The global toll from Severe Acute Respiratory Syndrome (Sars) climbed above 500 dead and 7 000 infected on Thursday as the World Health Organisation (WHO) declared that the disease is far more deadly than it previously thought.
Despite the dire warnings though, of the approximately 150 suspected Sars cases reported in South Africa, the only likely one was that of a Pretoria businessman who died recently due to heart failure.
The health department and the National Institute of Communicable Diseases (NICD) said the latest suspected Sars patient was a man admitted to a Pinetown hospital on Monday.
”Although all precautions have been taken… it seems increasingly unlikely that the man has Sars,” the department and the NICD said in a statement.
”He is responding well to antibiotic treatment for another infection.”
In all but one case in South Africa, Sars was ruled out after laboratory tests, because the clinical history and symptoms of the patients were not typical of Sars.
”In South Africa’s only probable Sars case — a man who visited Hong Kong and who exhibited symptoms that seemed to indicate Sars — repeated laboratory tests were negative,” said the department and the NICD.
”These tests were done both at our NICD and at the Centres for Disease Control (CDC) in Atlanta up to day 26 of his illness, when he died of a cardiac condition unrelated to Sars.”
The statement said tests performed in South Africa were the same as those used in international laboratories collaborating with the WHO, where the same quality control standards also applied.
More than 90% of the cases reported worldwide were not confirmed by laboratory tests. They were classified on the basis of strong clinical and circumstantial evidence.
”The criteria for identifying Sars are likely to be refined as more experience is gained,” said the department and the NICD.
They stressed that public as well as private health facilities in South Africa should remain vigilant to spot people infected with the disease.
Sars worldwide
Worst-hit China described its crisis as ”grim” and announced that 120 bureaucrats had been fired or punished for mishandling or even concealing cases of Sars, which has triggered fears and mass quarantines across the world’s most populous nation.
In one province, Communist Party members have been told to revive the ancient custom of bowing instead of shaking hands to prevent disease transmission.
In Geneva, WHO almost doubled its estimated global death rate for hospitalised cases to between 14% and 15%, with more than half of patients over 65 likely to die.
WHO also imposed Sars travel warnings to Taiwan and added more places in China to its banned list.
”The current Sars situation is still grim, and the economic impact is more pronounced each day,” the official Xinhua News Agency said in its report of a Chinese Cabinet meeting that ordered measures to protect exports and investments.
Li Kui-wai, an economist at the City University of Hong Kong, predicted China’s gross domestic product could fall by 1 to 2% due to Sars.
In Moscow, a top health official was quoted as saying that Russia had its first known case of Sars — a man from a town on the border with China. But other officials emphasised that laboratory tests had not confirmed the diagnosis.
Other Russian authorities ordered airlines to suspend reservations on flights to China, Hong Kong and Taiwan because of Sars and to be prepared to cancel all flights.
Sars has killed 208 people in Hong Kong and 224 in China — half in Beijing.
In Hong Kong a 100-year-old woman was among the new victims. One of the Chinese victims was from Shanghai — the first reported Sars fatality in the nation’s most populous city.
In the Taiwanese capital, Taipei, hospitals have been ordered to set up outside centres to screen individuals for Sars symptoms before allowing them into emergency rooms.
So far, Sars has mostly been an urban disease. But authorities fear it might spread into the countryside, where the majority of China’s 1,3-billion people live amid a shortage of doctors and hospitals unable to cope with epidemics.
WHO investigators were due on Thursday to go to Hebei, a province bordering Beijing — where there has been a marked surge in cases.
WHO officials in Geneva said it revised its initial death rate of 6% to 10% after studying data from Canada, China, Hong Kong, Singapore and Vietnam.
According to new estimates, less than 1% of patients aged 24 or younger die. This rises to 6% for those aged 25 to 44, 15% for those aged 45 to 64 and more than 50% for those aged over 65.
This week a separate survey of Sars cases in Hong Kong said one in five hospital patients in the territory were dying. The US Centres for Disease Control and Prevention (CDC) so far puts the death rate at 6,6%.
Sars-like outbreak contained
As the debate about the true death rate for Sars continues, a new unidentified pneumonia has appeared in the jungles of Cambodia.
An outbreak has been controlled but seven people have already died, and doctors remain baffled.
Sars first surfaced as a mystery illness in southern China last November, when it was called ”atypical pneumonia”.
The new illness has Sars-like symptoms including fever, coughing and breathing problems, but sufferers also have diarrhea but maintain normal white blood cell counts.
In Malaysia, Prime Minister Mahathir Mohamad, also a medical doctor, predicted more outbreaks of potentially deadly new diseases.
”In the future there will be more Sars (like) diseases due to mutation of bacteria and viruses. So we will have to face this kind of problem all the time,” he said.
Hospital staff on the front lines
in addition to affecting mainly urban populations, the disease has also taken the lives of many health professionals.
Doctors and nurses working in Sars wards across Asia are being hailed as heroes who put their own lives at risk to save others.
In China, they are being described by the state’s propaganda machine as ”angels in white”.
Highlighting the tragedy wrought by the disease, Taiwan said a young nurse, who had worked at a hospital during a Sars outbreak, died of the disease — just weeks before she was to deliver her first baby.
One doctor who died after contracting the virus on the job has been declared a revolutionary martyr, while others are being awarded medals.
In the US, thousands of customs and immigration inspectors were being trained to spot Sars symptoms and were ordered to detain those who exhibit them as part of attempts to prevent a US outbreak. ‒ Sapa-AP, Sapa