- The Washington Times - Sunday, May 4, 2003

The World Health Organization is helping China craft a six-month plan for containing the SARS outbreak there and then the Geneva-based group will set up a fund to help China do so.Other parts of the world appear to have a handle on the flulike illness known as severe acute respiratory syndrome, but it is still spreading in China.”The big question still remains in China,” said Dr. David L. Heymann, WHO’s executive director of communicable diseases.China reported 176 new probable SARS cases yesterday — 96 of which were in Beijing — and 11 deaths. This brings China’s total to 3,799 cumulative cases, with 181 deaths.Meanwhile, reports out of Hong Kong said the virus was mutating rapidly. Hong Kong authorities also said this week that 12 persons thought to have recovered from the disease have relapsed.Dr. Heymann said the relapse news is “concerning” and his team is having a videoconference with Hong Kong authorities Monday to discuss it.He suggested perhaps the steroid treatment given to SARS patients in Hong Kong was being tapered off too soon, causing the relapses. He also noted it is common for viruses to remain in the system and be excreted in bodily fluids for a period of time after a person recovers.”It’s not new that the virus remains; what is new is that the virus still causes symptoms,” he said. He noted, however, “there is no confirmation” that the Hong Kong group does indeed have SARS again.Dick Thompson, WHO spokesman, said news of the virus mutating is “something that we’re watching” but noted SARS “is a new virus in humans so naturally its going to undergo some changes. It’s typical behavior.”Mr. Thompson explained that a virus structure can change slightly as it replicates, but “what’s important is what these changes do” — whether they make the disease weaker or stronger.Thus far with SARS, he said, “we haven’t correlated any of these changes to a change in disease.”Dr. Heymann said the fund to help China will contain some money for research studies of SARS patients there, but most of the money will go toward things like training health care workers there on how to contain SARS.He said the research will include studying SARS patients in China to determine whether there is a milder form of the disease circulating that does not manifest symptoms. Scientists in other countries, like Canada, have noted they cannot do adequate studies because they do not have enough SARS patients to work with, Dr. Heymann said.WHO members in Beijing are currently working with city health officials to analyze how the virus is spreading there. But the WHO yesterday said much missing data still need to be collected, and reports must still be completed.

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