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Canada Reports 33 New Possible SARS Cases
Reuters ^ | May 24, 2003 | Rajiv Sekhri

Posted on 05/24/2003 5:17:01 PM PDT by CathyRyan

TORONTO (Reuters) - Ontario health officials said on Saturday they were monitoring 33 people for the deadly SARS virus with another 500 in quarantine and warned that the number of suspected cases could grow in coming days.

The possible SARS cases, up from 25 on Friday, have put hospital emergency rooms on high alert and raised concerns that the World Health Organization may again slap a travel advisory on Canada's largest city. Nurses are again wearing full-face masks and double gloves to protect themselves.

The U.N. agency last week said Canada was free of the spread of the deadly disease, which has killed 24 people in the Toronto area, the only place outside Asia where there have been SARS deaths. Officials are also investigating two more deaths to determine if they are SARS related.

All told, there have been 257 probable cases of SARS in Ontario province. Six remain hospitalized.

"This is still an institutional outbreak," said Dr. Donald Low, chief of microbiology at Mount Sinai Hospital. "This is not a disease that does well in the community."

Health officials said the public should not panic, but the news has prompted the U.S. Centers for Disease Control to tell travelers to take care if they visit Canada's largest city.

For several weeks it seemed Canada's battle with SARS was nearly over. No new cases had been recorded since April 19, a month after the outbreak first started in Canada in mid March.

"The cases do not currently meet the probable or suspect case definition set out by the WHO and the CDC," said Dr. Colin D'Cunha, Ontario's chief medical officer of health. He said officials were treating them as Severe Acute Respiratory Syndrome to be safe. The new possible cases, along with the discovery of mad cow disease in Alberta, is sending shock waves through the economy of Toronto and Canada. The United States and several other countries have banned Canadian beef imports.

Canadian health officials have also warned about West Nile virus as mosquito season starts with the summer near.

An editorial cartoon in Saturday's National Post showed a family exclaiming " AAh ... the weekend!" all dressed in head-to-toe protective suits, including the dog.

Toronto businesses are worried the summer might bring just a trickle of tourists instead of the millions who visit Toronto, which accounts for a fifth of Canada's economy.

"Economically, this (SARS) is far worse than the fallout from the (Sept. 11) terrorist attacks," Rod Seiling, president of the Greater Toronto Hotel Association, said. Occupancy levels were 46.7 percent in April at hotels in the greater Toronto area -- which has about 4.5 million people -- down from 68 percent in April 2002.

Most worry that another WHO travel advisory could send an economic recovery into a tailspin.

A WHO spokesman in Geneva said there was no talk or risk at the moment of a travel advisory being reinstated on Toronto.

WHO's Iain Simpson said in Geneva that Canada will get back to the agency with more information on Tuesday.

"Until then we won't know much more," he said.


TOPICS: News/Current Events
KEYWORDS: canada; sars; toronto
Navigation: use the links below to view more comments.
first 1-2021-24 next last

1 posted on 05/24/2003 5:17:01 PM PDT by CathyRyan
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To: CathyRyan
Canada is possibly reporting, maybe, 33 new and some old possible, maybe or maybe not, SARS cases or maybe they are cases of CRAP. We just can't be sure.

We also can't be sure of "reporting" like this, possibly.
2 posted on 05/24/2003 5:30:37 PM PDT by ido_now
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To: CathyRyan
This is just the last thing Canada needed. First, we,ve a stupidly anti-American Prime Minister who has completely baubled the relationship with the US. We have many trade disputes with the USA. Now we have a new outbreak of SARS, and the mad cow disease which will block our beef. The real problem is that our American friends will now hear nothing but bad news, week after week, from Canada. I want to remind them. over and over, that the lame-duck Chretien does not represent the good feelings and great respect we have for our USA friends. He doesn't represent public opinion which is broadly pro-American.
3 posted on 05/24/2003 5:35:42 PM PDT by johns4
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To: CathyRyan
That's it for Toronto's summer tourist season....it's really gone now, there's not time enough to recover....they'll lose a hundred million or more...
4 posted on 05/24/2003 5:38:20 PM PDT by johns4
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To: johns4
The Dominion may be lurching into some hard times. Just pray it peaks before the election. If Alliance and PC can't join forces, the only hope is a catastrophic Liberal loss.
5 posted on 05/24/2003 5:43:49 PM PDT by gcruse (Vice is nice, but virtue can hurt you. --Bill Bennett)
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To: johns4
The real problem is that our American friends will now hear nothing but bad news, week after week, from Canada

You do realize, don't you, that all WE hear about the United States day in and day out is bad news from our media,?

