Washington Times

     There has been a fourth death in Canada from Severe Acute Respiratory Syndrome, medical authorities told reporters on Sunday. Dr. Colin D'Cuhna, the Ontario public health commissioner, said the unidentified victim had died at York Central Hospital in Richmond Hill on Friday night.      The patient had earlier been treated at Toronto's Scarborough Grace Hospital, which has been the center of the province's SARS outbreak, D'Cuhna said.      Canada's previous three SARS deaths were also in the Toronto area, Canadian Broadcasting Corp. said.      Four Canadian provinces have reported about 100 confirmed or suspected SARS cases: Ontario (in the Toronto area), British Columbia, Manitoba (Winnipeg) and now in New Brunswick.      Dr. Wayne MacDonald, New Brunswick's chief medical health officer, told reporters Sunday that a teacher in Miramichi had developed symptoms of SARS before returning from a trip to China last Monday. He said the teacher had voluntarily quarantined herself until all symptoms disappear, but 60 people she was in contact with are being monitored.      CBC also said that health officials are monitoring three more suspected cases of the illness in British Columbia, in addition to a dozen previously reported cases. There's only been one confirmed case in the province, but about 10,000 residents of British Columbia travel each month to and from high-risk areas in Asia. The province has a large number of immigrants from East Asia.      The network also said that Ontario authorities have asked anyone who recently visited Scarborough Grace Hospital or York Central Hospital, both in greater Toronto, to stay home for a 10-day period. It said Toronto police have joined private security guards in keeping non-essential visitors from visiting the two area hospitals affected by the quarantine.      Separately, media reports in Asia detailed the spread of the syndrome in the region. Among the developments reported:      -- Taiwan might limit contacts with China to try to control the spread of SARS, with a decision possible Monday, the British Broadcasting Corp. said. Taiwan-China transport links generally go through a third nation. Taiwan has declared SARS an "infectious disease" subject to quarantine and banned visits by civil servants to affected areas, including China, Hong Kong and Vietnam.      Taiwan's Center for Disease Control put the number of local probable cases at 12, most of them reporting the illness after trips to China and Hong Kong. But several hundred other people are on a so-called "home confinement list."      -- In Hong Kong, the Standard newspaper reports 13 people had died of SARS in the Special Administrative Region as of Saturday: the latest victim was a 74-year-old woman. At one residential complex -- Amoy Gardens -- 121 people have so far been reported ill with SARS. The total number of those infected with SARS has passed 500, according to the Standard, with 60 new cases identified Saturday alone -- including six medical staff.      The Standard also reported that the South Korean consulate-general's office had warned its nationals to leave Hong Kong. The warning reportedly appeared in a weekly newsletter to the approximately 16,000 South Korean residents of the SAR.      -- Singapore Health Minister Lim Hng Kiang said his nation probably faced a longer-term situation with SARS than previously expected. He told reporters in Singapore on Sunday that the disease appeared to have a sub-set of cases involving what he termed "super-infectors." These were victims who were much more infectious than others and therefore affected many others.      He said that there had been only one such case in Singapore, but he added: "I don't want Singaporeans to be lulled into complacency. Because the problem is not going to stop next week or two weeks."      -- Thailand will detain arrivals who are suspected of carrying SARS for 24 hours, the health minister said. ChannelNews Asia quotes Sudarat Keyuraphan as saying that the measure wasn't based on the specific situation in Thailand but on the worsening regional situation.      Thailand had its first SARS death this weekend when Dr. Carlo Urbani, the World Health Organization doctor who first alerted colleagues to SARS, died of the illness in Bangkok.      -- Malaysia's Health Ministry sent a fact-finding team to Singapore to collect information on the treatment and prevention of SARS. Health Minister Datuk Chua Jui Meng said one team member was Dr. Chua Kaw Bing, one of those who identified the Nipah virus that caused an outbreak in Malaysia's pig population in 1998-99. The Star newspaper said that Malaysia had stationed medical personnel at the Causeway -- a major route that connects Malaysia and Singapore -- and distributed health cards to entering travelers.      It said that patients were being isolated if they were suspected of having SARS, but it didn't give any details on how such cases there might be.      There have been about 1,550 reported cases of SARS worldwide, with 54 deaths in 15 countries.

