PRESS BRIEFING ON ‘SARS’ BY WORLD HEALTH ORGANIZATION OFFICIAL

The potential of the newly identified Severe Acute Respiratory Syndrome (SARS) was still not clear, particularly whether it would become a permanent infectious disease, the Executive Director of the Communicable Diseases Cluster of the World Health Organization (WHO), David Heymann, said today at a Headquarters press briefing.

According to the WHO, which is coordinating the international investigation, SARS is an atypical pneumonia of unknown origin, which was first recognized at the end of February.  The WHO is set to convene scientists from around the globe at the end of this week in Geneva to seek a clearer picture of the infectious disease and consider appropriate global control strategies.

The WHO acted quickly when the new disease first emerged some weeks ago, by issuing a global alert.  Since then, it has created a virtual research centre, developed a diagnostic test, and established a global network, by which treating physicians can share clinical data on treatments and outcomes.

(According to WHO, a total of 3,169 cases of SARS had been diagnosed as of yesterday, with reports of 144 deaths in 21 countries.  China, with 1,418 cases and 64 deaths, remains the most seriously affected area.)

Following his briefing to correspondents, Dr. Heymann would discuss SARS at an open meeting co-sponsored by WHO, the Economic and Social Council, and the United Nations Medical Service.  He would review the virus that likely causes the new disease, the status of clinical care, new routes of transmission, trends in epidemiology, the success of containment efforts in Viet Nam, and China’s new commitment to the international fight against SARS.

Turning to the situation in China where the outbreak was first detected, he said that until the situation there had become clear, and a number of other key questions were answered, the future of the disease would not be known.  When the new global alert was issued just a little over four weeks ago, it had been hoped that SARS would not spread throughout Asia and the rest of the world, thereby becoming another endemic disease like tuberculosis or malaria.  The jury was still out on the disease’s potential.

Meanwhile, he lauded the Chinese Government’s efforts to stem the epidemic and cooperate with the world health agency, noting that there were now four teams working in Guangdong, Beijing and other major Chinese cities, where there were reports of the disease.  A national reporting system for SARS set up by the Chinese Government now ensured a daily flow of information about the epidemic, which was widespread around the country.  The WHO teams were now working with China to assess the situation there, and to gain access to the four months of information in Guangdong, where the disease began in November last year.  Excellent records had been maintained which stood in piles in Guangdong awaiting national and international analysis.

He also praised the media for its “responsible” reporting on SARS, saying that that had been very helpful to finding ways of tackling the epidemic.  Despite such reporting, there had been a big economic impact from the disease.  That would have occurred regardless of how the story was reported -- whether the articles

were sensational or truthful -- but, sometimes the public misunderstood.  Nevertheless, the press had done a very good job in discussing the disease and evolving the right profile for it.

At the time of the global alert four weeks ago, the disease was not known, he said.  Health-care workers appeared to be at greatest risk, comprising about  90 per cent of the cases.  It was now known that 90 per cent of patients recovered from that very serious illness.  But 4 per cent continued to die from it.  In Canada, an even greater percentage had died because certain people had pre-existing conditions, such as diabetes or other diseases, which appeared to have made SARS more severe.

Because there was no treatment for the disease, it had begun to travel internationally, from Asia to Canada and other parts of the world, including, in particular, Singapore, he said.  Two additional modifications had been made since the global alert.  The first alert had only advised international travellers to be aware of the disease and to report to a health worker in their own country if they developed symptoms.  Since then, it had been determined that SARS travelled on international air transport, which raised some questions about whether or not it could be transmitted to people sitting very close to those people on planes.

As a result, he continued, two additional measures had been recommended.  The first was a screening procedure at airports in affected areas, where the disease was known to be occurring in epidemic form, and the second was for travellers to Hong Kong to postpone their travel if that was not essential.  There was a growing sense that apart from the close contact, an environmental factor might be contributing to transmitting the disease from one person to the next.  Nine international passengers had left Hong Kong since the alert was sounded on  15 March.  A similar alert had been issued for the Guangdong province in China.

Responding to correspondents’ questions about whether the Chinese Government was not as forthcoming as it should be, Dr. Heymann said it was always useful to look forward rather than backward.  In China, like in many other countries, health issues were monitored at a provincial or State level.  It had only been in the last three weeks that China had established a national reporting system for SARS.  That was an unusual move in China, where at present, only three diseases reported to the central Government constituted a global alert situation, namely, cholera, plague and yellow fever.  By reporting on SARS, the Chinese Government had raised the issue to a very high political level, as well as health level, and the WHO was optimistic that a very clear picture would emerge in about four weeks.

Replying to a question about the possibility of developing a vaccine or treatment, in light of reports that the corona virus had been identified as the cause of SARS, Dr. Heymann said if it was going to be the private sector that developed the vaccine or drug, it would want to be sure that the disease was a permanent resident in humans, in order to recover its investment in research.  If it were a public, or public-private sector-funded effort, the situation would be different.  The history of treating viral infections showed that anti-viral drugs were very difficult to develop, and even then, they did not have an effect late in the disease, but only very early when the virus level was low.

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