Relax. We don't believe most of what we read until we have the facts.

6 posted on 05/24/2003 5:46:06 PM PDT by Howlin
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To: gcruse
The Liberal Party has hijacked Democracy in our now tinpot one-Party State. Like in Africa or somewhere...Canada has no hope of a functioning democracy with a real opposition for years, it's really too bad. Out here in the West a growing number like me, want separation from the terrible grip of the eastern Liberals. British Columbia should look to its future as a separate country . We're desperate to be rid of semi-Socialist Canada.
7 posted on 05/24/2003 5:55:27 PM PDT by johns4
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To: CathyRyan
Ugh. Just went up to Niagara-On-The-Lake on Tuesday evening to see a preview of "Widower's Houses" at the Shaw Festival. As it was a preview, it was not full, but I kept wondering "Have any of these folks been to the North York area?".

I heard some people cough here and there, but I'd say people acted fairly normally. I would venture to say that The Shaw Festival will see a decline in attendence this year if folks are afraid to travel to Ontario at all. When I passed back through the US border, there was no questions at all about how I physically felt, etc.

8 posted on 05/24/2003 6:04:06 PM PDT by Fury
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To: CathyRyan; Judith Anne; Mother Abigail; per loin; Dog Gone; Petronski; InShanghai; Ma Li; ...
Ping.
9 posted on 05/24/2003 6:09:50 PM PDT by aristeides
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To: CathyRyan
If this creeps south, and gets into a third world country like Detroit, it may never be stopped.
10 posted on 05/24/2003 6:18:25 PM PDT by per loin (DANGER: The alphabet has been set on stun. Post carefully.)
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To: aristeides
"This is still an institutional outbreak," said Dr. Donald Low, chief of microbiology at Mount Sinai Hospital. "This is not a disease that does well in the community."

Let's quit hospitalizing SARS patients, then, right?

11 posted on 05/24/2003 6:19:26 PM PDT by Dog Gone
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To: CathyRyan
Latest pro-med:

SARS - WORLDWIDE (119): CASES
***************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


In today's update:
[1] Worldwide - WHO
[2] Taiwan - CDC Taiwan
[3] China - WHO/Beijing Government
[4] Hong Kong - DOH
[5] Singapore - MOH
[6] Canada - Health Canada
[7] Travel Alert - CDC USA
[8] News briefs
   [A] Canada
   [B] Canada
   [C] Cambodia - NOT
   [D] China - earlier cases?

**********
[1]
Date: 24 May 2003
From: ProMED-mail  
Source: WHO SARS website [edited]


[A] Cumulative Number of Reported Probable Cases of Severe Acute
Respiratory Syndrome (SARS)


From: 1 Nov 2002 To: 24 May 2003, 19:00 GMT+2

Country: Cumulative no.case(s)/ no. new cases since last WHO update/ no.
deaths/ no. recovered/ date last probable case reported/ date cumulative
no. cases is current

