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. 2003 Apr 26;326(7395):897. doi: 10.1136/bmj.326.7395.897

SARS virus identified, but the disease is still spreading

Jane Parry 1
PMCID: PMC1125814  PMID: 12714455

As the epidemic of SARS (severe acute respiratory syndrome) continues to defy attempts to bring it under control, Chinese officials have recorded far more cases in Beijing than previously admitted—a total of 455 cases, or more than 12 times the number previously revealed.

Until 20 April, officials said that there were only 37 cases in the capital, despite estimates by the World Health Organization that at least 200 people there had contracted SARS. The health minister, Zhang Wenkang, and the mayor of Beijing, Meng Xuenong, have been fired over the cover up.

The news came as scientists conclusively identified the cause of the syndrome as a coronavirus that is unlike any other known virus in the same family, animal or human. Research is ongoing to try to establish how long the newly named SARS virus can survive outside the body, in what concentrations it appears in various body fluids, and at what point patients are the most infectious.

However, the information already gleaned about the SARS virus will help in the development of an accurate diagnostic test and antiviral drugs. A speedy test could be available by the end of this month, according to WHO, which coordinated the work of 13 laboratories around the world. “The pace of SARS research has been outstanding,” said Dr David Heymann, WHO's executive director of communicable diseases. The work of the laboratories and WHO has been dedicated to Dr Carlo Urbani, the WHO scientist who first identified the virus in Hanoi and subsequently died of SARS.

According to WHO figures, by 21 April there were 3861 probable cases of SARS, with deaths in 26 countries—including the revised numbers for cases in Beijing.

The virus has now spread to at least 16 provinces and municipalities in China. By 21 April, the number of probable cases in China stood at 1959 and the death toll was 92. Guangdong remains the worst affected area, with 1315 cases and 48 deaths recorded by 20 April. In Shanghai only two cases have been reported, but a WHO team went to the city on 21 April “to check on the numbers and see if the reporting system is reliable,” said Peter Cordingley, WHO's spokesman in Manila.

WHO still advises against non-essential travel to Guangdong and Hong Kong, where the number of new cases continues to climb. From 15 April to 21 April there were an additional 212 new cases, bringing the total to 1402. There were 47 deaths that week (bringing the death toll to 94), including 12 in one day; 17 of those who died were people who were neither elderly nor chronically ill. Health officials have announced that they will re-evaluate the treatment regimen of ribavirin and steroids.

The authorities in Singapore are still struggling to bring the situation under control there, with 178 cases recorded by 21 April. By that time, Vietnam had not reported any new SARS cases for over a week and was considering closing its border with China to prevent new cases from being imported.

Meanwhile in India, reports Sanjay Kumar from Delhi, four cases of SARS have been confirmed—one in Goa of a marine engineer who had sailed from Hong Kong to Mumbai but has now been cured and another three in a family in Pune one of whom had recently visited Indonesia.


Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

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