United Nations Workers Grapple with SARS. (Global Health Threat)

By Reinhardt, Erika | UN Chronicle, June-August 2003 | Go to article overview

United Nations Workers Grapple with SARS. (Global Health Threat)


Reinhardt, Erika, UN Chronicle


The world's first recognized case of a deadly new disease, later named Severe Acute Respiratory Syndrome (SARS), occurred in the Guangdong Province of China on 16 November 2002. The disease is characterized by high fever and respiratory symptoms, including a dry cough, shortness of breath and difficulty in breathing, and is transmitted by face-to-face exposure to droplets released when an infected person coughs or sneezes. There is no evidence that the disease spreads through casual contact. A new pathogen, a member of the coronavirus family never before seen in humans, has now been identified as the cause of SARS.

As of 13 May, the worldwide cumulative number of reported probable cases of SARS since November 2002 has risen to 7,548, with 573 deaths, from 30 countries; of those infected, 3,298 have recovered.

On 12 March, the World Health Organization (WHO) issued its first global alert describing the disease in Viet Nam, while the Department of Health of the Hong Kong Special Administrative Region of the People's Republic of China reported an outbreak of severe respiratory disease in one of its public hospitals. WHO recommended that infected patients be isolated with barrier-nursing techniques and that any suspect case be reported to national authorities. On 26 March, 80 clinicians from 13 countries participated in a virtual conference on the treatment of SARS patients. WHO plans to hold an international meeting in Kuala Lampur, Malaysia from 17 to 18 June, to review the epidemiological, clinical management and laboratory findings on SARS and to discuss global control strategies. A report of the meeting will be posted on its web site (www.who.int/csr/sars/en/).

The WHO Global Outbreak Alert and Response Network (GOARN) was rapidly mobilized in response to the SARS outbreak involving international field support, epidemiological and clinical networking, and laboratory collaboration.

GOARN provides an operational platform for international teams on the ground in China, Hong Kong, Singapore and Viet Nam. These teams involve 60 experts representing 20 organizations and 15 nationalities working with national authorities on case management, infection control and surveillance, as well as laboratory and epidemiological investigation. Epidemiologists investigating disease transmission and clinicians treating SARS cases have come together in a global collaboration, together with 17 laboratories from nine countries which test samples from SARS patients. These international groups also participate in the WHO multi-centre collaborative networks on SARS aetiology and diagnosis (see photo).

In Viet Nam, the outbreak began with a hospitalized case of atypical pneumonia of unknown origin. The patient became ill shortly after travelling from Shanghai and Hong Kong to Hanoi. Following his admission to the hospital, approximately twenty hospital staff became ill with similar symptoms. The situation seemed to have stabilized by 21 April, following the introduction of infection-control measures. WHO officials said that while Viet Nam appears to have controlled the disease within its borders, it still faces the threat of importation of the disease from China, and the Vietnamese Government is considering closing its land border with China.

According to WHO Executive Director of Infectious Diseases Dr. David Heymann, the outbreak was well established in China, Hong Kong, Viet Nam, Singapore and Canada before WHO issued its global alert. "What we've seen is that countries who have known about SARS early on were able to raise awareness within their countries and stop local spread of that disease within their countries. So we believe that the global alert has been effective in sensitizing Governments to this disease."

Chinese authorities have reported over 1,500 cases and 56 deaths in Guangdong Province as of May, making it the most affected region. A WHO team of experts arrived in that province on 3 April and met with senior provincial health officials and discussed with health workers, including epidemiologists and clinicians treating SARS patients, patterns of transmission, clinical profiles and the suspected causative agent. …

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