Australia:    6/    0/    0/    6/    12/May/2003/    22/May/2003
Brazil:    2/    0/    0/    2/    10/Apr/2003/    24/Apr/2003
Canada:    140/    0/    23/    109/    4/May/2003/    23/May/2003
China:    5309/    34/    308/    2675/    24/May/2003/    24/May/2003
China, Hong Kong
SAR:    1724/    0/    262/    1266/    23/May/2003/    24/May/2003
China, Macao SAR:    2/    0/    0/    0/    21/May/2003/    23/May/2003
China, Taiwan:    538/    55/    60/    82/    22/May/2003/    22/May/2003
Colombia:    1/    0/    0/    1/    5/May/2003/    5/May/2003
Finland:    1/    0/   0/    1/    7/May/2003/    20/May/2003
France:    7/    0/    0/    6/    9/May/2003/    22/May/2003
Germany:    9/    0/    0/    9/    9/May/2003/    23/May/2003
India:    3/    0/    0/    3/    13/May/2003/    14/May/2003
Indonesia:    2/    0/    0/    2/    23/Apr/2003/    23/May/2003
Italy:    9/    0/    0/    9/    29/Apr/2003/    24/May/2003
Kuwait:    1/    0/    0/    1/    9/Apr/2003/    20/Apr/2003
Malaysia    8    0    2    5    20/May/2003    23/May/2003
Mongolia:    9/    0/    0/    8/    6/May/2003/    19/May/2003
New Zealand:    1/    0/    0/    1/    30/Apr/2003/    23/May/2003
Philippines:    12/    0/    2/    10/    15/May/2003/    24/May/2003
Republic of Ireland:    1/    0/    0/    1/    21/Mar/2003/    23/May/2003
Republic of Korea:    3/    0/    0/    2/    14/May/2003/    23/May/2003
Romania:    1/    0/    0/    1/    27/Mar/2003/    22/Apr/2003
Singapore:    206/    0/    31/    163/    18/May/2003/    23/May/2003
South Africa:    1/    0/    1/    0/    9/Apr/2003/    3/May/2003
Spain:    1/    0/    0/    1/    2/Apr/2003/    7/May/2003
Sweden:    3/    0/    0/    3/    18/Apr/2003/    13/May/2003
Switzerland:    1/    0/    0/    1/    17/Mar/2003/    16/May/2003
Thailand:    8/    0/    2/    5/    13/May/2003/    21/May/2003
United Kingdom:    4/    0/    0/    4/    29/Apr/2003/    23/May/2003
United States:    65/    0/    0/    33/    17/May/2003/    23/May/2003
Viet Nam:    63/    0/    5/    58/    14/Apr/2003/   14/May/2003

Total:    8141/    89/    696/    4468

Notes:

Cumulative number of cases includes number of deaths.

As SARS is a diagnosis of exclusion, the status of a reported case may
change over time. This means that previously reported cases may be
discarded after further investigation and follow-up.

A decrease in the number of cumulative cases and discrepancies in the
difference between cumulative number of cases of the last and the current
WHO update are attributed to the discarding of cases.

[B] Areas with recent local transmission and travel recommendations can be
accessed at:   and
 and are unchanged
from yesterday's report.

[C] Update 65 - Situation in Toronto 24 May 2003


Situation in Toronto
---------------
Health authorities in Canada have today informed WHO that 2 clusters of
cases of respiratory illness are undergoing investigation for respiratory
illness, including pneumonia. One cluster of 5 cases is associated with St
John's Rehabilitation Hospital in Toronto. The second cluster of 26 cases,
including 10 health care workers, is associated with North York General
Hospital. One patient undergoing investigation has been linked to both
hospitals.

As a precaution, both clusters are being managed as possibly representing
cases of SARS until proven otherwise. Results of laboratory, clinical, and
epidemiological investigations are expected early next week.

The status of Toronto, which was removed last week from the WHO list of
areas with recent local transmission, remains unchanged pending further
information made available as the investigations progress.

Update on cases and countries
---------------------------
As of today, a cumulative total of 8141 probable cases with 696 deaths have
been reported from 28 countries. This represents an increase of 89 new
cases and 7 deaths when compared with yesterday. The new deaths occurred in
China (5) and Hong Kong SAR (2).

All of the new cases were reported from 2 outbreak sites, Taiwan and China.
Taiwan has today reported 55 new cases, bringing the cumulative total to
538 cases and 60 deaths. China reported 34 new cases, bringing the
cumulative total to 5309 cases and 308 deaths.

--
ProMED-mail


******
[2]
Date: 24 May 2003
From: ProMED-mail  
Source: Taiwan CDC Taiwan [edited]


SARS Update 24 May 2003 As of 9:00 AM
-----------------------------
Cumulative Probable Cases: 548
New cases last 24 hours: 10
Released from hospital: 102
Cumulative Deaths reported to WHO: 60

Cumulative Suspect Cases: 1042
New cases last 24 hours: 29
Released from hospital: 168

Total of probable & suspect cases: 1590
(270 of which have been released from hospitals today)

--
ProMED-mail


******
[3]
Date: 24 May 2003
From: ProMED-mail  
Source: WHO SARS website/Beijing Government SARS website [edited]



[The Beijing Government SARS website link is changed daily, but the
WHO  website maintains each daily report in archives. - Mod.MPP]

Data on the daily reports of cases by province, probable cases, suspected
cases, health care worker cases, number of deaths, number of cases
discharged from the hospital, and dates of last reported cases (probable
and suspected) can be accessed at the above WHO and Beijing Government
links.

