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Washington File

23 June 2003

WHO Says SARS Transmission Stopped in Hong Kong

(Whole world is safer from disease, official says) (730)
The chain of transmission of severe acute respiratory syndrome (SARS)
has been broken in Hong Kong, according to a finding announced by the
World Health Organization (WHO) June 23.
Health officials reach that conclusion now that 20 days have passed
since the last case was isolated, according to a WHO press release.
That time period is considered twice the normal incubation period for
the highly infectious, sometimes fatal respiratory condition.
Hong Kong suffered the most serious outbreak of the disease outside
mainland China, recording 1755 cases as of June 23 and 296 deaths.
WHO officials praised the openness with which officials handled the
disease, and the professionalism of Hong Kong's medical and scientific
community.
This success means that the whole world can now feel safer from the
SARS threat," said Dr. David Heymann, WHO's director of communicable
diseases.
Following is the WHO text:
(begin text)
WORLD HEALTH ORGANIZATION
Update 86
Hong Kong removed from list of areas with local transmission 
23 June
WHO has today removed Hong Kong from its list of areas with recent
local transmission of SARS. Twenty days, which is twice the maximum
incubation period, have passed since the last case was isolated on 2
June.
When 20 days have passed since removal of the last case from the
community at large, the chain of human-to-human transmission is
considered broken, thus eliminating the risk of infection for both
local residents and travelers.
"This is a very significant achievement," said Dr David Heymann,
Executive Director of Communicable Diseases at WHO. "Hong Kong, with
its dense population and fluid border with China, had one of the
hardest outbreaks to control. This success means that the whole world
can now feel safer from the SARS threat."
SARS was first carried out of southern China into Hong Kong, and then
on to Hanoi, Toronto, and Singapore in late February. Some 16 visitors
and guests to the ninth floor of a Hong Kong hotel became infected
through contact, in ways that remain mysterious, with a symptomatic
medical doctor from Guangdong Province, who stayed in the hotel's room
911. The index case for Hong Kong's first outbreak, in the Prince of
Wales Hospital, visited an acquaintance staying on the same floor
during the critical days in February. Additional clusters were also
subsequently linked to the hotel.
SARS had not yet been identified as a dangerous new disease when the
outbreak hit Hong Kong's hospitals. Doctors and nurses, unaware of the
need to isolate patients and protect themselves, became the first
victims as they struggled to save lives. In a particularly unfortunate
incident, the index patient at Prince of Wales, admitted on 4 March,
was treated four times daily with a jet nebulizer, which probably
aerosolized the virus and greatly increased opportunities for spread.
In late March, Hong Kong suffered a major setback when a large
cluster, eventually numbering more than 300, of almost simultaneous
new cases was traced to a single building in the Amoy Gardens housing
state. That event, which raised the possibility of an environmental
source of infection or even airborne spread of the virus, was
investigated by teams of local specialists. The outbreak was
attributed to an "unlucky" convergence of environmental conditions
that allowed the contamination of vertically-linked apartments. This
conclusion, subsequently confirmed by additional studies, calmed fears
that the SARS virus might be airborne.
From the day when the first cluster of cases was recognized, Hong Kong
officials have provided open, honest, and abundant information about
SARS to both the public and the media. Hong Kong also benefited from
the contribution of its outstanding scientists, epidemiologists, and
clinicians, who were at the forefront of efforts to track down source
cases in the various clusters, identify the causative agent, develop
diagnostic tests, and work out treatment protocols.
Faced with the largest outbreak outside mainland China, Hong Kong also
pioneered many of the control measures used to successfully contain
smaller outbreaks elsewhere. It is gratifying that these measures have
now brought Hong Kong to the point of victory over the virus, although
continued vigilance remains vital.
On 2 April, WHO advised the public to consider postponing all but
essential travel to Hong Kong. That recommendation was removed more
than 7 weeks later, on 23 May.
(end text)
(Distributed by the Bureau of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)



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