reporters, he said two other overseas residents of the city were declared SARS-free after diagnosis. The Indian patient was not identified.

Another foreigner, apparently on a visit to the city, was still in hospital. A visiting official of the International Labour Organisation, Pekka Aro, died of SARS in China last month.

Chinese being treated for SARS

By Our Staff Reporter

NEW DELHI MAY 6. A 28-year-old Chinese national was admitted to the Infectious Diseases Hospital here today after she reported to a private hospital with symptoms of Severe Acute Respiratory Syndrome (SARS). Her tests, according to the Director-General of Health Services control room, are under way.

Meanwhile, doctors have warned that people should go soft on high fever and avoid strong non-steroidal anti-inflammatory drugs (NSAIDs) such as Nimesulide which can cause a sudden drop in the body temperature and mask the symptoms of SARS.

Also, experts treating SARS patients the world over have issued a warning against the use of NSAIDs. Such medicines are found to suppress the symptoms of SARS, like high fever and body ache and may delay proper diagnosis and prognosis of SARS.

Expressing concern at use of wrong medicines, the Editor of the Monthly Index of Medical Specialities, C.M. Gulati, said: "In the initial stages, signs and symptoms of SARS are similar to those of flu, fever, bad throat and body aches. However, respiratory disorder occurs later."

SARS unabated in China; toll 206

By P. S. Suryanarayana

SINGAPORE May 5. China today registered a psychologically critical index in the ongoing battle against Severe Acute Respiratory Syndrome (SARS) when the death roll crossed 200. Mainland China acknowledged toll of 206 as against a total of over 4,200 confirmed cases.

While the death roll as a ratio of the total number of cases was not as alarming as in some other places, China's concerns centred on the reality that there was as yet no sign of any abatement of the menace on the mainland. A matter of some relief in this gloomy situation was that the Hong Kong Special Administrative Region of China recorded a single-digit figure of incremental cases for yet another day. The diminishing incidence of the disease was noted for the first time yesterday. Yet, Hong Kong's toll today stood at over 170.

In Taiwan too, the situation worsened, with the territory reporting a total of 10 deaths so far. The SARS-related situation in Singapore remained somewhat stable for yet another day.

2003-05-05T12:32:00.000-07:00

SARS: China extends school vacation

BEIJING MAY 4. China announced on Sunday that elementary and middle schools in Beijing would remain closed for two more weeks to help prevent the spread of SARS, affecting over a million students, as Taipei's mayor warned that violators of home quarantine orders would be strictly punished.

Two doctors from the World Health Organisation arrived in Taiwan to help cope with its worsening SARS outbreak after China put aside politics and agreed to the visit. The number of probable cases in Taiwan has surged in the past 10 days to 116, including eight fatalities.Twelve new SARS deaths were reported on Sunday in East Asia — seven in mainland China and five in Hong Kong. But the number of new infections in Hong Kong was just eight, as numbers of new cases in the territory decline steadily. Globally, the disease has killed 448 and sickened more than 6,300.

A Malaysian freighter heading for mainland China from Thailand made an emergency stop in Hong Kong on Sunday after 10 Indian sailors aboard complained of SARS-like symptoms. But the sick seamen underwent tests and doctors said they were clear of SARS. Meanwhile, hospital officials said none of the 12 recovered Hong Kong SARS patients who became ill again had suffered relapses, as had been feared earlier.

Eight have already been discharged, and though the patients had reported symptoms including fevers that are common in SARS victims, all were sick with something else, said Dr. Liu Shao-haei, senior executive manager of the Hospital Authority.

In Australia, a Qantas flight attendant was being treated at a Sydney hospital for suspected SARS, a hospital spokesman said.

— AP

SARS-scare for Indian sailors

By P. S. Suryanarayana

SINGAPORE May 4. Ten sailors of a Malaysian-registered cargo vessel, all of them Indian nationals, were declared free of the Severe Acute Respiratory Syndrome (SARS) on Sunday night after first being rushed to a hospital in Hong Kong. They were taken to the Princess Margaret Hospital earlier in the day, following a scare that they might have caught the SARS-causing virus while on a voyage.

The Government of the Hong Kong Special Administrative Region of China announced late on Sunday night that the Indian seamen, who were subjected to medical tests and kept under observation, were discharged from the hospital and sent back to their vessel. X-rays and blood tests "confirmed that they had not contracted the (SARS) virus,'' the Hong Kong authorities said.

Earlier, the 10 Indian seamen were transferred to the hospital after the ship, `Bunga Melawis Satu,' was allowed to "moor'' off the Lamma Island. This followed a decision by Hong Kong to respond positively to an urgent "distress call'' from the captain of the vessel, also an Indian who was not among the 10 who took ill while at sea. Those who were hustled to hospital had complained of some symptoms common for several infectious diseases, including the SARS. The vessel was on its way towards South China Sea after having made port calls in Thailand, Malaysia and Singapore.

Acceding to the captain's request, Hong Kong intimated the World Health Organisation about the SARS scare. Fourteen persons out of the 24-strong crew — all but two of them being Indians — were allowed to remain on the ship, throughout the tense drama, after the Hong Kong health staff thoroughly examined them.

However, all those who were cleared of the SARS symptoms aboard the ship were still quarantined or "isolated'' on the vessel itself for a period of 10 days. The ship, too, was placed under maritime "surveillance.'' Even as the hospitalised seamen were discharged, there was no indication when the ship could set sail again.

Suspected SARS patient to file defamation suit

By Our Staff Reporter

JAMMU MAY 4. A person with suspected Severe Acute Respiratory Syndrome (SARS), who was discharged after the National Institute of Communicable diseases, New Delhi, confirmed that she was free of it, has decided to file a defamation suit against the hospital "for blowing the incident out of proportion".

Maliti Singh of Nagpur was admitted to Katra hospital on May 1 when she complained of respiratory problem after returning from the Vaishnodevi temple here.

Later, the hospital referred her to the Government Medical College here where she was treated as the State's first suspected SARS patient.

Alarm bells began to ring and pilgrims thronged the information centres to enquire about the possibility of them catching the disease.

Now, that Ms. Singh has been declared free of SARS, her husband, J.P. Singh, has decided to file a defamation suit against the doctors after reaching Nagpur.

"There was not even a single symptom of SARS in my wife, but doctors admitted her to hospital which led to the harassment of the whole family'', he said adding that they (doctors) blew the incident out of proportion to "get publicity".

The suspicion about his daughter, who had recently returned from Australia, had no ground as neither any case of SARS had been detected in Australia nor had she tested positive on her arrival at the airport.