There have been a total of 5309 probable cases reported to date, of which
34 are newly reported in past 24 hours. In the 24-hour period covered by
this update, new probable cases were reported from Beijing (26), Hebei (1),
Inner Mongolia (2), Liaoning (1), and Shanxi (4).  An additional 1632
suspected cases have been reported from the affected provinces.  No cases
(probable or suspected) have been reported from Guizhou, Hainan, Qinghai,
Tibet, Xinjiang, or Yunnan.

There are a total of 308 deaths reported due to SARS, of which 5 were newly
reported in the past 24 hours.

Of the 34 probable cases reported in the past 24 hours, 30 had been
previously reported as suspect cases. In Beijing, 24 of the 26 newly
reported probable cases had previously been reported as suspected cases and
1 previously reported probable case was excluded. In Hebei, the 1 newly
reported probable case had previously been reported as a suspected case and
6 probable cases were excluded, of which 2 were reclassified as suspect
cases.  In Inner Mongolia, both of the  newly reported probable cases had
previously been reported as suspected cases. In Shanxi, 2 of the 4 newly
reported probable cases had been previously reported as suspected cases and
1 previously reported probable case was excluded.

Case reports were received from 31 provinces/autonomous
regions/municipalities.

--
ProMED-mail


******
[4]
Date: 24 May 2003
From: ProMED-mail  
Source: Hong Kong Department of Health [edited]


***Noteworthy: no new probable cases reported

Situation report on Severe Acute Respiratory Syndrome 24 May 2003
-------------------------------------
Hong Kong has recorded zero [new infections] for the first time since it
[began waging] its war against Severe Acute Respiratory Syndrome
(SARS).  Speaking at a press briefing today (24 May 2003), Director of
Health, Dr Margaret Chan, reminded members of the public not to be [caught]
offguard in the prevention of SARS.  "We are glad that the figures are
improving significantly. However, there may still be fluctuations before
the situation stabilizes," she said.  "Therefore we must stay vigilant and
take measures to avoid contracting the disease and prevent its spread."

A total of 1266 patients have recovered from SARS and have been discharged
from public hospitals. Of them, 11 were discharged today. There are now 119
active cases under treatment in hospitals, of whom 40 patients are in
intensive care units. Most of the patients currently in hospital are
showing positive responses to the treatment protocol. In addition, 77 are
recovering patients in convalescence and in preparation for discharge.

2 patients died, bringing the total number of deaths attributable to SARS
to 262. The deaths were in 2 men aged 35 and 88.

The cumulative numbers of patients who have been admitted to public
hospitals with SARS since 12  Mar 2003 are:

Cumulative no. cases/ total no. discharged patients/ total no. deaths
(change in past 24 hours presented in parentheses with minus sign for
decrease)

Health care workers of Hospitals/Clinics and medical students: 380 (0)/ 342
(1)/ ?
Patients, family members & visitors: 1344 (0)/ 924 (10)/ ?
Total: 1724 (0)/ 1266 (11) / 262 (2)/ 196 (-13)

Total in hospital: 196 (-13)
Recovering patients in convalescence: 77
Active cases: 119 (-27)  (including  40  patients in Intensive Care Unit)

Suspected cases: 9

Additional epidemiologic analyses are available in the daily SARS bulletin
for 24 May 2003  

There is a table with the average number of new cases reported per day by
week demonstrating the steady decline in reporting:

Period: Average no. of new cases reported per day

29 Mar -- 4 Apr 2003: 48
5 Apr -- 11 Apr 2003: 43
12 Apr -- 18 Apr 2003: 38
19 Apr -- 25 Apr 2003: 26
26 Apr -- 2 May 2003: 14
3 May -- 9 May 2003: 8
10 May -- 16 May 2003: 6
17 May -- 23 May 2003: 3

There is a bar-graph representation showing the cumulative number of
discharged cases and fatal cases as a percentage of the cumulative total
cases on the respective reporting date available at the above given weblink
for the bulletin.  As of 23 May 2003, 73 percent of the 1724 SARS cases
have recovered and have been discharged from the hospital, and 15 percent
of cases have died.

