WHO May Renew Toronto Alert if SARS Jump Confirmed

http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030611/wl_canada_nm/canada_sars_who_col_9 ^ | Richard Waddington

[IYAAYAS]

GENEVA (Reuters) - The World Health Organization (news - web sites) may renew a warning against travel to Toronto if a feared upsurge in SARS (news - web sites) was confirmed in Canada's largest city and business capital, a WHO spokesman said on Wednesday.

But there was "nothing automatic" about issuing a call to avoid unnecessary travel to Toronto, even if the suspected outbreak could push it further above some WHO trigger points for such alerts, spokesman Iain Simpson added.

Canadian health officials said on Tuesday they were investigating 12 pneumonia patients at a Toronto clinic who had developed symptoms of the potentially fatal respiratory disease.

Also on Tuesday, officials said a U.S. traveller from North Carolina, who visited a friend at a hospital in the city in mid-May, had developed fever, pneumonia and then SARS a week after returning home.

"It (the upsurge) would be a reason for us to look at the situation again," Simpson told Reuters, although no decision would be taken before Friday when the WHO travel review body next meets.

"(But) there is nothing automatic about the travel recommendation. It is a judgement about whether there is a risk for people travelling to that area," he said.

WHO issued a travel alert on Toronto, the only place outside southeast Asia where people have died of SARS, in April before withdrawing it a week later after angry Canadian protests.

The warning hurt tourism, and Toronto is still cancelling shows and suffering high hotel vacancies.

In issuing an alert, WHO weighs several factors including the number of outstanding cases, the rate of new infections and the danger that the area could export the disease elsewhere.

Toronto already has slightly more than the 60 current cases WHO uses as one of its potential triggers. The number of probable cases dropped to 64 on Tuesday from 66 on Monday in and around Toronto, a city of four million people.

SARS, which has no simple treatment, originated in southern China last November and has spread to 30 countries and killed about 780 people worldwide.

[IYAAYAS]

Figured this needs its own post, a milestone, Canada probably going back on the list Friday. (export already confirmed, reads like a heads-up)

[IYAAYAS]

I retract my remark. Canada will not be on a WHO travel advisory list. Toronto the city maybe, but not Canada the country. Toronto is a medium sized city in N.America, Canada is an entire country, almost the size of Texas.

[xJones]

Canada is an entire country, almost the size of Texas.

Actually Canada is bigger than the U.S., if you count tundra and ice.

[IYAAYAS]

Ya right.

[blam]

"Canada will not be on a WHO travel advisory list. Toronto the city maybe, but not Canada the country. Toronto is a medium sized city in N.America, Canada is an entire country, almost the size of Texas."

Okay, then where is Peoria?

[xJones]

Okay, then where is Peoria?

I don't know, somewhere in Illinois maybe, and we're marching toward it.

[dc-zoo]

Tundra and ice doesn't count.

[Future Useless Eater]

Canada Toronto probably going back on the list Friday.

I beg to differ...
Toronto still has 2 days to 'massage' their numbers and may try to scrub their caseload down to 59 active 'probable' cases by Friday.

• They may 'reassign' some to the 'suspected' category
• They may declare some sick patients 'recovered'
• They may 're-diagnose' a few as TB or something else

Wednesdays numbers...
Ontario reports 234 probable (65 active) and 133 suspect (7 active) cases.

Watch for lower numbers Thursday, and if still not there, watch for a 1st-ever early-in-the-day report of their numbers, (below 60 'probable' cases of course) on Friday

[Truth29]

"Toronto still has 2 days to 'massage' their numbers ..."

Unfortunately, Toronto and Ontario officials have a credibility problem. Some of us now suspect that politics are interferring with accurate reports and containment efforts. If that were to become confirmed, such as by the recently authorized investigations or the nurse's association, they will do long-term harm to Toronto that will last long after SARS has really been contained.