SARS in India

70 foreigners quarantined (20030505) New

Suspected SARS patient to file defamation suit (20030505) New

2 more test SARS-positive (20030504)

SARS: Australian quarantined (20030504)

`SARS wards needed, despite WHO declaration' (20030504)

Health Minister clarifies (20030504)

SARS — a full-blown farce? (20030504)

How it spreads (20030504)

Fear over the nation (20030504)

Breathing easy now (20030504)

SARS patient discharged from CMC Hospital (20030503)

Three hospitalised 'for SARS' (20030503)

No SARS case in India as per WHO definition: Minister (20030502)

`An irresponsible act' (20030502)

IMA to launch SARS sensitising programme (20030502)

SARS incidence tapering off? (20030502)

SARS: 9 test positive (20030501)

Hospital staff quarantined in Pune (20030501)

SARS: Results of blood tests yet to arrive (20030501)

SARS: `no need for panic' (20030501)

High-level panel to combat SARS (20030430)

Vellore patient tests positive (20030430)

Two more test positive for SARS (20030429)

Pilots' stir may be declared illegal (20030429)

12 chargesheeted (20030429)

SARS paranoia grips city residents (20030429)

SARS: more security masks arriving (20030429)

Tiruchi airport on high SARS alert (20030429)

Singapore-bound AI flights cancelled (20030429)

Air India hardens stand, suspends 15 more pilots (20030428)

Reports of 13 SARS cases awaited (20030428)

Isolation of SARS suspects `not up to the mark' (20030428)

AI flights cancelled (20030428)

SARS alert in hill stations (20030428)

AI suspends dozen pilots (20030427)

3 more SARS cases, total 7 (20030427)

Concern over Mumbai patient (20030427)

Steps taken to tackle SARS: Kagodu (20030427)

No confirmed SARS cases in State (20030427)

Quarantined family shows no SARS symptom: Collector (20030427)

SARS alarm: AI flights in disarray (20030426)

7 more samples received for testing for SARS (20030426)

Test for SARS proves negative (20030426)

Patient unlikely to have infection (20030426)

SARS family quarantined (20030426)

Anthrax death? (20030426)

Two cases in Kerala? (20030426)

Govt. announces tough measures to tackle SARS (20030425)

SARS affects growth projections in Asia (20030425)

Steps on to fight SARS, says IATA (20030425)

Centre to discuss SARS with IMA (20030424)

2 with SARS symptoms quarantined (20030424)

Centre convenes meet on SARS tomorrow (20030423)

Fernandes to be screened (20030423)

SARS case: Search on for taxi driver (20030423)

Three SARS cases in Pune (20030422)

SARS patient weds, guests quarantined (20030422)

SARS suspects test negative for virus (20030421)

Another SARS case in India (20030420)

`Tests done on all suspected SARS cases' (20030420)

SARS patient discharged (20030419)

SARS orientation programme for nursing staff (20030419)

India's first SARS case found in Goa (20030418)

WHO clarifies on SARS (20030418)

Drug shortage hampers efforts to tackle SARS (20030418)

International scene

SARS-scare for Indian sailors (20030505) New

Health Minister clarifies (20030504)

SARS situation stabilises (20030503)

SARS virus genome sequenced (20030502)

Man of Indian origin dies of SARS (20030501)

SARS 'remains severe' in Beijing, says Mayor (20030501)

China, ASEAN plan to fight epidemic (20030430)

Vietnam may be removed from SARS list (20030429)

SARS impact — ADB assessment (20030429)

SARS: U.S. offers China help (20030428)

SARS crisis: Potential threat to Asian economy (20030428)

China names Vice-Premier to tackle pandemic (20030427)

SARS shadow over Cannes (20030427)

Singapore clamps down on violations (20030426)

SARS spread: Singapore to punish violators (20030426)

Situation turns grim as toll goes up (20030425)

Fatalities soar, China closes schools (20030424)

Worldwide SARS fatalities rise to 217 (20030423)

Editorials & Articles

SARS wars (20030428)

The SARS scare (20030419)

Medical & General Information

Eat papaya & `tulsi' to ward off SARS, says Jayalalithaa (20030501)

Facts about SARS (20030430)

'Tulsi can cure SARS' (20030427)

Anthrax: experts begin investigation (20030427)

SARS Information: Round-the-clock helpline soon (20030427)

SARS: Health dept. issues guidelines (20030426)

'No need to panic over SARS' (20030426)

2003-05-02T21:34:00.000-07:00

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

2003-05-01T05:12:00.000-07:00

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.

2003-04-29T13:48:00.000-07:00

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.

2003-04-27T20:50:00.000-07:00

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."

2003-04-26T11:03:00.000-07:00

SARS: Health dept. issues guidelines

By Our Staff Reporter

THIRUVANANTHAPURAM April 25. The Health Department has issued a set of guidelines as part of stepping up surveillance to prevent cases of Severe Acute Respiratory Syndrome (SARS) viral infections being carried into the State through international air passengers.

So far, two air passengers, one from Singapore and the other from Toronto, have been kept under observation at isolation wards in the Thiruvananthapuram Medical College and the General Hospital, Kochi, after their pneumonia-like symptoms raised suspicions among treating physicians.

The serum samples of the patients, collected at the Public Health Laboratory, have been despatched for sophisticated confirmatory tests to the National Institute of Virology (NIV), Pune.

Meanwhile, the Director of Health Services, V. K. Rajan, has issued directives to District Medical Officers to strengthen surveillance and preventive measures against SARS.

A team of medical experts has been stationed at the international airports in Thiruvananthapuram, Kochi and Kozhikode to augment screening of incoming passengers.

Ambulance facilities have also been made available to reach suspected cases to designated Government hospitals, which have put in place special isolation wards to deal with such cases.

The Additional Director of Health Services, P. K. Sivaraman, who is leading preventive measures, has urged the public against getting panicky as the department was fully equipped to safeguard SARS infections from spreading in the community.

Meanwhile, in its set of guidelines, the Health Department has underscored the need for vigil against the SARS virus, whose mode of spread, is through the respiratory route. Since travellers may carry this virus of a highly contagious nature, it was imperative to identify a suspected case without delay and quarantined to protect the public.

As fever and respiratory symptoms are very common in the community, persons routinely reporting with these clinical signs, should not be suspected to have probability of SARS without adequate reasons.

However, at the same time, it should be known both among clinicians and the lay public that SARS, in its initial phase, could be mistaken for common respiratory ailments.

Any individual who has contact with anyone with SARS, or suspected for SARS, or has been in an aircraft in which a passenger was suspected to have SARS, must disclose the fact within 24 hours of reaching Kerala, to the doctor/clinic/hospital, to which the person would ordinarily go for medical attention or the nearest health care institution.

Any health care worker (doctor or physician of any system of medicines, any medical practitioner) who is approached by any person with fever and respiratory symptoms (cough, sore throat, nasal discharge) must take a detailed history of travel by the person, in the two weeks prior to the consultation.

In case of travel, the following details are to be recorded in order to assess the poteintial risk: Anyone who has visited China, Hong Kong or Singapore within the past two weeks, persons who has travelled to any country outside India in the past fortnight, or anyone who has travelled to Goa or Pune in the past two weeks.

The responsibilities of health care worker/institution are to immediately report to the DMO concerned or Corporation Health Officer. In case of contact being not established with these officers, the Additional Director of Health Services (Public Health) or the Director of Health Services, should be intimated on these numbers 2302160, 2331177, 2302490 ext: 277, or over mobile: 9447204987).