--
ProMED-mail


******
[5]
Date: 24 May 2003
From: ProMED-mail  
Source: Singapore Ministry of Health [edited]


** Noteworthy: no new probable cases reported

SARS Situation update 24 May 2003
--------------------------
There were no new SARS probable cases reported today. One more patient has
been discharged, bringing the total number of patients who have recovered
from SARS to 164. 10 patients remained hospitalised, including 5 who are in
intensive care.

Suspect and Observation Cases
--------------------------
There were no new suspect or observation cases admitted to [Tan Tock Seng
Hospital] TTSH today.

Quarantine Figures*
------------------
**Discharged patients under home quarantine = 486
Contacts under home quarantine = 42
Total under home quarantine orders = 528

*Quarantine cases refer to those who are required to stay at home for
precautionary reasons as they may have had contact with a SARS patient.
These are healthy individuals.
** This is an added precautionary measure for discharged SARS patients as
well as those with co-morbidities.

A summary of SARS cases is as follows:
----------------------------
Discharged: 164
Hospitalised: 10 (including 5 in ICU [intensive care unit])
Deaths: 31
Probable cases: 206*
Suspect cases: 1
Observation cases: 3

*Includes 1 case who died from non-SARS causes

--
ProMED-mail


******
[6]
Date: 24 May 2003
From: ProMED-mail  
Source: Health Canada 23 May 2003 available for access 24 May 2003 [edited]


Summary of Severe Acute Respiratory Syndrome (SARS) Cases: Canada 23 May
2003
------------------------------------------------------------
Since 21 May  2003, no additional probable cases of SARS have been
reported. The total number of probable cases reported to date in Canada, by
reported symptom onset date and type of exposure (where known), is provided
[in Figure 1, Number of probable cases of SARS in Canada by symptom onset
date and exposure type 23 Feb 2003 to 23 May 2003, on above weblink -
Mod.MPP].

A cluster of 5 individuals with pneumonia has been linked to St. John's
Rehabilitation Hospital in Toronto, including 3 patients, one family
member, and one health care worker. Their onset dates of symptoms were
between 1 and 16 May 2003. 3 are in critical condition, one is stable in
hospital, and one has recovered after being treated with antibiotics and
has been discharged.

One of the 5 patients, a 57-year-old male who is immunocompromised due to a
prior lung transplantation, had one respiratory specimen (broncho-alveolar
lavage) positive for SARS-associated coronavirus (SARS Co-V) by PCR and
genetic sequencing.

2 cases in this cluster are in the same family. One is a patient at St.
John's Hospital, who shared the same room with the 57-year-old patient, and
had symptom onset on 15 May 2003.  The other travelled to Hong Kong,
returned on 22 Apr 2003, and developed the symptoms approximately 24 days
after her return [?16 May 2003]. Therefore, it is unlikely that she
acquired the illness abroad. However, she visited the hospital once on 11
May 2003.

Although the clinical presentations of the 5 patients are consistent with
SARS, they do not meet the SARS case definition, as to date, a definitive
epidemiologic link has not been established. An intensive investigation is
in progress to determine whether there is an epidemiologic link and to
confirm the presence of SARS Co-V within this cluster.

The current status of all probable and suspect cases in Canada as of 23 May
2003 is presented in Tables 1 and 2 [available at the above weblink]. Of
the 318 probable and suspect SARS cases identified to date, most (84
percent, 267 of 318) have been discharged from hospital or have recovered
at home. An additional 18 of the 318 (6 percent) suspect and probable cases
are currently stable or recovering at home.

As of 23 May 2003, a total of 140 individuals who meet the probable case
definition and 178 who meet the suspect case definition of SARS have been
reported, including 24 deaths (see Table 3 below). Since 21 May 2003, no
new probable or suspect cases have been identified, and no additional
deaths have been reported in Canada. The number of active cases is down as
a result of increasing numbers of probable and suspect cases who have
recovered from their illness.

