Taiwan's health chief resigns over SARS

Saturday, May 17, 2003

TAIPEI, Taiwan -- The escalating SARS crisis in Taiwan cost the health chief his job Friday, as he quit to take responsibility for the rapid spread of the virus that has forced the closing of two hospitals.

He was the second top Asian health official to lose his job because of SARS; mainland China's health minister resigned a month ago, and more than 100 other Chinese officials have been punished or fired because of SARS, according to Xinhua news agency.

Taiwan Health Department boss Twu Shiing-Jer will be replaced by a respected epidemiologist, Chen Chien-jen, who studied at Johns Hopkins University in the United States.

Meanwhile, the World Health Organization reported details of how a huge apartment outbreak in Hong Kong in March was caused by sewage leaks and powerful ventilation fans sucking the virus inside homes.

And in China, the government said it was suspending foreign adoptions to help curb the disease. Paperwork on adoptions will continue, but Beijing has stopped authorizing prospective parents to come there.

Severe acute respiratory syndrome has infected 7,700 people worldwide and killed at least 613. It is continuing to spread through Taiwan, although new infections are on the decline elsewhere.

On Friday, health officials said the disease had killed three more people, including two doctors. Taiwan reported 10 new cases for a total of 274, and its death toll rose to 37.

In Singapore the prime minister said a suspected cluster of new SARS cases at a mental health facility was a false alarm. He expressed hope the WHO would be able to declare the city-state SARS-free on Sunday.

"I am 99 percent sure they are not suffering from SARS," Prime Minister Goh Chok Tong told reporters.

One of Taiwan's top SARS fighters warned more cases were about to erupt.

Lee Ming-liang, head of the government's SARS Control Committee, said more infections were expected as the result of the two most recent hospital outbreaks, at Taipei's National Taiwan University Hospital and at Chang Gung in southern Kaohsiung city.

Illustrating the random nature of many SARS outbreaks, most of Taiwan's 274 cases of the respiratory disease can be traced to one woman's 40-minute stay in a Taipei emergency ward, a doctor said Friday.

The woman was four days into her SARS infection, said Dr. Yeh Chin-chuan, an adviser to the Taipei city government.

The woman's brief hospital stay set off a chain of events that ultimately caused outbreaks at four Taiwanese hospitals where dozens of people were sickened, Yeh said in a report released Friday.

A report by WHO investigators into Hong Kong's Amoy Gardens outbreak, which was concentrated in a building called Block E, blamed an "unlucky" combination of circumstances -- a patient with diarrhea, seeping pipes and drafty air shafts.

The WHO's findings largely confirm an earlier Hong Kong report.

"It's just an accumulation of events," team leader Dr. Heinz Feldmann told a news conference Friday. Feldmann said there was no way to guarantee against a repeat, but another one seems "unlikely."

More than 300 people contracted the illness in the apartment complex in late March, and hundreds more were quarantined. Thirty-five residents died.

Investigators found no live coronaviruses -- the family of virus believed to cause SARS -- and no remaining genetic material from the virus, Feldmann said.

The disease was brought to Block E by a sick man visiting his brother, the Hong Kong government said earlier. The man had diarrhea, and others who caught SARS also developed diarrhea, spreading the virus through the sewage system.

Droplets containing the virus apparently entered some apartment units through dried-out drain traps -- U-shaped pipes that are supposed to keep gases and waste from coming back up. Bathroom exhaust fans sucked droplets into apartments, the WHO said.

Feldmann found no evidence the virus was airborne, but small droplets can travel up to five feet through the air, perhaps further with a strong wind.

Feldmann said an earlier outbreak at Hong Kong's Metropole Hotel apparently was caused by close person-to-person contact. An ill mainland Chinese medical professor visiting the Metropole in February infected 16 people who spent time on the ninth floor. They spread SARS throughout Hong Kong and to Vietnam, Canada and Singapore, which all had fatal outbreaks.

In China, officials started punishing people Friday for violating SARS-related restrictions. A woman received a one-year sentence for leading protesters who vandalized a building being turned into a quarantine center.

Beijing, the world's hardest-hit area, reported one new death Friday and 28 new cases, raising total reported cases to more than 2,400.

WHO doctor Daniel Chin warned Beijing's true number of cases may have been underreported because of inconsistent hospital records.

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