The World Health Organization (WHO) took Toronto off its list of SARS-affected areas on Wednesday, the second time it has done so, prompting hopes that the city's nightmare with the deadly respiratory disease is finally over after nearly 400 cases and 39 deaths.
Ontario's Ministry of Health said Toronto would remain vigilant in its fight against the virus. Health officials had thought they had ended the outbreak in May, but it resurfaced, dealing the city's health workers a devastating blow.
"We're not out of the woods yet," a spokeswoman for the ministry said. "It is likely we are going to have deal with this disease for some time."
Eleven people are still in critical condition but there have been no new cases of severe acute respiratory syndrome since June 12 in and around Toronto, the only place outside Asia where the virus has claimed lives.
The WHO required 20 days -- twice the normal incubation period for the virus -- to pass without a new cases before taking Toronto off the list.
"I think we can declare that Canada has finally beaten the disease," said Dr. Bhagirath Singh, scientific director of the Canadian Institutes of Health Research's Institute of Infection and Immunity.
But he warned, "The only issue is what happens later in the year. Would we see resurgence of the disease or is it now a thing of the past?"
Toronto's first outbreak of SARS started in mid-March and lasted until early May. In the middle of that month, the city was taken off the WHO's SARS-affected list, But health officials let down their guard in hospitals, where the virus still lingered and infected a 96-year-old patient, who then spread the disease to nurses, other patients and visitors.
"First time around, probably we were in too much haste to make sure that Canada had a presence on the international stage, showing that we had taken measures which really had made the disease a thing of the past," Singh said in an interview.
"Unfortunately, the optimism was too premature and the time window was too short to be absolutely sure. I think this time around, the time window has been a bit longer and we've learned that things are not as they appear."
SARS has infected more than 380 people in Ontario, most of them in the Toronto area. As of Monday, there were 22 probable cases of SARS in the city of about 4 million people. Across Canada, there have been about 440 cases of SARS since March.
The Canadian Department of Foreign Affairs recommended on Wednesday that people defer all nonessential travel to Taiwan until the SARS epidemic has ended.
"Given the uncertainties of the current situation, Health Canada believes it is prudent to await the outcome of national and international control measures before undertaking travel to Taiwan," the ministry said in a statement.