[aristeides]

New cluster possible at seniors' homes: Durham region: More than 20 residents displaying mild symptoms.

[aristeides]

WHO voices major concern over SARS in Toronto.

[aristeides]

SARS Takes Toll on Nurses : Ontario's Second Outbreak Strains Health Workers, System .

[aristeides]

HK Back on Edge as Cab Driver Contracts SARS.

[Betty Jo]

Thats PRETORIA, right?

[xJones]

Got me, you're right! :)

[Dr. Luv]

"I retract my remark. Canada will not be on a WHO travel advisory list. Toronto the city maybe, but not Canada the country. Toronto is a medium sized city in N.America, Canada is an entire country, almost the size of Texas."

In fact Canada is the second largest country in the world in terms of size, behind Russia and far larger than the entire U.S. Comparing city to city, Toronto is about the same size as Chicago...

[aristeides]

China Says Antibody Offers a Way to Diagnose SARS. Hope this pans out.

[aristeides]

Antibody Find Sheds Light on Mild SARS Cases. I've already speculated on this board that mild cases may not be very infectious. Apparently empirical evidence is appearing bearing this out.

[aristeides]

Whitby cluster looking less like SARS, say experts: Apparent lack of transmission to health workers suggests SARS not involved.

[blam]

"Whitby cluster looking less like SARS, say experts: Apparent lack of transmission to health workers suggests SARS not involved."

I thought this is where the North Carolina person was infected?

[aristeides]

I believe the NC man is thought to have been infected in a Toronto hospital (North York?).

[jacquej]

I am trying to remember when the Whitby cluster developed... having a hard time, but it seems that it hasn't been long enough.

Thank you for the pinging and posting, Aristeides. I am following the situation closely, but now deferring to your excellent work on keeping us all up to date.

[aristeides]

Speaking of that NC man, 2 co-workers of N.C. man who developed SARS after Toronto visit in (isolation after developing pneumonia). The place in Toronto the man is thought to have caught SARS in turns out to have been the Baycrest Centre for Geriatric Care.

[blam]

"Officials said they remained hopeful that the two would not be diagnosed with SARS for two reasons: the man had no symptoms at work and there are no cases of someone catching SARS from an asymptomatic person; and the workplace has not typically been the place where people contract the illness.

LOL. That's because most of the cases have benn in the hospital, silly.

[aristeides]

I take it the man works at some place in the University of North Carolina, Chapel Hill. Anybody know exactly where?

[aristeides]

WHO to downgrade Toronto handling of SARS . But no travel advisory, at least so far.

[aristeides]

Liquorice may tackle SARS: After trying all sorts of compounds researchers say root extract looks promising.

[aristeides]

HONG KONG BACK ON EDGE: Appeal out for those who rode with Sars cabby .

[aristeides]

SARS-hit Ontario health system one disaster from collapse: cabinet document.

[aristeides]

Australian teen in SARS scare. He visited Toronto 12 days ago. Seems unlikely he would have visited a hospital.

[per loin]

I thought they already had antibody tests but that such tests were not useful until several weeks into the disease. Any idea how soon in the disease this one might be useful?

[aristeides]

I have no idea.

[aristeides]

Come fall, beware of SARS

By Anita Weier
June 12, 2003

The real danger from severe acute respiratory syndrome, known as SARS, will come this fall and winter, warns Dr. Dennis Maki, a University of Wisconsin Medical School professor.

"Will it explode on the world when we all go indoors?" Maki said.

Maki, a renowned expert on infectious diseases, told the Downtown Rotary Club on Wednesday that the parallels to the 1918 influenza epidemic, which killed 50 million people worldwide, are frightening.

"The source was an animal-human recombinant" - related animal and human viruses that mix to form a new virus that has features of both. "They both arose in southern China, where millions of people live on the land under the same roof as animals. And there is no natural immunity," Maki said.

