China is still not open enough about SARS, says WHO

Whereas the outbreaks of severe acute respiratory syndrome (SARS) in Singapore and Hong Kong are showing signs of coming under control, the spread of the disease in both China and Taiwan remains a major cause for concern, the World Health Organization says.

Whereas the outbreaks of severe acute respiratory syndrome (SARS) in Singapore and Hong Kong are showing signs of coming under control, the spread of the disease in both China and Taiwan remains a major cause for concern, the World Health Organization says. By 12 May there were 6583 reported probable cases and 364 deaths worldwide. More than 67% of the world’s cases have occurred in China, with major outbreaks in Beijing and Tianjin as well as Guangdong, Hebei, and Shanxi provinces and Inner Mongolia. In Taiwan the number of cases rose by almost 37% to 184 in the week to 12 May. Twenty people have died. “We are very worried about Taiwan. There are infections in hospital, infections in the community, unexplained links. We don’t know what’s going on there,” said Peter Cordingley, WHO’s spokesman in Manila. In China, Beijing remains the worst affected place, with over 2300 cases and 129 deaths. By 12 May, 23 000 people in the capital were in quarantine. Health officials in the city have said that the outbreak has peaked there, but WHO remains unconvinced, not least because there is still not enough information being made available to make sense of the outbreak. In half the cases in Beijing, for example, there has been no established link to existing cases. “The WHO team doesn’t understand how the virus is being spread and has not been given enough data to join up the dots,” said Mr Cordingley. The outbreak in Hong Kong has now peaked, and there were only 46 cases in the week to May 12, bringing the total to 1683 infected and 252 dead. Only Singapore, the third worst affected place in Asia, with 205 cases and 28 deaths, will be declared SARS-free on 18 May if there are no new cases by then. With the SARS epidemic now in its third month, data on survival rates and a range of treatment options are emerging. In a report published online in the Lancet (http://image.thelancet.com/extras/03art4453web.pdf) scientists from the United Kingdom and Hong Kong report estimated death rates of 6.8% for patients aged under 60 and as high as 55% for those over 60on the basis of analysis of 1425 cases in Hong Kong. While doctors in Hong Kong continue to use a combination of ribavirin and corticosteroids as the first line treatment for SARS, the use of corticosteroids has been delayed until the second week of infection in order to minimise side effects.(Source: BMJ; Jane Parry; BMJ 2003;326:1055 (17 May))