Table 3: Cumulative Number of SARS Cases Reported in Canada: 23 May 2003

Province/Territory: Persons meeting the criteria for: probable case/
suspected case/ no. deaths**

British Columbia: 4/ 44/ 0
Alberta:  0/ 6/ 0
Saskatchewan: 0/ 1/ 0
Ontario: 136/ 121/ 24**
New Brunswick: 0/ 2/ 0
Prince Edward Island: 0/ 4/ 0

Total: 140/ 178/ 24
* Persons may be excluded from the probable or suspect case list if another
cause is identified to fully explain their illness. Case numbers may change
as cases are reclassified based on new information (e.g. disease
progression or re-evaluation of the data).

** 23 of 24 deaths were probable cases, while 1 was a suspect case. Another
death not included in this total count occurred in a 46-year-old female who
died in the Philippines on 14 Apr 2003. It is believed she may have
contracted SARS while in Toronto.

The list of at-risk settings in the province of Ontario can be obtained at
the following address:


--
ProMED-mail


******
[7]
Date: 24 May 2003
From: ProMED-mail  
Source: CDC SARS website [edited]


Travel Alert Reinstated: Toronto, Ontario, Canada (Released 23 May 2003,
4:00 PM)
-----------------------
On 8 May 2003, CDC issued a travel alert for Toronto. On 20 May 2003, CDC
lifted this travel alert because more than 30 days (or 3 SARS incubation
periods) had elapsed since the date of onset of symptoms for the last case.
On 22 May 2003, Health Canada reported a cluster of 5 new suspicious cases,
indicating new transmission in Toronto that is currently under
investigation. CDC is therefore reissuing a travel alert for Toronto,
Ontario, Canada.

In response to the SARS epidemic, CDC has issued 2 types of notices to
travelers: advisories and alerts. A travel advisory recommends that
nonessential travel be deferred; a travel alert does not advise against
travel but informs travelers of a health concern and provides advice about
specific precautions.

[Note that WHO, which removed Toronto last week from the WHO list of areas
with recent local transmission, has not changed the status of Toronto -- see
[1][C] above. - Mod.JW]

--
ProMED-mail


******
[8]
Date: 24 May 2003
From: ProMED-mail  
Source: News briefs [edited]

[A] Canada from Canada East 24 May 2003  [edited]


Officials of the World Health Organization and Health Canada held a
teleconference Saturday after the Geneva-based organization [requested]
additional information about a disturbing new large cluster of possible
SARS cases in the city.

"Health Canada is not reporting probable cases of SARS to us. They do tell
us that they are investigating 31 people with respiratory disease, 5 in one
cluster and 26 in another," said Dick Thompson, director of communications.
[Elsewhere the date of 22 Apr 2003 has been given for the date of onset of
the newly identified cluster in the York hospital - Mod.MPP]

[B] Canada from the Globe and Mail 24 May 2003


Health officials in Toronto had been hesitant to label 5 new cases at St.
John's Rehabilitation Hospital as SARS, because they have been unable to
establish a link with a known case of the disease. Last night, information
emerged that could firm up a connection. Government officials and doctors
said that a patient who was transferred to St. John's had been exposed to a
person at North York General Hospital who is now believed to have severe
acute respiratory syndrome.  It is unclear where that initial patient, who
has since died, contracted the disease.

At a press conference last night, Donald Low, chief microbiologist at Mount
Sinai Hospital, said the female patient transferred from North York
probably introduced SARS to St. John's. 3 of these 5 patients are in
critical condition; the other 2 are considered stable.  Before being
transferred, the woman from North York General had shared a ward with a
96-year-old patient recovering from a broken pelvis. That person had
exhibited signs of what was believed then to be routine postoperative
pneumonia but was probably actually SARS; the patient died on 1 May
2003.  The transferred woman went to St. John's on 28 Apr 2003 and within
days was displaying SARS-like symptoms.  However, without known connections
to a proven case of the disease, she was not treated as a potential SARS
case. She is believed to have passed the disease to a health-care worker at
St. John's.

One of these 4 people is believed to have passed the disease to a visitor
at St. John's. There is not believed to have been any community
spread.  However, in investigating the 5 cases, officials discovered a
cluster of previously unknown cases of SARS at North York General.