Patients are required to be kept under observation for 24 hours and also keep in contact with the subject for close follow-up on a daily basis until all suspicion is over.

Whether or not any investigations are conducted by any institution, appropriate specimens will have to be collected and forwarded with all infection containment precautions, to either of the two institutions identified for SARS investigations, namely NIV, Pune or the National Institute for Communicable Diseases, New Delhi. The Health Department will collect and despatch the specimens.

Patient unlikely to have infection

By Our Staff Reporter

THIRUVANANTHAPURAM April 25. The 72-year-old patient who has been admitted to the Thiruvananthapuram Medical College on suspicion of carrying an infection of the Severe Acute Respiratory Syndrome (SARS) virus, is highly unlikely to be a victim of the killer-pneumonia virus, clinical experts have said.

The city resident, who holds a Singapore citizenship, had been referred to the medical college after reporting to a private hospital with signs of viral fever within a couple of days of reaching Thiruvananthapuram by flight on April 17.

However, medical college sources said that all available clinical pointers have led them to believe that the patient was least likely to have a SARS virus infection, even though serological confirmation is awaited from the Pune-based National Institute of Virology.

Diagnostic routines such as chest X-ray and other clinical evaluation parameters indicate that it is not even a case of pneumonia. The patient, who is diabetic, has been at present diagnosed with a bronchial infection, sources said.

``The patient should normally have been sent home but for the extraordinary circumstances that warrant his being kept under observation,'' a senior doctor said.

At present, the referral of the patient as a suspected SARS case to the medical college is being pointed out as a case of some doctors over-reacting in the wake of the global alert on the killer-pneumonia.

Meanwhile, the hospital administrators are in a fix over ensuring proper isolation of the patient. Following protests by other patients over accommodating the suspected SARS case in a common isolation ward, they have shifted the patient to one of the pay wards.

Vigilance stepped up at Karipur against SARS

MALAPPURAM: The Airport Authority of India (AAI) has beefed up vigilance against the SARS disease at the Karipur Airport following a directive from the Union Health Ministry.

Airport director M Subba Rao said that all international air passengers arriving at the Airport were being screened for suspected SARS symptoms.

He said that the medical facilities at the airport had been enhanced with a team of six doctors and paramedical staff for overseeing the precautionary measures.

He said that the doctors and the paramedical staff at the Airport had been provided with masks.

SARS spread: Singapore to punish violators

By P. S. Suryanarayana

SINGAPORE April 25. Singapore today led the battle against the Severe Acute Respiratory Syndrome (SARS) in East Asia by adopting a drastic new legislation to punish those who might break the home-quarantine orders or expose the community to the infection by other means of willful action or sheer neglect.

The law, an expansion of the scope of the Infectious Diseases Act, provides for exorbitant fines and/or jail terms. The enactment, carried out at a session of Parliament here today, flows from the concerns of the Singapore authorities over the continued prevalence of this new disease as a potential danger to society at large despite the steps already taken in recent weeks. Given a sense of fear-psychosis among some sections of Singaporeans, the authorities here have repeatedly assured the public that there is nothing amiss about a particular hospital that has been designated for the diagnosis of the SARS symptoms and the treatment.

The anxieties of the people on this score were set off by the indications that the SARS transmissions initially occurred in hospitals themselves in Singapore. Today's legislation was enacted through a fast-track approach by using a Certificate of Urgency under the relevant rules. Elsewhere in the region, Thailand's Prime Minister, Thaksin Shinawatra, who would host a special summit of the Association of South East Asian Nations on the SARS question in Bangkok next week, indicated today that the participant-leaders would not be subjected to any SARS-detection tests.

In China, the authorities `quarantined' three hospitals and reassured the public that "people's lives are more important than economic growth''. Steps were also announced to build a disease control network this year at a cost of over $420 millions.

The total number of SARS cases in China was today put at 2,601. The death toll in mainland China as also the Hong Kong Special Administrative Region was 115 each.

The Indian Defence Minister is now in Shanghai on the final leg of his China tour which, too, has served as a political gesture of goodwill in the SARS context in China.

Govt. announces tough measures to tackle SARS

By Our Special Correspondent

NEW DELHI April 24. With reports of fresh cases of the Severe Acute Respiratory Syndrome coming in from several countries, the Union Health Minister, Sushma Swaraj, today announced a series of measures to further boost the country's preparedness in meeting the threat posed by the killer disease.

The measures include provision of masks to all airport employees, doctors and paramedical staff who ran the risk of contracting the disease through contact with affected persons. The masks — ranging from simple three-layered ones to the high-tech respirators developed by the Defence Research and Development Organisation (DRDO) for use in case of nuclear, chemical or biological attacks — would be given according to the risk potential.

While the staff at airports would be provided with the three-layered masks, costing between Rs. 3 and Rs. 5 a piece, doctors treating confirmed SARS cases would be provided with the DRDO's high-tech respirators, which cost about Rs. 2,200 each.

In the intermediate categories, paramedical staff at airports would be given what are called A-71 masks which cost about Rs. 80 each while doctors stationed at airports would get the nex grade, N-95 masks costing Rs. 230 a piece. The masks would be distributed in the next few days.

At a press conference, Ms. Swaraj said all passengers arriving at the country's international airports would be screened for the disease and those suspected to be carrying the virus would be confined to isolation wards and would be discharged only when blood tests and other examinations proved negative.

In case the tests proved positive, the patients would be kept under observation. If they showed clinical symptoms, they would remain in isolation wards; and if they did not show clinical symptoms they would be kept in the isolation wards for two days and discharged on the condition they would remain in `home isolation' at least for 10 days.

Ms. Swaraj also announced the constitution of a special Centre-State joint action group to keep track of the developments at the global and national level so that immediate mid-course correction of the strategy to fight the disease could be taken as and when necessary.

The panel would be headed by the Union Health Secretary, S. K. Naik, and would include the joint secretaries in the Civil Aviation and Shipping Ministries, the directors of health services of Maharashtra, Kerala, West Bengal, Delhi, Andhra Pradesh and Nagaland, the Director-General of Health Services in the Union Health Ministry and the Director-General, Indian Council of Medical Research. A WHO representative would also be included to ensure.

The new measures were decided upon following two high-level meetings chaired by Ms. Swaraj. The first was with representatives of various Union Ministries such as Home Affairs, Civil Aviation, Shipping and Tourism and also a representative from WHO. The second was with Health Secretaries and directors of health services of various States and Union Territories.

The main idea, Ms. Swaraj said, was to ensure that SARS did not come into India and if it did it should not be allowed to spread.

PTI, UNI report:

Meanwhile, two suspected SARS cases had been reported from Kerala and the patients were kept under observation in hospitals, the State Health Service Director, V. K. Rajan, said in Thiruvanathapuram. The blood samples of the two, who had recently arrived from Singapore and Toronto, had been sent to the National Institute of Virology, Pune, as they had come from SARS-prone countries, Dr. Rajan said.

