Faculty Bibliography

The rejections have been based on the rivalry between China and Taiwan dating to 1949 when the two split amid civil war. China considers Taiwan a province. Taiwan has sought observer status at the W.H.O. As an observer, Taiwan would not be allowed to vote but could attend W.H.O. meetings, and its sovereignty would be implied. In March, shortly after the W.H.O. issued a global alert about the threat of SARS, it asked the Centers for Disease Control and Prevention in Atlanta to work with Taiwan on the SARS epidemic, Dr. [David L. Heymann] said. Employees at the Miyako Hotel in Osaka, Japan, had their temperatures monitored yesterday as a precaution against SARS. A doctor from Taiwan who was a guest at the hotel had exhibited SARS-like symptoms. (Takeshi Tokitsu/Asahi Shimbun, via Associated Press)

[Michael Ryan] said that many superspreaders had numerous opportunities to spread the virus because they had spent a long time in the community while ill or because hospital staff had not used the proper infection control measures. Some evidence suggested that contaminated feces and urine could contribute to the spread of SARS if they became dispersed in droplets in the air and the droplets could be inhaled or swallowed. But that route is not a major means of spreading the disease, Ryan said by telephone in a news conference after the meeting in Geneva. Canadian environmental scientists invited by Hong Kong and the World Health Organization to investigate a large outbreak of SARS in an apartment complex in Hong Kong concurred with earlier findings by scientists there, [Margaret Chan] said. She said that the Hong Kong and Canadian investigators had found that a collection of factors had to converge to cause the outbreak. They included: an infected individual who transmitted the illness to a dozen or so other people living in one line of apartments in the complex, diarrhea developing in at least one of the infected, and a malfunctioning of the plumbing and sewage systems. Ryan said the SARS epidemic in China consisted of multiple outbreaks in different areas. As Chinese health officials get better data on the epidemic there, they are applying the important lessons of infection control learned in other countries. But the benefit of the health measures that are beginning to be put in place now will only be apparent in another few weeks, he said. World Health Organization officials have said that in many recent suspected SARS cases, Chinese health officials have not been able to identify the individual from whom a new case caught the infection. There are many potential explanations for that situation. One is that another respiratory illness caused by a different infectious agent had occurred simultaneously. The para-influenza virus is one that health officials are investigating as a possibility

Scientists brought together by the World Health Organization to review the data on SARS say that public health measures have been effective in containing the disease in many countries and should work eventually in China and Taiwan, where SARS is now concentrated. Crucial measures that have broken the chain of person-to-person transmission of the SARS virus are the detection and treatment of suspected cases as soon as they are identified and then the quarantining of all contacts. The measures also include providing timely public information and alerts to travelers

Canadian environmental scientists invited by Hong Kong and the World Health Organization to investigate a large outbreak of SARS in an apartment complex in Hong Kong concurred with earlier findings by scientists there, Dr. [Margaret Chan] said. She said that the Hong Kong and Canadian investigators found that a collection of factors had to converge to cause the outbreak. They included: an infected individual who transmitted the illness to a dozen or so other people living in one line of apartments in the complex, diarrhea developing in at least one of the infected, and a malfunctioning of the plumbing and sewage systems. Dr. Chan said that when her department first confronted SARS in Hong Kong, ''we had no idea what we were dealing with and we did not even know it was a virus.'' But Dr. Chan said the experience taught health officials not to ''be afraid to say you don't know what you are dealing with.'' ''SARS is too big for any country to handle single-handedly,'' Dr. Chan said. ''It calls for regional and global collaboration, and the collaboration has been unprecedented in terms of identifying the virus'' and carrying out other research. The W.H.O. has been widely praised for organizing teams of laboratory scientists, epidemiologists and health officials around the world immediately after it declared SARS a global health risk on March 12