Canada NewsWire

TORONTO, March 30 /CNW/ - In response to new information from the Commissioner of Public Security and the Commissioner of Public Health, St. Michael's Hospital is taking additional measures to ensure maximum protection for patients, staff and physicians. There is one suspected or probable SARS case identified within St. Michael's Hospital.
The reason behind the precautions is to ensure that we will be able to continue to provide essential patient care, by limiting movement in and out of the hospital as much as possible. The following measures are in effect until Friday April 4:
-   Emergency, Medical Day Care, Dialysis, TB Clinic, Prenatal clinic (with limited daily access) will remain open.
-   All elective inpatient and day surgery will be cancelled.
-   Only urgent and emergent services will be provided in the following areas: Cardiac Catherization and Pacemakers, Medical Imaging, Cystoscopy/Lithotripsy, Nuclear Medicine.
-   All outpatient clinics in the main hospital building (30 Bond), 61 Queen, 55 Queen or 38 Shuter and Family Practice Outreach to hostels and shelters are closed. There will be no physician office appointments in any of these locations.
-   Visitors to the hospital will continue to be restricted to parents of pediatric patients and those visiting critically ill or palliative patients.
-   Everyone moving through the hospital, including patients, authorized visitors, staff and physicians, will be required to wear masks at all times.
-   All staff and physicians in patient care areas must wear full protective clothing at all times (mask, gown, gloves and goggles).
-   As directed by the provincial government, St. Michael's cannot accept transfers from hospitals outside the GTA or in Simcoe County, or non-urgent transfers between health care facilities within the GTA.
-   No volunteers or students should come to the hospital until further notice.
-   All patients and visitors will enter and exit the hospital via the Queen Street entrance. Staff and physicians will enter via the Victoria Street entrance and exit via the Queen Street entrance.
-   All patients, visitors, staff and physicians will be screened every time they enter the hospital and are therefore encouraged to minimize movement in and out of the hospital as much as possible.
-   All receiving will be restricted to the receiving area on Shuter and Victoria Streets and will be limited to essential goods and servicesnecessary to run the hospital.
-   A St. Michael's Hospital hotline has been set up for public inquires at 416-864-5005.

St. Michael's Hospital is committed to taking precautionary measures in order to protect our patients, staff and physicians, while ensuring that we provide the best possible care. We would like to thank the media and the public for their cooperation in helping us to meet this commitment.

For further information: Darlene Frampton, Director of Corporate Communications, St. Michael's Hospital, Telephone: (416) 864-5488, Pager via Locating: (416) 864-5431

For more information visit: www.health.gov.on.ca

Sunday, March 30, 2003 By DANIEL YEE <a href=www.cantonrep.com>Associated Press writer

Putting on surgical masks, domestic workers from the Philippines read their hometown newspapers during their weekly day off on Sunday in Hong Kong where the new flu-like disease shows no signs of letting up. The disease has killed at least 55 worldwide.

ATLANTA — U.S. health officials said Saturday that none of the antiviral drugs and other treatment they have tested are effective against a flu-like disease that has killed at least 54 people and sickened nearly 1,500 others around the world.

They also expanded their travel advisory, suggesting that anyone planning nonessential travel to mainland China, Hong Kong, Singapore or Hanoi, Vietnam, “may wish to postpone their trips until further notice.”

“The global epidemic continues to expand,” said Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention. “We recognize this as an epidemic that is evolving.”

The CDC has reported 62 cases of severe acute respiratory syndrome, or SARS, in the United States, and at least 35 cases have been reported in Canada, where three people have died.

But the majority of the cases have been in Asia, where the illness is believed to have originated.

On Saturday, the first doctor to realize the world was dealing with an unfamiliar disease died of the illness in Thailand. Dr. Carlo Urbani, 46, of Italy, a World Health Organization expert on communicable diseases, became infected while working in Vietnam, where he diagnosed a U.S. businessman hospitalized in Hanoi, the U.N. agency said. The businessman later died.

U.S. health officials believe illness comes from a new form of coronavirus, the virus that causes about a fifth of all colds.

Gerberding said Saturday that no successful drugs or treatments had yet been found.

“We have no evidence that any specific antiviral, steroid treatment or other agents that are targeting this virus have any benefit to patients,” she said.

Two possible diagnostic tests that detect antibodies, indicating a person’s immune system has reacted to the virus, are under development, and CDC officials hope to soon be able to supply those tests to state health departments, CDC officials said.