In Jaipur, a person suspected to be suffering from SARS was found to be "quite normal", but he would be discharged after he was cleared by the National Institute of Communicable Diseases, a doctor attending on him said. A patient admitted to a private hospital in Bangalore with suspected SARS symptoms two days ago, was also discharged today after a blood test reported negative.

In a significant development, the Bangalore-based Manipal Hospital said it had developed a kit for diagnosing SARS. "The test is similar to the one developed by Bernhard-Nocht Institut fur Tropenmedizin, a medical institute in Germany and also an allied laboratory of the World Health Organisation and meets all the specifications of WHO," a press release said.

In Chandigarh, the Punjab Chief Minister, Amarinder Singh, said there was no SARS case reported so far in the State, and directed civil and health authorities to ensure requisite preventive measures to check the outbreak of the disease.

SARS affects growth projections in Asia

By Our Special Correspondent

NEW DELHI APRIL 24. The outbreak of SARS in the South-Asian region has led to widespread lowering of growth projections in the affected countries which otherwise form the fastest growing region of the world and has been described as an area which had basically been keeping the global economy afloat.

Data complied by the Federation of Indian Chambers of Commerce and Industry here has revealed that international financial organisations have estimated that the largest decline in growth projections has been in the case of Singapore where growth rates are expected to fall by 1.5 to 2.5 per cent. Malaysia's growth rate is also expected to fall by 0.9 per cent while Hong Kong is estimated to witness a 0.6 per cent decline in growth rates in 2003. However, China, which has the largest number of SARS cases, the gross domestic product (GDP) is expected to fall about 0.5 per cent and the country's growth rate could be around 6.5 per cent.

The sectoral impacts have been even more severe, according to the report. Already hit by the Iraq war, international airlines have been doubly hit because of the SARS outbreak with business travellers turning to e-mail and videophones rather than making business trips. The Japanese airlines, ANA has reported that passenger traffic between Tokyo and Hong Kong fell by a fifth after the disease was identified and visitor arrivals in Hong Kong and Singapore have reportedly collapsed by around 61 per cent.

Singapore Airlines recently announced that it has effectively grounded 13.5 per cent of all its flights while Hong Kong-based Cathay Pacific has indicated that it may need to ground its whole fleet next month.

Tourism too has been badly hit whereas this sector contributed significantly to the GDP of the South-Asian countries. Singapore, for instance, has a 10 per cent contribution from tourism to its GDP and has decided to implement a $230 million package to provide immediate relief for the most directly and adversely hit tourism and transport-related sectors.

Similarly, Malaysia, which has a seven per cent contribution from tourism which is also its second largest foreign exchange earner, is expected to lose around RM 200 million per month in terms of tourism revenue. The fall in tourism arrivals in the South-Asian countries also has its ripple effect on retail trade and other services.

The Federation report has suggested that collective efforts be undertaken by the affected countries to check the spread of the disease by undertaking joint scientific and laboratory exercises and increase surveillance and threat detection networks.

2003-04-24T10:42:00.000-07:00

Airports scan for SARS victims' flushed faces

NewScientist.com news service

In a bid to stop the alarming global spread of the deadly SARS virus, airports in the Far East have begun using thermal imaging cameras to detect the flushed faces of travellers suffering from a fever.

Other measures already deployed to try to slow the outbreak of Severe Acute Respiratory Syndrome (SARS) include compulsory quarantines, forced medical treatments and national travel bans. By Thursday, the virus had killed 263 people and infected over 4600 people in 25 different countries.

There is no cure or vaccine for SARS as yet. On Wednesday, the World Health Organization extended its unprecedented advisory against travel to infection hotspots, to include Beijing and the Shanxi province in China and Toronto in Canada.

The infra-red thermal imaging scanners are now being used at Singapore's Changi airport and Japan's Narita airport in Tokyo. Hong Kong, the worst hit region after China, is set to introduce the scanners over the coming weekend.

The technology can detect individual passengers with a temperature higher than 38.0°C or 100.4° - a telltale sign of SARS. These passengers' faces show up as a red image on the screen.

Doctor's note

Passengers with a fever stopped at Singapore's Changi airport will be taken aside by nurses for an examination. Those who have a high temperature will have to be certified by doctors as not having SARS before being allowed to fly, says the Civil Aviation Authority of Singapore.

Singapore's minister for transport, Yeo Cheow Tong, pointed out that the screening would not inconvenience healthy passengers: "Not only does the scanner speed up the process tremendously, it is also hassle free."

Thermal imaging will be very good at picking up people with SARS as fever is a key symptom, says Robert Booy, an infectious diseases expert at Queen Mary, University of London. However, such screening will also select out many other people, as there are many causes of a high temperature.

More seriously, the thermal screening will only detect people who contracted SARS some days earlier and have already developed a fever. People incubating the virus will not have developed symptoms and will not be stopped. The incubation period of SARS appears to be between two to 10 days, although there is some suggestion from China that it may be as long as 16 days.

Full screening would require a test to identify asymptomatic people, Booy told New Scientist. Labs around the world are currently racing to develop fast and reliable diagnostic tests for the novel coronavirus that causes SARS.

The spread of SARS can definitely be slowed with measures like thermal screening at airports, says Booy, but his overall assessment is gloomy: "It is unlikely that this outbreak can be contained, whatever steps are taken."

Shaoni Bhattacharya

Burgeoning SARS virus decoded in China

16:50 22 April 03 NewScientist.com news service

Chinese scientists have sequenced the genetic code of at least four samples of the SARS virus from different patients. Comparison of these genomes will determine whether the virus is mutating rapidly, which in turn will determine how difficult it will be to develop tests and vaccines based on the virus's genes.

The outbreak of Severe Acute Respiratory Syndrome (SARS) began in China in November, but was not made public until March. Now, 243 people have died and over 4200 infected in 26 countries around the world. Some experts fear it may already be too late to contain SARS, for which there is currently no cure.

The biggest challenge facing health officials is the lack of information from China. The country, home to about half the SARS cases, has been severely and widely castigated for its secrecy, but the criticism appears finally to be making an impact.

China has admitted that the virus is spreading into more remote provinces and has dispatched emergency SARS teams. On Sunday, the government raised the official number of SARS cases in Beijing from 37 to 358 and fired the health minister and the mayor of Beijing for covering up the crisis. By Tuesday, suspected cases of SARS in the capital had reached 602.

Nose and throat swabs

The latest gene sequences of the SARS virus were obtained by scientist at the Beijing Genomics Institute and the Institute of Microbiology and Epidemiology of the Academy of Military Medical Sciences. They have now released five sequences on the internet.

A short report on four of the coronavirus samples was also published. The samples came from nose and throat swabs, as well as lung, liver and lymph node tissue removed during autopsies. Three samples were from Beijing patients, with the fourth from a patient from Guangdong, the province where SARS originated.