Scientists brought together by the World Health Organization to review the data on SARS said Saturday that public health measures had been effective in containing the disease in many countries and should work eventually in China and Taiwan, where SARS is now concentrated. Canadian environmental scientists invited by Hong Kong and the World Health Organization to investigate a large outbreak of SARS in an apartment complex in Hong Kong concurred with earlier findings by scientists there, [Margaret Chan] said. She said that the Hong Kong and Canadian investigators found that a collection of factors had to converge to cause the outbreak. They included: an infected individual who transmitted the illness to a dozen or so other people living in one line of apartments in the complex, diarrhea developing in at least one of the infected, and a malfunctioning of the plumbing and sewage systems. 'SARS is too big for any country to handle single-handedly,' Chan said. 'It calls for regional and global collaboration, and the collaboration has been unprecedented in terms of identifying the virus' and carrying out other research. The WHO has been widely praised for organizing teams of laboratory scientists, epidemiologists and health officials around the world immediately after it declared SARS a global health risk on March 12

China's Health Ministry reported 28 new SARS cases Saturday, fewer than on any day since the government admitted a cover-up in late April and ordered full reporting on the spread of the disease; China now has 5,209 SARS cases. The government also reported seven SARS deaths, raising the death toll in China to 282

The agency also issued its first guidelines on blood donations by healthy travelers from areas affected by SARS and by people who later develop the disease. The recommendations were made as a precaution even though there are no known cases of SARS acquired by way of transfusions. Concern exists because low levels of the virus have been detected in the blood of SARS patients up to 10 days after the onset of symptoms. Formal studies of how long the virus persists in blood have not been performed. Healthy people who have had no contact with a SARS patient in such areas can donate as usual. But those without symptoms who have had contact with a SARS patient should defer donations for three weeks after the last contact

Ireland took the action on Thursday, the same day that the W.H.O. issued guidelines for travelers from SARS-affected countries who attend mass gatherings elsewhere. A traveler who has no symptoms of SARS and has not been in contact with a person suspected of having SARS should not face any restrictions, according to the guidelines from the W.H.O., a United Nations agency. But a traveler who develps SARS symptoms within 10 days of arrival should seek medical care, the W.H.O. said. Michael Martin, the Irish minister for health and children, said his government wanted to preserve Ireland's low level of incidence of SARS cases; the only case of probable SARS occurred seven weeks ago. Among the determining factors in the decision were that Ireland's ''severely stressed health system'' has been further taxed by strikes by health workers, Mr. [Dick Thompson] said. So, he added, ''they were worried about bringing in people who might require a lot of hospital services and then on top of that if they had to start isolating SARS patients, they would quickly be overwhelmed.''

The agency also issued its first guidelines on blood donations by healthy travelers from areas affected by SARS and by people who develop the disease. The advice was meant as a precaution even though there are no known cases of SARS acquired by transfusions. Concern exists because low levels of virus have been detected in the blood of SARS patients up to 10 days after the onset of symptoms. Formal studies of how long the virus persists in blood have not been performed. W.H.O.'s recommendations for deferral of blood donations are for longer periods than those the United States Food and Drug Administration made on April 17 when less was known about SARS. The F.D.A. continues to recommend a two-week deferral for people who have had contact with a SARS case and a 28-day deferral for those who had the disease. Other countries have recommended varying periods of deferral. Infection control is the main defense against the spread of SARS. A crucial measure in such control is isolation of patients with contagious respiratory diseases in specially engineered rooms, to prevent dispersal of the SARS virus or any other infectious agent elsewhere

The agency also issued its first guidelines on blood donations by healthy travelers from areas affected by SARS and by people who later develop the disease. The recommendations were made as a precaution even though there are no known cases of SARS acquired by transfusions. Concern exists because low levels of the virus have been detected in the blood of SARS patients up to 10 days after the onset of symptoms. Formal studies of how long the virus persists in blood have not been performed. The agency's recommendations for deferral of blood donations are for longer periods than those the U.S. Food and Drug Administration made on April 17, when less was known about SARS. The FDA continues to recommend a two-week deferral for people who have had contact with a SARS patient and a 28-day deferral for those who had the disease. Other countries have recommended varying periods of deferral. Infection control is the main defense against the spread of SARS. A crucial measure in such control is isolation of patients with contagious respiratory diseases in specially engineered rooms, to prevent dispersal of the SARS virus or any other infectious agent elsewhere in a hospital