Update 44 - Ontario SARS (July 2, 2003): WHO

UNCLAS SECTION 01 OF 02 OTTAWA 001876 SIPDIS STATE FOR WHA/CAN, CA/OCS, M/MED, and M/DASHO HHS FOR OFFICE OF THE SECRETARY, OFFICE OF INTERNATIONAL AFFAIRS (STEIGER),CDC FOR GLOBAL HEALTH OFFICE (COX) E.O. 12958: N/A TAGS: AMED SOCI TBIO ECON CASC CA SUBJECT: Update 44 - Ontario SARS (July 2, 2003): WHO Removes Toronto from List of SARS Affected Areas TORONTO SENDS Ref: Toronto 1816 and previous World Health Organization (WHO) Removes Toronto from List of "Areas with Recent Local Transmission" -------------- -------------- 1.In a move anticipated with measured optimism by Ontario Health Minister Tony Clement in a July 1 televised interview, the WHO on July 2 "removed Toronto, Canada, from its list of areas with recent local transmission." The WHO used as its measure the fact that 20 days - double the known incubation period for SARS - have passed since a new SARS case surfaced in the Greater Toronto Area (GTA). Twenty-two active probable cases remain in Toronto. The WHO, however, according to spokesman Christine McNab, determined that the disease's risk to people in the community is "extremely low to zero." ¶2. During Toronto's second bout with SARS, locally dubbed "SARS II," the WHO did not reinstate its earlier travel advisory on Toronto. However, Toronto's presence during May and June on the WHO's "local transmission" list delayed public/private sector marketing programs to bring travelers back to Canada's largest city - programs which can now be launched with confidence. Keep up the Guard, Experts Caution -------------- ¶3. Despite the good news, both the WHO and Toronto experts such as Dr. Donald Low, Mount Sinai Hospital's chief microbiologist, are urging continued vigilance. The mechanisms of SARS' spread are still not fully understood, and modern hospital settings appear to be particularly vulnerable to SARS. Toronto's most recent SARS fatality, for example, was a front-line nurse. The WHO's statement notes that the efficient spread of the virus in "sophisticated hospital settings may have contributed to the severity of Toronto's outbreak ... certain procedures, such as difficult intubation and use of nebulizers that are more common in sophisticated hospitals, also increas[e] the risk of infection." ¶4. A combination of the CDC and Health Canada's review of hospital procedures, a just-underway Health Canada expert committee examination of infectious disease controls, and an Ontario provincial lessons-learned exercise should help to fine-tune the "new normal" of identifying, containing, and dealing with infectious diseases, implemented by Ontario's Health Ministry last month. June 30 Case Statistics (Ontario Ministry of Health) -------------- -------------- ¶5. Summary: --22 active probable cases (hospitalized/under investigation),compared with 37 on June 17. Of the 21 hospitalized cases, 11 are in critical/ deteriorating condition. --2 active suspect cases, compared with 4 on June 17. Of the 2, both hospitalized, none are in critical/deteriorating condition. --316 cumulative discharges (probable and suspect), compared with 299 on June 17. --379 cumulative cases (probable/suspect/ fatalities) compared with 375 on June 17. Case Statistics: Probable (Active): 21 hospitalized 1 under investigation 0 home 188 cumulative discharges to date. Suspect (Active): 2 hospitalized 0 under investigation 0 home 128 cumulative discharges to date. Fatalities: 39 cumulative fatalities to date, compared with 33 on June 11. MARWITZ