In Hong Kong, the number of people suffering from flu-like disease increased sharply Saturday to 12 people killed and 470 sickened. Hong Kong health secretary Dr. Yeoh Eng-kiong said more residents likely will become sick. More than 1,000 have been quarantined.

Thousands of Hong Kong residents donned surgical masks but many others refused to venture out, and activity in the usually bustling city stopped. Schools were closed and some companies shut down after workers became sick.

Singapore, which has had two deaths, nearly doubled the number of people quarantined to more than 1,500 on Friday.

The illness appears to have originated in China, which has been criticized for being slow in reporting cases. WHO officials who went to China to investigate the disease said Beijing has promised to improve monitoring of the illness, with daily updates from every province.

“We are desperate to know more about the scope and the magnitude of” SARS in China, Gerberding said. “It’s the biggest predictor of where this will be headed in coming weeks.”

On the Net: CDC: www.cdc.gov World Health Organization: www.who.int

<a href=www.abs-cbnnews.com>abs-cbnNEWS.com monitor

TORONTO - Health officials closed a second Toronto-area hospital to new patients and asked hundreds of its employees to quarantine themselves as a deadly flu-like illness continued to spread worldwide.

Anyone who has worked at York Central Hospital since March 16 has been asked to stay in their homes for 10 days to try to contain the outbreak of severe acute respiratory syndrome, hospital president Frank Lussing said Saturday. The hospital has 1,800 employees.

The disease has killed three people in Canada and caused authorities to advise thousands of people in Toronto, the largest city, to quarantine themselves at home. Worldwide, the disease has killed at least 54 people and sickened nearly 1,500.

U.S. health officials said Saturday that none of the antiviral drugs and other treatment they have tested are effective against SARS.

On Saturday, the disease killed Dr. Carlo Urbani, the World Health Organization doctor who was the first to identify the latest outbreak when it appeared in Vietnam.

Canada Newswire

TORONTO, March 30 /CNW/ - Ontario's lack of preparedness for the outbreak of Severe Acute Respiratory Syndrome (SARS) has nurses extremely worried about the health of their patients, the community at large and their own safety, says Barb Wahl, RN, President of the Ontario Nurses' Association (ONA).
"We're seeing a shortage of supplies, especially the N-95 masks that nurses need to wear to protect themselves and the public. This is putting the public in danger," says Wahl. "These masks are essential gear in an event like this to stop the further spread of infection, and yet our nurses say some facilities are rationing them."
"Nurses also have reported they are being excluded at some facilities from meetings where plans are being formulated to deal with the outbreak. This is unacceptable to our members and should be unacceptable to the public," said Wahl.
Currently the majority of SARS cases in Ontario are front-line nurses and doctors, while many more are in quarantine in their homes awaiting to see if they will develop the disease. More nurses have been reporting symptoms, which means their families and colleagues are also at risk.
"With a nursing shortage already hampering our ability to provide safe patient care in Ontario, we can't afford to see even one of our nurses sidelined with SARS, especially during an outbreak like this. It is essential that they are fully protected when caring for these patients," said Wahl.
Asked to notify ONA if any of their employers are not complying with the provincial 12-point directive to Toronto and GTA facilities for containment of SARS, nurses have been reporting some alarming scenarios, including:
- some facilities haven't got N-95 masks to provide to staff.
- nurses are being made to wear masks beyond their effectiveness because of rationing or limited supplies.
- nurses are being told to decided for themselves whether or not they need to wear a mask.
- nurses are being asked to care for both SARS patients in isolation wards and non-SARS patients in regular wards, which increases the chances of contamination.
"If we are to control this outbreak and ensure that more health care workers aren't infected, they must be provided with full protective gear for treating SARS patients," said Wahl. "That includes gowns, gloves, eye protection and masks. And as the front-line care providers, nurses must be involved in planning and implementing strategies for dealing with the outbreak."
ONA is urging the provincial government to broaden its 12-point directive to facilities across Ontario, which includes visitor restrictions, encompassing hospitals, homes for the aged, nursing homes, retirement homes, and home care in the community.
"We strongly recommended facilities be closed to visitors early last week and yet many facilities are continuing to allow the public to come and go at will. This has to stop. We can't emphasize this enough," said Wahl.
ONA is the union representing 46,000 registered nurses and allied health professionals working in hospitals, long-term care facilities, community agencies, industry and other settings across Ontario.

For further information: Laura Ziemba, (416) 803-8028