- The Washington Times - Tuesday, April 29, 2003

The SARS epidemic appears to have peaked in Singapore, Hong Kong and Canada, and has been contained in Vietnam, the World Health Organization said yesterday.
"We're on a downward curve at the moment" in these areas, said WHO spokesman Dick Thompson. "That doesn't mean that it can't climb back up."
The respiratory virus continues to spread elsewhere in China, and WHO officials are receiving "more and more reports of cases" there, said David Heymann, chief of communicable diseases for the WHO.
WHO officials attributed the overall downward trend to robust infection-control measures, such as quickly identifying the sick and isolating them, and aggressively tracing and tracking those who have been exposed to severe acute respiratory syndrome.
Vietnam has reported no new cases since April 8, and fewer cases are being reported daily in Hong Kong, Singapore and Toronto.
Still, WHO officials are cautious.
"I think the key unanswered question is the ability of the virus to circulate in the population without causing obvious disease," said Dr. Arthur Reingold, professor and chairman of epidemiology at the School of Public Health at the University of California, Berkeley.
"We're going to need more time in observing."
Dr. Albert Osterhaus, professor of virology and head of the virology department at Erasmus University in Rotterdam, the Netherlands, agreed, saying the number of those infected who have no or few symptoms but still can spread the virus could be higher than data show.
"We just don't have all the data yet," said the doctor, whose laboratory is one of 13 working in close collaboration with the WHO on SARS.
Mr. Thompson said officials have not seen symptom-free carriers of SARS. He said authorities are tracing SARS cases carefully and, "if there were asymptomatic carriers, we probably would have spotted them by now."
As of yesterday, 5,050 probable SARS cases, including 321 deaths, had been reported from 26 countries, according to the WHO. In China, there have been 2,914 cases and 131 deaths, the WHO said.
The WHO has recommended postponing all nonessential travel to Hong Kong, as well as Toronto, Beijing, and China's Shanxi and Guangdong provinces. Outside of Asia, Canada has been the hardest hit, with 142 cases and 18 deaths so far, according to the WHO. Canadian government officials, however, have put the number of SARS deaths at 21.
Canadian officials have been arguing that the travel advisory should be lifted because new cases are on the decline. An international conference on SARS will be held in Toronto starting tomorrow.
Canadian officials expect the death toll from SARS to rise in the coming days, because five persons are in critical or deteriorating condition, Dr. Colin D'Cunha, Ontario's commissioner for public health, said yesterday. But he and others stressed that the overall situation in Canada has improved greatly.
In the United States, a Senate committee will receive a general SARS briefing today from the head of the Centers for Disease Control and Prevention, and other health experts.
The CDC has been working on putting together diagnostic tests that states can use to effectively and efficiently test patients for SARS.
In the Netherlands, Dr. Osterhaus and his team have infected monkeys with the virus that causes SARS and are observing which organs are damaged and how best to detect it. They also are experimenting with various antiviral medicines to see if any will be effective in fighting the virus. They plan to test the most promising ones on the monkeys.
Dr. Osterhaus said a vaccine against SARS is years away but authorities could allow scientists to fast-track the process, if the epidemic gets worse.
Meanwhile, China is working aggressively with the WHO and others to identify and isolate SARS patients. The disease got out of control there, in part, because China tried to downplay the number of cases, experts say.
"We didn't start getting realistic figures from them until about a week and a half ago," said Maria Cheng of the WHO.
Dr. Heymann was in Bangkok yesterday, attending a SARS meeting of Southeast Asian leaders. Health care officials say that containing the disease in China is crucial.
"The future of this disease will be determined in China," Mr. Thompson said. "Whether we deal with this disease for the next 20 years will be determined there."
This story is based in part on wire service reports.

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