Four other code sequences have been released by scientists in Canada, the US, Hong Kong and Singapore. All differ by up to 15 "letters" in the 30,000 that comprise the virus. The Chinese scientists note the differences and write that "the virus is expected to mutate very fast and easily". Such slight differences could also be explained by errors in the sequencing process.

However, most of the variations seen so far seem to affect one gene in particular, while 12 more genes show no changes between non-Chinese sequences. This suggests the variants may genuine mutations.

Scientists will now be working to determine whether different strains produce different symptoms in patients and are spread in different ways. In Hong Kong, the group of patients from the now infamous Amoy Gardens tower block were much more likely to suffer diarrhoea and the virus's spread there has been linked to the sewer system. Scientists at Hong Kong University are now sequencing key regions of the virus.

"Dark misgivings"

China's increased openness has given a cautious welcome by the World Health Organization. "We're now much closer to what we always thought was the reality in Beijing," says Peter Cordingley, spokesman at the WHO's Western Pacific headquarters in Manila. "But as for the rest of the country, we have dark misgivings."

New data reveals that SARS now ranges from the densely populated Sichuan province in the southwest to Liaoning in the northeast. "We're very worried about the less accessible provinces, where there is poor health care and poor resources," Cordingley says.

But another WHO official says China is still not revealing some key data. "Without the date of onset for patients, you can't say what the trend of the disease is," Jeff McFarland, a WHO virologist, told AFP. "This is the data that we need to have to fully understand the epidemic."

"To be able to contain SARS, we have to know what is happening in China," says microbiologist John MacKenzie at the University of Queensland, Australia, and a SARS investigator for WHO. "Until the Chinese authorities come totally and utterly clean, they will maintain a sink that will carry on affecting us globally," he told New Scientist.

MacKenzie adds that problems with the flow of information between authorities and the WHO have also been a problem in Hong Kong, particularly in relation to the spread of SARS in the Amoy Gardens housing block. "Details of work on transmission, on what animals, if any, might be involved is still to come out," he says.

On a more positive note, MacKenzie says the draconian quarantine measures have had an impact in Hong Kong and Singapore, the worst affected places after China. Most secondary schools re-opened on Tuesday after weeks of being closed.

Damian Carrington, Emma Young and Debora MacKenzie

2003-04-24T09:46:00.000-07:00

Two suspected SARS patients admitted to hospital in Kerala

Thiruvananthapuram: Two suspected Severe Acute Respiratory Syndrome (SARS) patients, who reached Kerala from Canada and Singapore, have been admitted to a hospital for treatment.

Ramakanthan, 73, who arrived from Singapore, was admitted to the Medical College Hospital here, while Varghese, 63, from Toronto in Canada was being treated at a hospital in Kochi, Health Services Director V.K. Rajan said on Thursday.

He said there was only a remote chance of them being infected with the deadly SARS virus, but the authorities wanted to keep them under observation.

The blood samples of the patients were sent to the National Institute of Virology in Pune for investigations. Earlier, a case of suspected SARS was reported in Kochi but it was found to be negative during blood tests.

Dr Rajan said round-the-clock facilities had been set up at the international airports in Kerala to screen suspected SARS cases. Doctors would be appointed at all the three international airports.

Isolation wards would be kept ready in all major centres if a large number of suspected cases landed, he added.

First suspected SARS case in Tvm

THIRUVANANTHAPURAM: A suspected case of Severe Acute Respiratory Syndrome (SARS) has been reported here. This is the second suspected SARS case in the State.

The patient who arrived here from Toronto, Canada, on April 11 is now undergoing treatment at a private hospital. The 73-year-old patient had complained of chest infection and fever three days ago.

An official of the Health Department told this website's newspaper that the patient would undergo various blood tests tomorrow. The blood samples would be sent to the National Institute of Virology, Pune, for investigations.

A case of suspected SARS was reported in Ernakulam district two weeks ago. The blood samples of the patient were sent to the Pune Institute for investigations. The case was found to be negative.

According to the official, a special ward has been set up for SARS cases at the General Hospital here. Round-the-clock ambulance services have been arranged at all the three international airports in the State.

‘‘We are planning to conduct awareness programmes for the public and the medical staff. A special training programme is also being arranged for the doctors to meet the SARS threat,’’ the official added.

The Health Department has finalised a report on the steps initiated by the State Government to tackle the SARS threat. The report will be presented by Health and Family Welfare secretary K.Ramamoorthy at the meeting of Health Ministers and Health Secretaries in Delhi on Thursday.

Singapore deputy PM warns of SARS catastrophe

Singapore, April. 24. SARS could have "catastrophic" consequences for Singapore if not controlled, Deputy Prime Minister Lee Hsien Loong warned today. He pledged that the Government would muster all resources to fight the outbreak.

"The Severe Acute Respiratory Syndrome (SARS) is a grave threat to Singapore. It has taken a heavy toll on our public health, our economy and society," he told Parliament.

"We have to muster all our resolve and resources in order to fight SARS. Then we can bring the SARS outbreak under control, restore confidence, boost morale and get the economy moving."

SARS: Beijing city invokes emergency measures

Beijing, April. 24. (PTI): Even as the World Health Organisation (WHO) issued an unprecedented global travel advisory against Beijing, the Chinese capital today invoked emergency measures to quarantine people exposed to the deadly SARS virus and bar access to buildings where there has been an outbreak of the infection.

The Beijing Municipal Government issued a circular late last night to quarantine people, areas, animals and products infected, or suspected of being infected, by Severe Acute Respiratory Syndrome (SARS), in its latest bid to curb the spread of the virus.

The SARS outbreak seems to get out of control in Beijing which is home to some 13 million people. The Ministry of Health said the city had 693 cases of SARS and 35 deaths.

According to a circular, those having had close contact with people infected or suspected of being infected by SARS will also be isolated for quarantine.

No case of SARS in Punjab: Amarinder

Chandigarh, Apr. 24. (PTI): Claiming that there was no case of Severe Acute Respiratory Syndrome (SARS) reported so far in the State, Punjab Chief Minister Amarinder Singh today directed civil and health authorities to ensure requisite preventive measures to check the outbreak of the disease.

"Detailed instructions have already been sent to all deputy commissioners and civil surgeons to make requisite preventive measures to check the outbreak of SARS," the Chief Minister was quoted as saying in a official communique from Ropar.

He asked Director, Health Services, to ensure adequate supply of medicines and masks in the hospitals to face any eventuality.

Wife of suspected SARS patient admitted to hospital

An earlier report said the wife of a suspected SARS patient in Bathinda was today admitted to the Civil Hospital there.

Forty-five-year-old Saroj, wife of Jagdish Rai, the first suspected Severe Acute Respiratory Syndrome case reported from Punjab yesterday, was admitted to the Civil Hospital, Bathinda, after she complained of "high fever and respiratory complications," Bathinda Chief Medical Officer Dr S K Goyal said over phone.

Goyal said both suspected patients have been kept in an isolation ward and were under observation. "Rai's condition has shown improvement," he said.

