Last hot spot for deadly SARS removed from infection list

HONG KONG -- The World Health Organization removed the last SARS hot spot -- Taiwan -- from its list of infected areas, saying Saturday the illness that killed more than 800 people worldwide has been contained.

There are lingering fears the virus could return, but experts said the public health lessons learned from this crisis will help in any future outbreak of infectious disease.

"Today is a milestone," WHO director-general Dr. Go Harlem Brundtland said at the group's headquarters in Geneva.

But she warned that severe acute respiratory syndrome could spread again if countries are not careful. There still are close to 200 cases in hospitals around the world.

"The world is not SARS free," she said. "It is possible that SARS cases have slipped through the surveillance net and we know that one single case can spark a new outbreak."

SARS has sickened more than 8,400 people worldwide and killed at least 812. About 80 percent of the victims were in mainland China, where SARS originated in November, and Hong Kong, where infected people then carried it in airplanes to Singapore, Vietnam and Canada -- and all three suffered fatal outbreaks.

China, Hong Kong and Toronto recently were dropped from the SARS-infected list. Toronto, Canada's largest city, had the biggest outbreak outside of Asia, with 39 deaths among almost 250 cases.

The United States reported 73 cases but no deaths.

To get off the list, infected areas have to go 20 consecutive days without reporting a new infection. In Taiwan, the countdown began June 15, the day the island's most recent SARS patient was isolated in a hospital.

"We can finally return to our normal lives," Taiwanese Premier Yu Shyi-kun said.

Dr. David Heymann, WHO's executive director of communicable diseases, said Saturday the agency believed the SARS virus had been contained. But he warned against becoming complacent.

"We cannot let a false security develop over the containment which has occurred today because a false sense of security could become our worst enemy," he said.

WHO said the illness could recur next winter but a vaccine could take years to develop.

Lessons learned

Still, experts say the lessons learned from the crisis -- the importance of greater vigilance on health and hygiene, and of openly sharing medical information -- will help in any future outbreak of an infectious disease.

"The silver lining in this is the greater awareness," said Peter Cordingley, a WHO spokesman at the U.N. health agency's regional office in Manila, Philippines.

"First-world health systems like Toronto's and developing world health systems like China's were all found wanting," Cordingley said.

Economies also are struggling to repair the damage from SARS, which cost billions of dollars and wiped out thousands of businesses and jobs. WHO travel advisories devastated air traffic and tourism and Asia suffered its worst economic calamity since the 1997-1998 financial meltdown.

WHO insists it acted properly in issuing SARS warnings in fighting a new disease that experts believed they might be able to stamp out before it spread too far. But the travel warnings angered many in places that depend heavily on tourism.

"The question we ask people is where we would be if we hadn't done this," Cordingley said. "I think we'd have something very close to a pandemic on our hands."

The surgical masks worn by hundreds of thousands of Hong Kong residents to protect themselves from SARS are nearly gone, but the virus has changed attitudes and daily life in places badly affected -- Hong Kong and Beijing are cracking down on spitting and littering.

"SARS will likely change people's habits here," said Dr. Wu Shuh-min of Taiwan, who was quarantined for 10 days when a colleague caught the disease. "They'll be taking their temperatures more and developing better hand-washing habits."

Passengers moving through airports in SARS-hit areas, including Singapore and Hong Kong, still are screened for fever. Infrared heat detectors were set up at other airports and immigration points around the region -- and will stay in some locations.

In Singapore, most shopping centers and hotels take their staffers' temperatures each day. Many retail workers wear stickers that say "I'm OK" or "Fever Free."

Health care workers were among the people hit the hardest by SARS because of their close contact with patients, who typically spread the virus by coughing or sneezing.

Doctors, nurses and health assistants learned that many routine procedures -- such as feeding elderly patients -- can be dangerous, so they will take extra precautions, like wearing more protective gear, more often.

"Now, we have to dress up like we're from outer space," said Dr. Sydney Chung, medical dean at the Chinese University of Hong Kong.