Posted on Wed, Apr. 02, 2003
400 new SARS cases in China
By MICHAEL DORGAN and SETH BORENSTEIN
Knight Ridder Newspapers
BEIJING - (KRT) - As China on Wednesday disclosed nearly 400 new cases of the mysterious fast-breaking respiratory illness and international health
officials urged travelers to avoid southern China, U.S. doctors were trying to figure out why the disease has not hit America that hard yet.
Severe acute respiratory ayndrome, or SARS, continues to spread in Hong Kong, China's southern Guangdong province and distant Canada, while
neighboring countries have had only sporadic travel-related cases.
U.S. officials said Wednesday that a new diagnostic test, which seems to identify the virus that American officials think is responsible, is ready to
be sent to state health officials for preliminary use.
So far, SARS has sickened 2,236 people and killed 78. Nearly 1,200 of those cases have been in China with 708 in Hong Kong. Although Hong Kong has
been part of China since 1997, international health officials treat it as a separate entity. Eighty-five percent of all cases and 79 percent of all
deaths have been in Hong Kong and China.
According to data released Wednesday by China, 1,153 cases, including 40 deaths, have been in Guangdong, where the virus is believed to have
originated. The latest data showed 361 new cases, including nine deaths, in Guangdong in March. The data also showed that the virus spread to the
Guangxi region and to Hunan and Sichuan provinces, which together had 21 cases and three deaths.
In the United States, there have been 85 cases. All but seven of those victims had traveled to SARS hot spots. No one has died in the United States,
and only one victim was sick enough to need a mechanical respirator, according to the U.S. Centers for Disease Control and Prevention in Atlanta.
But China's numbers caused the World Health Organization - and the U.S. State Department - to issue a first-of-its-kind travel advisory about Hong
Kong and Guangdong.
"People who are planning to travel to Hong Kong or Guangdong should consider postponing their travel until another time," said Dr. David Heymann,
WHO infectious diseases chief, in Geneva.
The CDC warned against unnecessary travel in China, Singapore and Vietnam. And soon, the CDC will release specific advice for parents who are adopting
Chinese children, CDC Director Dr. Julie Gerberding said Wednesday.
"The epidemic is not over over there," Gerberding said. "The global community has to take this very seriously and do everything we can to contain
its spread and stay on top of it."
China's government had been widely criticized for responding slowly to the epidemic. It previously acknowledged only the cases in Guangdong and a
handful in Beijing and Shanxi province.
While Wednesday's disclosures reinforce China's standing as the epicenter of the epidemic, they also suggest a hopeful trend. The data indicate a 48
percent drop in new SARS cases in Guangdong from February to March.
"I don't think this problem has peaked internationally, but it may have peaked in Guangdong," said Dr. Robert Breiman, leader of a WHO team in
Beijing. "If true, we have a lot to learn here about what might happen elsewhere."
Dr. James Maguire, an epidemiologist with the WHO team in Beijing, said it is not yet known why the epidemic appears to be waning in Guangdong.
One possibility is that the virus weakens after several transmissions, he said. Another is that Guangdong health officials took effective measures to
treat or prevent the spread of the disease.
In addition to releasing data to the WHO team, Chinese officials gave the team permission to travel to Guangdong to search for evidence of the origin
and transmission routes of the virus. The WHO team put in an urgent request for the trip nearly a week ago.
The virus, which produces a severe pneumonia-like illness, has spread to 17 countries, and suspected new cases were reported Wednesday in Indonesia
and Malaysia, where none had previously appeared.
"We don't know why the transmission of the epidemic looks different in different places," Gerberding said. One reason the United States has fewer
and less virulent cases is that American health officials are using very broad definitions when counting victims, including people who might not be
considered a SARS patient elsewhere, and these people are not as sick, she said.
But Canada has similar broad definitions and a much worse situation with six dead, Stanford University professor of medicine Dr. Stanley Deresinski
said. And the disease looks to be waning in Hanoi and Singapore, he said.
What should help is that the CDC has developed a test that would tell whether a patient has coronavirus - which the CDC thinks is the likely cause of
SARS - and will soon send test results to state health departments.
Health officials expect to battle SARS "for at least several weeks if not longer," Gerberding said.