"You never see influenza in the summer. In 1918 it spread all summer, and in September it burst on the world. SARS has smoldered all spring. Most respiratory viruses spread like wildfire in the fall."

Whether SARS will do so remains to be seen. But Maki is certain that other diseases most people know little about lie ahead.

http://www.madison.com/captimes/news/stories/50719.php.

[DannyTN]

"But there was "nothing automatic" about issuing a call to avoid unnecessary travel to Toronto, even if the suspected outbreak could push it further above some WHO trigger points for such alerts, spokesman Iain Simpson added. "

Sound like the "Hedgeomatic" machine is in full force. I don't think Toronto's going back on the list unless it really gets bad.

Don't want some politician complaining to the press. "Who did they talk to? Did they talk to the Hospitals?

[IYAAYAS]

Counting down to <60 by Fri morning it looks like. Maybe WHO isn't going to play their game though. The last paragraph is interesting, the truth will lie in the new provisions of this act.

[IYAAYAS]

Have you seen this?

[IYAAYAS]

Sorry, HTML is to complicated.

http://www-micro.msb.le.ac.uk/3035/Coronaviruses.html#SARS

[Future Useless Eater]

Toronto still has 2 days to 'massage' their numbers and may try to scrub their caseload down to 59 active 'probable' cases by Friday.

Watch for lower numbers Thursday

Just as I predicted... Toronto's new 'improved' numbers were out late today, and they reported EXACTLY what they NEEDED TO REPORT!!!

Ontario is reporting 238 probable (60 active) and 133 suspect (4 active) cases.

That PLUS, for reasons I don't understand, the WHO ALWAYS records 1 patient less than what Canada publishes. So tomorrow's WHO charts WILL indicate the magic '59' active cases!

WHO will have its hands tied from this, and WILL NOT be able to issue a travel warning to Toronto!

This successful deception that will be rewarded tomorrow can only encourage more countries to lie about SARS.

[IYAAYAS]

My humble apologies. I remember you predicting this yesterday, but I posted to aristeids because I was too lazy to double check.

I'm betting they will impose a new travel restriction tommorow. A close reading of the wording of the last two articles on this subject leads me to this belief. I think the jig is up for Toronto, they weren't smart enough not to be obvious. Of course, as always, I'll be the first to admit I was wrong.

[flutters]

But Maki is certain that other diseases most people know little about lie ahead.

Not a pleasant thought.

[aristeides]

WHO expresses concern about SARS contact tracing in Toronto outbreak.

[flutters]

This stinks. I think Canada has lied about SARS cases from the start.

Thanks for all your work FL_engineer. You're a whiz at deciphering the information. We’re lucky to have you.

I’m off to update the SARS threads. I won’t be around this weekend so I’ll get the weekend threads posted Sunday evening.

I hope all of you have a great weekend.

[aristeides]

Co-Workers At UNC-Chapel Hill Worry About Exposure To SARS Patient: N.C. Health Officials To Hold Briefing Thursday . Man worked as an "energy consultant" at UNC-Chapel Hill. I wonder what that means.

[Calpernia]

Curious.

If WHO issues a travel warning 'to' an area, what does that mean for residents of that area to travel out?

It is summer time. Time of the Canuck migration down route I95 to North Carolina's Outer Banks.

So, if they have a travel warning for us going there...what about them coming here?

[flutters]

I forgot to add that the news is reporting a new SARS case in Ohio tonight. This is number 14 for us. I haven't been able to find any information since case 11.

[aristeides]

what about them coming here?

My guess is, that's a lot less dangerous. Almost all the spread seems to occur in hospital and household settings.

[aristeides]

Health Officials Retrace (NC) SARS Patient's Steps.

[aristeides]

WHO unhappy with Toronto .

[Calpernia]

What about the Chapel Hill reference? Could be from the tourists....

[aristeides]

The guy in Chapel Hill seems to have gotten SARS from visiting a nursing home in Toronto.