[C] Cambodia NOT SARS from Yahoo News 24 May 2003


A Cambodian boy isolated 3 days ago with symptoms of SARS has been given
the all-clear, the World Health Organisation said on Saturday [24 May
2003]. The 16-year-old, who was studying in a heavily infected part of
southern China, was put into a special SARS isolation unit on Wed [21 May
2003] after a local doctor alerted health authorities to suspect symptoms,
such as coughing and fever.  After 3 days of monitoring, officials said
tests had concluded the boy did not have the virus.  "He does not have the
definitions [criteria] of a probable case of SARS, and he has been
discharged from hospital," WHO country representative Jim Tulloch told
Reuters.

[D] China - earlier cases? from eTaiwan News 24 May 2003 [edited]


After reviewing several case records, scientists yesterday said that the
initial outbreak of severe acute respiratory syndrome may have erupted as
early as November 2001.

Dr. James Maguire, a team member from the U.S. Centers for Disease Control
and Prevention temporarily based in Beijing, who traveled to Guangdong to
investigate the SARS outbreak last month [April 2003], said that the death
of a Taiwanese man in Guangdong in January 2002 is the earliest suspected
case of SARS now known.

Maguire said [this] case was crucial to research on the disease, since he
doesn't think the case in November [2002] is the first one. After
discussing [this] with [the case's] family, Dr. Maguire said that requiring
doctors and hospitals in the area to review their patients' records would
be necessary, to investigate whether SARS emerged earlier than
expected.  [The case], who had worked in the Delta Electronics Group's
Dongguan plant for 7 years, died shortly after suffering  "flu symptoms" at
the age of 45. [Dongguan is east of Foshan where the November 2002 case was
reported and southeast of Guangzhou, the capital of Guangdong province. -
Mod.MPP]

[He was admitted to Guangdong's Shijie Hospital] and his cause of death was
eventually determined to have been  "pneumonia exhaustion."  Based on his
analysis, Dr. Chang Shang-chwen [of the National Taiwan University Hospital
determined] that the virus broke out in the fall or winter of 2001.  Chang
said he was told by [the] Guangdong doctor [who took care of this case]
that there were other cases who displayed similar symptoms and died in a
very short period of time, which makes him believe that the outbreak could
have erupted between the fall of 2001 and the winter of 2002.  Chang said
that the SARS outbreak could have temporarily disappeared [during the
summer of 2002] and then resurfaced last fall, which finally resulted in
the international outbreak.

--
ProMED-mail


******
[As of 24 May 2003 there have been a cumulative total of 8141 probable
cases of SARS with 696 deaths reported to WHO.  In the past 24 hours there
have been 89 new probable cases reported, of which 55 were from Taiwan and
34 were from China.  The daily SARS update available on the Taiwan SARS
update (see [2] above) reflects 10 newly reported probable cases in the
past 24 hours.  The number given on today's WHO update website is current
through 22 May 2003 (see Table in [1][A].

In the Health Canada SARS update (see [6] above), the newly identified
cluster of 5 cases of SARS-like illness has not been included in the tables
presenting numbers of probable and suspected cases.  According to the
discussion on the Health Canada website, this cluster does not currently
meet the epidemiologic criteria for inclusion in this list, as they have
not identified an epidemiologic link to SARS exposure (either through known
contact with an identified case of SARS or through travel to a geographic
area with known ongoing SARS local transmission).  The SARS-associated
coronavirus has been isolated from one of the cases. If this is confirmed,
then there will be a need to reassess the current case definition criteria
for epidemiologic exposure.  We await further information.

The newswire from Taiwan is curious, as it suggests there may have been a
smaller outbreak in Guangdong in late 2001. Given the extensive SARS
transmission that occurred in Guangdong during the period November 2002 to
April 2003, it would be very difficult to confirm this via serology, as the
presence of antibodies against the SARS-associated coronavirus would not
confirm when the infection occurred, just that there had been an infection
in the past.  Information from retrospective hospital chart reviews might
shed more light on this curious observation. - Mod.MPP]