SARS toll rises to 209 in China

Beijing, April 24. (PTI): In its latest move to fight the deadly SARS virus, China today sealed off a major hospital in the capital where four more people died of the disease and invoked emergency measures to quarantine the affected individuals and areas.

According to latest SARS statistics announced by China's ministry of health, the Chinese mainland reported a total of 2,422 confirmed cases of SARS while 209 people have died nationwide.

The panic-stricken capital itself has registered 39 deaths.

Hong Kong also announced four more deaths and 30 new cases of SARS taking the territory's toll to 109.

2 with SARS symptoms quarantined

By Our Staff Reporter

BANGALORE April 23. Two persons with suspected severe acute respiratory syndrome (SARS)- like symptoms were reported in Manipal Hospital, the hospital authorities said here on Wednesday.

A 24-year-old man, who arrived here from Montreal in Canada around a week ago, came to the hospital on Tuesday night, complaining of fever and body pain. He is here with his wife on a holiday and has been staying at a resort on the outskirts of the City. As he had travelled from a SARS-affected country and showed SARS-like symptoms, he has been quarantined and is being kept under observation in the isolation ward of the hospital.

The results of his blood and sputum tests to find out whether he is infected by the SARS-causing Corona virus is awaited in a day or two. "We are sure that the results of the test will be negative, as the patient's chest X-ray was clear. But we are just taking the necessary precautions as directed by the Union Government,'' Malathi, Medical Administrator of the hospital, said.

The other case was that of a school-going boy who came to the City from Singapore. He was quarantined in the isolation ward as he had fever and cough. But apparently, he did not have SARS as his test results were negative, hospital authorities informed.

However, there appears to be confusion as the Government health authorities said they were not informed about the case of the boy.

All suspected SARS cases have to be immediately reported to the SARS nodal officer or the health officials. Kumaraswamy, Additional Director (Communicable Diseases), Department of Health and Family Welfare, who is the nodal officer, told The Hindu that he was not aware that such a case was reported. "None of the Government health officials who are dealing with SARS have been informed about this case by the hospital authorities,'' he said.

The hospital claims to have developed a SARS diagnostic kit. The test is said to be based on the reverse transcription polymerase chain reaction (RT-PCR) technique for detecting the presence of the virus in the patient's blood and sputum. "The test is a modified version of a similar one developed at a medical institute in Hamburg, Germany, and meets the specification of the World Health Organisation (WHO)," the hospital authorities said. The Government authorities are not convinced. "As per Union Government specifications, the blood and sputum samples taken from patients have to be sent to the National Institute of Communicable Diseases (NICD), Delhi, or the National Institute of Virology (NIV), Pune, as these are the recognised institutions for testing the SARS virus,'' Dr. Kumaraswamy said.

Another 70 Hong Kong residents were placed under home quarantine as their observation confirmed one in five chance of infection with the mystery virus.

Malaysia ordered quarantine for 203 citizens, mostly low waged earners, who had visited a SARS-infected produce market in Singapore and warned that it would jail those who would break the orders.

Authorities here sealed off the 1200-bed People's Hospital of Peking University because of multiple SARS infection preventing staff and patients from leaving the complex or allowing anybody to enter.

The Beijing municipal government issued a circular late last night to quarantine people, areas, animals and products infected, or suspected of being infected, by SARS virus, in its latest bid to curb the spread of the disease.

Places infected by the virus that require quarantine include hospitals, factories, construction sites, hotels, restaurants, office buildings, residential buildings, villages, schools and other designated places, according to the circular.

"Compulsory measures may be taken if those involved refuse to cooperate with the relevant departments, and those who violate related laws and regulations will be punished accordingly," the circular warned.

Samples of both suspected patients had been taken and sent to the National Institute of Communicable Diseases at New Delhi.

Fatalities soar, China closes schools

By P. S. Suryanarayana

SINGAPORE APRIL 23. As the fatalities caused by the virulent incidence of SARS (Severe Acute Respiratory Syndrome) in China crossed 100, with nine persons succumbing to the disease in the past 24 hours, the Chinese authorities today intensified their efforts to contain the spread of the new disease.

The most striking aspect of the new measures being taken by China was the mass closure of schools for nearly a fortnight. The objective was to protect the health of well over a million students in the context of Beijing's admission of the severity of the outbreak in China.

At one level, China continued to present a picture of business as usual by hosting India's Defence Minister and a ranking U.S. State Department official among others at this time. On a different track, though, it began to take the SARS crisis very seriously. Home quarantine of suspected patients was also being resorted to. The number of confirmed SARS-related deaths on the Chinese mainland was officially put at 106 today, even as the definitive cases were said to have gone up to 2,305.

Economic package

In China's Special Administrative Region of Hong Kong, the authorities today unveiled an economic package worth about $1.5 billions to stimulate the economic activities that had suffered as a result of the SARS epidemic. With six more SARS-related deaths occurring in Hong Kong in the past 24 hours, the overall situation continued to stay grim. In Singapore, the Prime Minister, Goh Chok Tong, indicated, through an `open letter 'to the people, that tough measures would be taken through legislation and other means so that the disease could be controlled.

Centre convenes meet on SARS tomorrow

By Our Special Correspondent

NEW DELHI April 22. Even as three new suspected cases of the Severe Acute Respiratory Syndrome were reported from Delhi, Jaipur and Nasik, the Union Health Minister, Sushma Swaraj, today announced that a meeting of the State health authorities had been convened here on Thursday to discuss and chalk out an action plan to tackle the killer disease.

Responding to members' concern in the Lok Sabha during zero hour, Ms. Swaraj said she would personally meet all the Ministers and the Health Secretaries to discuss steps to prevent the spread of the disease.

Sharing the concerns expressed by members over the detection of four cases of SARS so far in the country, she said the "Government has taken all effective measures to deal with the situation and it will not be found lacking in future also."

Later, senior Health Ministry officials said declaring SARS as a notifiable disease was under consideration. Once so declared, doctors treating patients suffering from it would be legally bound to inform the authorities. Now, only three diseases were notifiable — plague, yellow fever and cholera.

As regards the three fresh suspected cases, the Director-General of Health Services, S.P. Agarwal, and the Director, National Institute of Communicable Diseases, Shiv Lal, said that though on the face of it these patients did not fit the criteria for SARS, they were being treated in isolation wards and their sputum and other samples had been sent for further tests.

In the Delhi case, the patient, a 29-year-old woman from Guangdong, the southern province of China from where the worldwide epidemic of SARS is suspected to have begun, had complained of cough and cold after landing here on Monday. She was initially taken to a private medical practitioner and then to the Infectious Diseases Hospital, where after repeated X-rays, her lungs were found to be clear, indicating that she was not suffering from SARS.

In Jaipur, a 29-year old man who returned from New York on April 15 was admitted to hospital on Monday after he complained of fever and cough. But, preliminary tests indicated that he was not suffering from SARS.

In Nasik, a 23-year old man, who arrived from the U.S. on April 18 with dry cough and temperature, was admitted to hospital and initial investigations revealed that he was free of SARS, the officials said.

