Mon, Jun 16, 2003 page5

• China's focus shifts in fight against SARS

  • AFP
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  After four months of frantic but largely successful efforts to contain SARS in China, World Health Organization (WHO) experts are now focusing on finding the source of the illness and preventing a new outbreak.

  The number of new SARS cases in China, the worst hit country in the world, has dwindled to just a handful in June, leading to a widespread belief that control measures are working and that the mysterious pneumonia-like disease may be on the brink of disappearing -- for now.

  

  Tourists visit the Forbidden City in Beijing yesterday. More people are visiting the Forbidden City as the government says fewer cases of SARS are emerging, but the World Health Organization said it needs to know more about the pattern of SARS before scrapping its recommendation against travel to China's capital.

  PHOTO: REUTERS

  "Before we can talk of eradication we need to know all the facts," Peet Tull, a Swedish epidemiologist who has been in Beijing monitoring the disease for the last five weeks told reporters.

  "I think it is about eradicated, but there are some problems, one is the environment, how did it get started? We have to find the source," he said.

  "Another question is the sub-clinical carrier, people who don't have the disease but carry the virus. This is a concern but so far from the epidimeological cycle there is no data supporting this," he said.

  Since the WHO began sending expert teams into China in March, much of their work has been aimed at helping China set up control and surveillance measures and collecting data on the spread of SARS.

  But now as the number of new cases dwindle, more attention is being focused on the origin of the disease, its molecular make up, whether it jumped from an animal species to human beings and whether it is a seasonal disease, Tull said.

  Finding the source of the disease will help to know whether SARS can truly be eradicated, or whether it could become an endemic or regularly reccuring disease like hepatitis, tuberculosis or a number of other common illnesses.

  "Being an endemic disease is partly related to whether there is a reservoir [of the virus] in animal sources, and partly related to whether the control measures can be maintained," Daniel Chin, a Beijing-based WHO medical officer told AFP.

  "In other words, it may keep coming back, but if you have adequate control measures you can keep containing it."

  Whether or not SARS becomes an endemic disease has been at the root of the international fuss over the epidemic that has infected some 8,400 people and killed 780 worldwide since it was first discovered in southern China in November.

  SARS has not been as fatal or infectious as many other diseases but its recent appearance and unanswered questions about its spread and origins that have set alarm bells ringing.

  Studies have shown that up to 70,000 people die from pneumonia every year in the US alone, while in China it was estimated that in 2001 up to 174,000 people died from respiratory diseases, not including tuberculosis.

  Most of the world's SARS infections have occurred in greater China, with over 5,300 cases and around 340 fatalities recorded in the mainland, 1,750 cases and nearly 290 deaths in Hong Kong.

  By March, researchers worldwide had identified a new strain of the coronavirus, long known for causing the common cold, as the cause of SARS.

  In late May, Chinese and Hong Kong researchers found strains of a coronavirus in a number of wild animal species being bred for southern China's exotic food restaurants that was more than 99.8 percent similar to the SARS coronavirus found in humans and the likely origin of SARS.

  They also found that some wild animal breeders and sellers were carrying SARS antibodies without ever coming down with the disease, meaning that there is a possibility that SARS spread through these "sub-clinical carriers" to others, Tull said.

  "The WHO hopes to send a team down to Guangdong to look into these studies, a lot more work needs to be done here," he said, in order to verify that these animals were the source of the outbreak.
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