Severe Acute Respiratory Syndrome (SARS) - update on the international
outbreak, 8 April 2003
The state of the international outbreak of Severe Acute
Respiratory Syndrome (SARS) was summarized by the International Department
at the Institut de veille sanitaire in France at 1900 hours Central European
time, 8 April 2003, as follows. Data were compiled from the following sources:
Government of Hong Kong Special Administrative Region (SAR) Department of
Singapore Ministry of Health (http://app.moh.gov.sg/
Health Canada (http://www.hc-sc.gc.ca/
the World Health Organization (WHO, http://www.who.int
Center for Disease Control Taiwan, (http://www.cdc.gov.tw
Robert Koch-Institut, Germany (http://www.rki.de
, and other national public health institutes.
Four cases originating from Ninh Binh province have been hospitalised in
Bach Mai. The index case (a 67 year old man) may have been infected when
visiting his son at the Hanoi French Hospital. Around 50 healthcare staff
of the Ninh Binh hospital who cared for the index case were quarantined.
As of 8 April, 928 probable cases have been notified: 283 are residents
of the Amoy Gardens housing complex, 226 are healthcare staff, and 419 are
relatives or close contacts of existing cases. Of the 220 cases notified
in the past seven days, 51 are healthcare staff, 43 are residents of the
Amoy Gardens housing complex, and 126 are relatives or close contacts of
cases. Since the epidemic started, 24 deaths have been reported (excluding
the index case in Hanoi), 116 patients have been admitted to intensive care
hospital wards, and 138 patients are considered to have recovered, and have
been discharged from hospital. Investigation around the Amoy Garden cases
is ongoing. Although several hypotheses have been suggested to explain the
transmission route in this atypical cluster, no evidence has yet confirmed
any of them.
People’s Republic of China (excluding Hong Kong)
Health authorities have started official reporting of cases, and the World
Health Organization team of experts has been permitted to travel to Guangdong
Province. Little data on the investigation has yet been released. As of
8 April, 1271 cases have been notified, of which 1206 in Guangdong Province.
The remaining 65 cases were notified in six other provinces of China. Sixty
five deaths have been officially reported, 45 of which occurred in Guangdong
Province. A Finnish patient who worked for the International Labour Organization
died in Beijing on 6 April after suffering from SARS symptoms. The source
of infection has not been determined.
As of 8 April, 118 SARS probable cases have been reported (20 of which in
the past week). These include seven index (or imported) cases, 59 healthcare
workers, and 52 relatives or close contacts of cases. Nine deaths have been
notified. A new cluster without any apparent epidemiological link to the
first cluster has been identified at Singapore General Hospital, involving
46 people, 31 of whom are medical staff, 11 hospital visitors, and 4 patients.
Seven are probable cases, 38 are suspected cases and one person has been
admitted to hospital for monitoring.
As of 8 April, 91 probable cases have been notified, (88 in Ontario and
3 in British Columbia). All probable cases have been in people who had travelled
in South East Asia or had been in contact with SARS cases, either as relatives
of cases or at a healthcare institution. Ten deaths have occurred, mainly
in people over 70 years of age, who had a concomitant condition. Currently,
61 of the 91 probable cases have been admitted to hospital. Among them,
40 are in a good clinical condition. According to the health authorities
there is currently no evidence of transmission in the general population,
all cases having being associated to exposure while travelling in an affected
area or directly exposed through contacts with a patient (family members
or medical staff).
Only one case definition, for suspected cases, is currently being used in
the United States (US) (http://www.cdc.gov/ncidod/sars/casedefinition.htm).
Therefore the cases reported in the US are not comparable to those reported
in other countries. As of 8 April, 148 suspected cases had been notified
in thirty states. Although very little information about these cases has
been released, only 27 of the 115 cases notified up to 4 April presented
clinical signs of pneumonia.