[see also:
SARS - worldwide (118) cases  20030523.1270
SARS - worldwide (116) cases 20030522.1259
SARS - worldwide (115) cases 20030522.1258
SARS - worldwide (114): cases 20030521.1249
SARS - worldwide (93): etiology 20030505.1122
SARS - worldwide (87): case definition and diagnostics 20030502.1103
SARS - worldwide (85): clinical aspects 20030501.1094
SARS - worldwide (69): diagnostic testing 20030425.1015
SARS - worldwide (58): diagnostic testing 20030419.0958
SARS - worldwide (51): etiology 20030416.0925
SARS - worldwide (42): WHO historical overview 20030411.0878
SARS - worldwide (38): etiology 20030410.0869
SARS - Worldwide (34): etiology 20030408.0857
SARS - worldwide (13): etiology 20030327.0758
SARS - worldwide (04): etiology 20030325.0737
Severe acute respiratory syndrome - worldwide (17) 20030322.0713
Severe acute respiratory syndrome - Worldwide: alert (03) 20030316.0660
Severe Acute Respiratory Syndrome - Worldwide      20030315.0637
Acute respiratory syndrome - Canada (Ontario)      20030314.0631
Acute respiratory syndrome - East Asia      20030314.0630
Acute respiratory syndrome - China (HK), VietNam (03) 20030313.0624
Undiagnosed illness - Vietnam (Hanoi): RFI      20030311.0595
Pneumonia - China (Guangdong) (07) 20030221.0452
Pneumonia - China (Guangdong): RFI      20030210.0357]
...............................mpp/pg/jw


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12 posted on 05/24/2003 6:20:45 PM PDT by Cachelot (~ In waters near you ~)
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To: Cachelot; Judith Anne; Mother Abigail; CathyRyan; per loin; Dog Gone; Petronski; InShanghai; ...
Note the location of that Nov. 2001 case: [Dongguan is east of Foshan where the November 2002 case was reported and southeast of Guangzhou, the capital of Guangdong province. - Mod.MPP]
13 posted on 05/24/2003 6:25:25 PM PDT by aristeides
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To: per loin
If this creeps south, and gets into a third world country like Detroit, it may never be stopped.

Cheap shot..........I live 50 miles west of Detroit................We have indoor plumbing, I speak broken English and I do not have AIDS........Third World indeed!

14 posted on 05/24/2003 6:32:59 PM PDT by Tripleplay
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To: Tripleplay
If Detroit's not a third world country, then why doesn't it have a professional baseball team?
15 posted on 05/24/2003 6:38:34 PM PDT by per loin (DANGER: The alphabet has been set on stun. Post carefully.)
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To: johns4
I heard more really bad news last night on the 'Coast-to-Coast-AM' broadcast. It seems that Canada has been covering up its 'Mad Cow Crises' and the nasty prions have infiltrated more than just a few cattle herds. Alberta cattle feed more than Canadians. They feed Americans. Last night it was revealed that McDonalds Corp buys meat for hambergers from Alberta, Canada.

I predict that McDonald's buyers will be in a full panic mode by Tuesday May 27th. Further predict the American fast food industry will be decimated by 'Mad Cow Madness' in about 60 days.

As for me -- I will not be buying any meat unless I am absolutely sure of its original source. May take a trip to Montana to fill up my freezer.

16 posted on 05/24/2003 6:42:34 PM PDT by ex-Texan (primates capitulards toujours en quete de fromage!)
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To: CathyRyan
Canada Reports 33 New Possible SARS Cases

A friend's wife had to go to Vancouver recently for an academic conference.
He asked me if I thought it was safe for her to go.
I said "Sure it's safe to go...but if she gets sick, tell her to REFUSE
to be hospitalized in Canada...tell her to hire an ambulance to get her
back to the USA first."
17 posted on 05/24/2003 6:46:34 PM PDT by VOA
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To: per loin
If Detroit's not a third world country, then why doesn't it have a professional baseball team?

Because we don't want to embarass the Lions.

18 posted on 05/24/2003 6:49:39 PM PDT by Tripleplay
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To: CathyRyan
"Canadian health officials have also warned about West Nile virus as mosquito season starts with the summer near."

I guess the news wasn't bad enough so, throw this in too?

19 posted on 05/24/2003 6:55:40 PM PDT by blam
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To: ido_now
My friend, who is a nurse in Ontario. told me this morning about there being a bunch of new cases. I can't remember the exact number she mentioned. Pretty scarey up there. I am keeping her, her husband(also works in a hospital) and their children in my prayers. She said they are very cautious in how everything is handled, but still...
20 posted on 05/24/2003 7:32:56 PM PDT by ozaukeemom
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