Health Ministry sources said the Thursday meeting would also focus on the way the local authorities had handled the first confirmed case in Goa as also the three subsequent confirmed cases in a family in Pune.

In the Goa case, the patient was discharged even as reports of his sputum and other samples were under test and then suddenly readmitted to the hospital when the reports came in, only to be discharged the next day.

In Pune, even after a mother, her son and daughter had tested positive for SARS, the daughter was allowed to go ahead with her marriage in the presence of a group of relatives and friends. The two incidents have raised concerns about the seriousness being attached to the disease.

SARS case: Search on for taxi driver

By Mahesh Vijapurkar

MUMBAI April 22. As three positive cases of Severe Acute Respiratory Syndrome (SARS) have been reported in the State all of a sudden, the Maharashtra Government has asked the Centre to request China, Hong Kong and Singapore where SARS has occurred widely to detect passengers with any telltale symptoms and detain them for treatment in their own countries and not allow them to leave there for India.

According to the State Health Minister, Digvijay Khanvilkar, "the letter went out today" to the Union Health Minister, Sushma Swaraj, "because we think it is easier and more efficient to check passengers as they leave" than check them as they arrive here. Two of the three SARS victims, Stanley D'Silva, and his mother, Vimla, had travelled by the same flight from Hong Kong on which one of the passengers had symptoms indicates from where the D'Silvas may have got the infection; it was passed on to his sister, Julia, before they surfaced with the problem in Pune. The suspect passenger was taken off the aircraft at Singapore.

Another need, conveyed to the Centre and apparently conceded is, for 1,000 speciality masks, so that Maharashtra can "in a day or two" set up isolation units in all its district hospitals. So far, two in Mumbai and another in Pune have come into being for SARS cases. "Setting them up is one thing, but people have to report to the hospitals if they have symptoms," Mr. Khanvilkar told The Hindu. While these precautions are being taken, what is worrying is the manner in which, despite testing positive and despite advice to be quarantined at home, Julia got married on Monday before being moved into the quarantine.

Though initial reports spoke of her having ducked the request to come to the hospital, she actually threatened unspecified "dire consequences" if prevented from tying the knot.

Apparently, top-level officials were aware of her determination, allowed her to get married at a church in Pune in the presence of a "controlled number of guests."

The bridegroom, Sailesh Suryavanshi, the sources said, is one of the several — including even the domestic servants of the D'Silvas — and Julie's uncle have been quarantined to prevent the possible spread of SARS though, as top officials said, "all of them are as of now stable., including all the three D'Silva family members who tested positive.

The search is on for the driver of the taxi who took the D' Silva's from Ambernath, a distant suburb of Mumbai in Thane district to Pune for the wedding.

Worldwide SARS fatalities rise to 217

By P. S. Suryanarayana

SINGAPORE April 22. With both China and its Special Administrative Region of Hong Kong registering nearly 100 deaths each, the upsurge in the international menace of the Severe Acute Respiratory Syndrome (SARS) stayed at an alarming level on Tuesday.

The World Health Organisation (WHO) is reported to have said in Geneva that almost 87 per cent of the global-scale SARS cases, estimated at 3861 as on Monday, had occurred in China and Hong Kong.

The total number of SARS fatalities globally was put at 217 as on Monday. Of these, 83 per cent of the deaths were traced to China and Hong Kong by the time the WHO took its latest count.

Two other places prominently affected by SARS are Singapore and Toronto.

Giving updated figures on Tuesday, the Chinese Ministry of Health said in Beijing that 97 SARS patients had died across the mainland, while the total confirmed cases of infection rose to 2,158.

The suspected SARS cases were 918 on the Chinese mainland. In Beijing alone, the disease accounted for 588 confirmed cases, including 100 health-care workers.

The WHO team, which had visited Beijing, has turned its attention to Shanghai too.

The Chinese Prime Minister, Wen Jiabao, said the anti-SARS campaign was being treated as a national priority and promised the international community that the Central Government in Beijing would take steps to prevent SARS from spreading to the country's rural areas where, in the reckoning of the international institutions, the available medical facilities left much to be desired.

Mr. Wen promised help to Hong Kong and even Taiwan (which Beijing regards as China's province) in the fight against the SARS.

The updated figures in Hong Kong as of Tuesday were 99 deaths (including five in the last 24 hours) and 32 new cases that brought up the total number of afflicted persons to 1,434.

2003-04-22T09:56:00.000-07:00

SARS scare grips Britain

By Hasan Suroor

LONDON APRIL 21. The SARS scare has taken what many believe a bizarre turn in Britain with hundreds of schoolchildren returning from their Easter holidays in South East Asia — mainly Hong Kong and Singapore — facing forced `isolation' before they are allowed to resume their classes. At the weekend, about 150 children from some of the country's most snobbish boarding schools such as Eton were whisked away straight from Heathrow airport and put into quarantine in a remote Victorian mansion in Isle of Wight where they would spend ten days before they can attend their schools.

The children were reported to be `traumatised' and `baffled' at being treated as `outcasts' and a spokesman for the Association of Guardianship Services, which was looking after them, said they were "very confused and upset." Many were forced to cut short their holidays in order to meet the quarantine requirements.

The move, widely criticised as a panic reaction, came even as the Government's health department insisted that quarantine was not necessary.

SARS suspects test negative for virus

By Aarti Dhar

NEW DELHI APRIL 20. The Centre today heaved a sigh of relief with the laboratory reports of two suspected patients of the Severe Acute Respiratory Syndrome (SARS), including a foreigner, testing negativefor the disease-causing new corona virus. There is only one suspected case of SARS in New Delhi whose test reports are awaited now.

Unconfirmed reports said one more person, who arrived at Mumbai from Bangkok last night, was admitted to the Kasturba Gandhi Hospital after he complained of hypertension, showing signs of high blood pressure and slight breathlessness though he had no fever. However, the Director-General of Health Services, S.P. Aggarwal, said he had no information about the case.

The patient had stopped over at Bangkok before taking a flight to Mumbai and had been advised hospitalisation.

Talking to reporters today, Dr. Aggarwal said the foreigner, who had been admitted to the RML Hospital on arrival from Australia on April 16, had tested negative for the new corona virus in the genetic sequencing. Earlier, his urine and sputum had shown the presence of the virus but his blood sample had tested negative in the commonly carried out PCR test.

Admitting that testing of the new corona virus was a totally new experience for the medical professionals the world over, Dr. Aggarwal said that genetic sequencing was carried out to confirm the results if there was any doubt.

The urine and sputum samples of the foreigner could have tested positive for any other kind of virus and hence he was being kept in the hospital for some more time. The PCR and genetic sequencing tests were time-consuming and expensive with each costing about Rs. 8,000.

The test reports of the seven-year-old girl, who has been admitted to the Infectious Diseases Hospital here upon arrival from Beijing where she stayed with her parents, have certified that she has not been affected by the SARS-causing new corona virus.

Now the Health Ministry is awaiting the test reports of the 34-year-old person who was admitted to Safdarjung on Saturday on his arrival from Malaysia.

