WHO says SARS is contained worldwide

Jul 7, 2003 (CIDRAP News) – SARS is no longer spreading in Taiwan and therefore appears to be contained worldwide, the World Health Organization (WHO) announced Jul 5.

The last probable SARS case in Taiwan and, for now, the world, was detected and isolated Jun 15, WHO officials said. After 20 days with no new cases in Taiwan, the WHO determined that the country was free of recent local transmission.

"We do not mark the end of SARS today, but we observe a milestone: the global SARS outbreak has been contained," said WHO Director-General Dr. Gro Harlem Brundtland. She said the world owes a debt of thanks to scientists and health workers who took risks and, in some cases, gave their lives in the battle against SARS.

Dr. David Heymann, WHO's executive director for communicable diseases, said, "The whole world can breathe an initial sigh of relief. At the same time, public health must not let down its guard, as more cases could still surface somewhere in the world."

After mainland China and Hong Kong, Taiwan had the third largest SARS outbreak, with 674 cases and 84 deaths, the WHO announcement noted. The disease spread slowly at first, as only 23 probable cases were detected in the first month. But after a lapse in hospital infection control measures, the outbreak picked up speed in mid-April and moved into the community. Health authorities responded with a series of sweeping control measures, including the establishment of fever clinics.

"Interruption of the last known chain of person-to-person transmission has come just in time," said Heymann. "Health systems at every major outbreak site were strained to the limits of their capacity."

The WHO said it continues to receive rumors of possible cases, which shows that surveillance systems are working. "Failure to detect new cases over the next two weeks will greatly increase confidence that the SARS coronavirus has indeed been pushed out of its new human host," the announcement said.

But the disease could return next winter, the agency said. Also, the virus may still be circulating in animals and "may cross into humans again when conditions are right."

Although SARS seems to be contained, research must continue, the WHO said. The agency's top three research priorities for SARS are development of a rapid diagnostic test, identification of the original source of the outbreak (such as an animal reservoir for the virus), and creation of a global SARS database.

"Without a diagnostic test, hospitals may be forced to isolate all persons with respiratory disease fitting the SARS case definition, and this will be enormously expensive and divert essential resources from other health needs," the agency said.

Brundtland said the SARS crisis showed that the world needs to strengthen its public health systems. "We have an opportunity now, and we see the need clearly, to rebuild our public health protections," she said. "They will be needed for the next global outbreak, if it is SARS or another new infection."

See also:

WHO statements:
"Update 96—Taiwan, China: SARS transmission interrupted in last outbreak area"
http://www.who.int/csr/don/2003_07_05/en/print.html

"SARS outbreak contained worldwide"
http://www.who.int/mediacentre/releases/2003/pr56/en/

"SARS: Breaking the chains of transmission"
http://www.who.int/features/2003/07/en/