SARS contained in Vietnam, continues to spread in China

BANGKOK, Thailand -- The World Health Organization said Monday the worst of the SARS outbreak appears to be over in Singapore, Hong Kong and Canada, while Vietnam has become the first country to contain the highly infectious respiratory disease.

But SARS is spreading in China even as the government takes increasingly aggressive steps to halt the disease, said David Heymann, the chief of communicable diseases for WHO.

Heymann, who is in Bangkok to attend an emergency summit on SARS of Southeast Asian leaders Tuesday, said the situation is worrisome in China.

"In China, as you know, we are receiving more and more reports of cases and it doesn't appear it has peaked as far as spread" of the disease is concerned, Heymann told reporters.

Fewer cases reported

Hong Kong, Singapore, and Toronto are having fewer cases every day and Vietnam has reported no new SARS victims, the WHO said.

"It appears that the outbreak has peaked in those countries," Heymann said.

Heymann also said wearing a mask in public for protection against SARS is not necessary, and the risk of getting the illness was not as great as people believed.

"SARS is not transmitted when you are walking down the street," Heymann said. "We have concerns about the perceived risks of people living in Asia. The perception that these people have in many places appears to be greater than the actual risk."

There were eight new fatalities in China, five in Hong Kong and one in Singapore reported Monday, raising the worldwide death toll for severe acute respiratory syndrome to at least 333, mostly in China and Hong Kong. It has sickened around 5,000 people.

India reported two new SARS cases Monday, raising the number of cases in the country of 1 billion to nine so far. One of the cases was a taxi driver apparently infected by members of a family with SARS.

Asian governments kept up the fight with quarantines and travel restrictions. Taiwan began enforcing a 10-day quarantine for visitors arriving from areas hit hard by SARS, prompting airlines to cancel some flights there. Taiwan's Premier Yu Shyi-kun warned hospitals Monday not to reject patients suspected of having SARS after the city of Hsinchu refused to take seven people sent there.

Eleven new cases were reported in Taiwan, the largest jump so far on the island. Heymann said the virus had not yet peaked in Taiwan.

SARS has prompted a rare global alert from WHO and travel advisories against affected countries.

But the WHO lifted all travel advisories Monday for Vietnam, which had five deaths from SARS after the virus spread in February through Hanoi's only international hospital.

Sixty-three people contracted the virus in Vietnam. But the Hanoi French Hospital was cordoned off March 11, a move credited with slowing the rate of infection and keeping SARS from spreading beyond its doors.

No new SARS cases have been reported in Vietnam since April 8. WHO has set a 20-day window -- double the disease's incubation period -- as the standard for lifting travel advisories and declaring that an outbreak is no longer spreading.

In Hong Kong, authorities said Monday that another five SARS patients died, while 14 new cases were confirmed, the lowest yet since the government began releasing daily statistics last month. The latest deaths in Hong Kong brought the territory's toll to 138.

Hong Kong's political leader, Chief Executive Tung Chee-hwa, said the "downward trend" indicated that the territory's battle against the disease was yielding results. But he warned against complacency.

"The situation is still not totally under control," Tung said. "We must not take the disease lightly; we must not let up our guard."

In China, health officials raised the mainland's death toll to 140 on Monday and said 3,106 people have been confirmed infected -- an increase of 203 cases from the previous day's figures.

In contrast to Vietnam, China has been widely criticized for failing to respond earlier to pleas for action to contain the disease, which surfaced in the southern province of Guangdong in November and spread internationally via travelers from Hong Kong.

But officials there have been taking strong action in recent days. Police in Beijing and nearby areas are stopping vehicles to check people for SARS symptoms, said Li Yongjie, an official of the provincial Administration of Road Transportation. Several regions have reportedly barred traffic from the capital in hopes of keeping out the virus.

Those reports prompted the Chinese government to issue an emergency order to local governments Monday banning them from blocking regular passenger and freight traffic with areas infected by SARS.

China closed its border with Nepal on Sunday because it fears the disease could spread from there, said a tourism official in China's Tibet province who gave only his last name, Liao.

Chinese officials worry that the virus would be difficult to control if it enters Tibet because of poor sanitation and low medical standards, Liao said. Nepalese health authorities say they have no confirmed SARS cases in their country.

Beijing on Sunday closed the city's theaters, cinemas, Internet cafes and other public entertainment venues to "stop possible spread of the SARS virus and ensure public health," the official Xinhua New Agency reported.

Starting Monday in Taiwan, foreigners arriving from countries hit hard by SARS will be quarantined for 10 days at government-designated quarters, while returning Taiwan residents will have to stay at home.

In Malaysia, health authorities sealed off a psychiatric hospital they fear may be the site of a SARS outbreak, quarantining its 540 staff and patients.

Fifteen patients and four nurses reported respiratory problems at the hospital in Kuching, the capital city of eastern Sarawak state on Borneo island, said Health Ministry Deputy Director General Ismail Merican.

"We hope the cases are not SARS-related," Ismail said. "For now, nobody comes in and nobody gets out of the hospital."