The Department of Health (DOH) said for the first time yesterday that local transmission of severe acute respiratory syndrome (SARS) has occurred in Taiwan.
"Taiwan has six probable cases whose contact or travel history shows no known contacts with probable SARS cases," said Lee Ming-liang (李明亮), former director-general of the DOH and head of the SARS task force that the department has set up.
The World Health Organization (WHO) describes the extent of local transmission of SARS in Taiwan as "medium" on a three-level grading, meaning "more than one generation of local probable SARS cases, but only among persons that have been previously identified and followed-up as known contacts of probable SARS cases."
The country has reported, 131 "probable" cases and 229 "suspected" cases of SARS. Thirteen people have died of it, according to the Center for Disease Control under the DOH.
Lee said the contact or travel history of some probable cases could not be traced or identified because health officials, with their heavy workload, did not have enough time to investigate them.
However, despite the acute shortage in manpower, Lee stressed the urgency of tracing the cases because Taiwan, with six probable SARS cases with unknown origins for infection, was approaching the definition of a "high" local transmission area.
The WHO defines local transmission as when "one or more reported probable cases of SARS have most likely acquired their infection locally regardless of the setting in which this may have occurred."
"Low" levels of local transmission are when an imported probable SARS case has produced only one generation of local probable cases, all of whom are direct personal contacts of the imported case.
"If we can't trace how our cases were infected, the WHO may issue a further warning against travel to Taiwan," Lee said. "If we can efficiently trace the cases, the WHO may remove us from the list of affected areas."
"There are cases whose contact or travel history cannot be traced. As it is, we have to accept the situation" that local transmission of SARS has occurred, Lee said.
Lee said containing local transmission of SARS would be one of the task force's priorities.
"If we fail to cope with `upper stream' SARS cases, `middle and lower stream' SARS cases will keep emerging," he said.
Lee said that officials from the US Centers for Disease Control and Prevention and the WHO were taking part in Taiwan's battle against SARS.
According to Lee, the visiting WHO officials praised Taiwan's medical laboratories and clinical treatment as "top in the world," but said the country needed to strengthen its disease control.