He has been discharged with advice for home quarantine and doctors believe that he did not fit into the clinical definition of SARS suspects.

Chinese Minister axed

P. S. Suryanarayana reports from Singapore: To win the confidence of the international community, China today wielded the political axe in the battle against the SARS, even as the new disease claimed more lives and threatened to spiral into a regional crisis. The country's Health Minister, Zhang Wenkang, and Beijing's Mayor, Meng Xuenong, were sacked from their positions in the powerful Communist Party of China. While the World Health Organisation welcomed Beijing's new acknowledgement of the severity of the disease, the death roll rose to 79 in mainland China and 88 in Hong Kong.

SARS: Many nations remain on high alert

By P. S. Suryanarayana

AP

SINGAPORE APRIL 20. Even as the Severe Acute Respiratory Syndrome (SARS) continued to claim more lives in Hong Kong and the Chinese mainland, the ruling Communist Party of China (CPC) today removed the country's Health Minister and the Mayor of Beijing from their key positions within the party.

While no reasons were formally cited, it was obvious that they were being held responsible for China's lurch towards the SARS crisis. The death toll in China is now put at 79, while the fatality figure in its Special Administrative Region of Hong Kong has climbed to 88, with seven more persons succumbing to the scourge today. The clean-up drive on the streets of Hong Kong was sustained for yet another day even as the city struggled to come to grips with a major public health disaster.

Singapore, too, remained in a state of high SARS alert, with people being advised to utilise, if need be, a telephone hotline set up for this purpose. The death toll in Singapore on this count is placed at 14 out of 177 cases. The possibility of SARS being the cause of two other fatalities is still under investigation.

For the moment, China's Health Minister, Zhang Wenkang, and the Mayor of Beijing, Meng Xuenong, remain in their respective official positions, but the CPC's action against them for mishandling the crisis is seen in the Asia Pacific diplomatic circles as a political reprimand at the least. The general inference is that the action by the CPC may well be a prelude to the dismissal of these two functionaries from their official positions as well. One of them was the Secretary of the CPC unit within the Health Ministry, while the other was the Deputy Secretary of the party within the Beijing Municipal Committee.

China's political display of firmness and transparency has come in the wake of the World Health Organisation's decision to publicise its displeasure over the manner in which the epidemic was being handled including in the military hospitals. The WHO is now understood to be pleased with the action (as distinct from the inspection tours and exhortations by the President and the Prime Minister).

China's State Council today announced the cancellation of the traditional week-long May Day holidays so that the possible spread could be averted during the period which, in the normal course, would be marked by mass travel by people within the country.

Explaining the reasons for China's apparent failure to have been more definitive so far, the Executive Vice-Minister, Gao Qiang, said at a press conference in Beijing today that the sheer novelty of the disease and the logistical difficulties of collecting information from varied types of hospitals should account for the latest update in SARS-related figures. The number of confirmed cases in mainland China was now put at 1,807 (a jump of several hundreds). In Beijing alone, the number of confirmed cases was estimated to be 339, with another 402 being placed in the category of suspected cases. So far, 18 patients had died in Beijing. The incidence of SARS among the foreigners in Beijing was said to be confined to five confirmed patients and four other suspected cases.

2003-04-22T01:40:00.000-07:00

Suspected SARS case reported in Jaipur

April 22, 2003

PTI

JAIPUR: A patient with suspected symptoms of severe acute respiratory syndrome has been admitted to a hospital here.

The patient, who returned here from New York on April 15, was admitted to SMS hospital yesterday and was immediately shifted to the isolation ward, hospital sources told PTI here today.

While some tests are being conducted at the local laboratory, samples of the patient's blood and cough have been sent to Delhi, they said.

A team of doctors has been constituted to closely monitor the patient who was referred to the hospital by his famly physician after he complained of high fever, fatigue and bodyache, the sources added.

109 more fall victim to SARS

BEIJING APRIL 21. Chinese health authorities on Monday reported two new SARS deaths and 109 new cases in Beijing as the nationwide toll of fatalities rose to 86, the World Health Organisation said.

The new figures raised the death toll in Beijing to 20 and the number of cases of infection to 448. They were included in a daily report by China's Health Ministry to the WHO.

WHO also reported one death in the southern province of Guangdong and another in the northern region of Inner Mongolia. The new national death toll of 86 was an increase of seven over the total of 79 reported on Sunday by the Health Ministry. It wasn't clear where or when the additional three deaths occurred.

The WHO announcement did not give any other details.

Govt. confident

Meanwhile, in Hong Kong, the Government efforts to contain the spread of SARS by quarantining households of victims and tracking down potential contacts were paying off, sources said. Health officials were confident about beating the disease. Hong Kong reported six more deaths on Monday, bringing the toll here to 94. There were 22 new cases, for a total of 1,402, but 436 patients have recovered and been discharged from hospitals. The Chief Executive Tung Chee-hwa said 150 suspected cases were identified through stepped-up measures to find people exposed to the disease. Those people have been able to get early treatment — which Hong Kong doctors fighting the disease say is crucial.

AP

2003-04-22T01:38:00.000-07:00

SARS hits Pune after bride tests positive

PUNE: The Severe Acute Respiratory Syndrome (SARS) scare hit Pune after a woman from Ambarnath in Thane, who tested positive for the virus, refused to let it come in the way of her wedding.

Health officials waited at a city church for the wedding to get over and then took the bride to hospital.

Officials said her brother, who works in Jakarta and flew in to attend the wedding, and mother had also tested positive. The tests were conducted by the National Institute of Virology (NIV).

It's suspected that 29-year-old Stanley D'Silva, brother of the bride Julie, was the carrier and passed on the infection. He was the first to be admitted to the Siddharth hospital.

The D'Silvas, who had come from Ambarnath for the wedding, were staying with a relative in a middle class housing society in Bibwewadi in Pune.

Dr Subhash Salunkhe, Director General of Health Services who was on his way from Mumbai to Pune, said health officials had asked the family to postpone the wedding but that hadn't happened.

Eleven people, staying in the apartment with the D'Silvas, have been quarantined, said Salunkhe. Health officials in Ambarnath have been asked to quarantine all people with whom Stanley had come in contact.

Dressed in bridal finery, Julie was about to enter the Oldham Methodist Church when the groom Shailesh Suryawanshi, tehsildar of Guhagar in Ratnagiri district, was called by health officials and told to postpone the wedding. He was briefed on the preliminary report from the NIV which confirmed Julie as afflicted with SARS.

But the couple decided to go ahead with the wedding.

Shortly after 6 pm, with just 10 to 15 close family members, the wedding was solemnised at the church. "A team of health officials was present at the wedding. Many people had to return without attending the wedding," said a friend.

And at the reception later, the 150-200 guests found it strange that the bride was missing. "She suddenly took ill and is in hospital now. But she should be here in the next 30 minutes," said a guest. Another said, "Wait until 10 pm, she's definitely going to show up."

Finally, when it was announced that dinner had been served, the hall emptied.