Severe Acute Respiratory Syndrome in the
City of Hanoi, Vietnam; the People's Republic of China including the Hong
Kong Special Administrative Region; Singapore and Taiwan
Updated: April 16, 2003
At this time, Health Canada is monitoring recent confirmed reports of outbreaks
of severe acute respiratory syndrome (SARS) in the City of Hanoi, Vietnam;
the People's Republic of China including the Hong Kong Special Administrative
Region; Singapore and Taiwan, and the occurrence of isolated cases in other
countries. Health Canada's recommendations for travellers are based on the
best available information at this time and are subject to change as more
information becomes available.
As of April 16, 2003, the World Health Organization (WHO) reports:
Brazil - 2 cases, France - 5 cases, Germany - 6 cases,
Hong Kong Special Administrative Region of the People's Republic of China
- 1268 cases (61 deaths), Indonesia - 1 case, Italy - 3 cases, Japan -
1 case, Kuwait - 1 case, Malaysia - 5 cases (1 death), People's Republic
of China - 1432 cases (64 deaths), Philippines - 1 case, Republic of Ireland
- 1 case, Romania - 1 case, Singapore - 162 cases (13 deaths), South Africa
- 1 case, Spain - 1 case, Sweden -1 case, Switzerland - 1 case, Taiwan
- 27 cases, Thailand - 8 cases (2 deaths), UK - 6 cases, USA - 193 cases,
and Vietnam - 63 cases (5 deaths).
While the cause(s) of these illnesses and the source of the outbreaks have
not been fully established, health authorities report that, to date:
No link has so far been made between these outbreaks of
SARS and the cases of a "bird flu", the avian influenza A (H5N1),
in Hong Kong Special Administrative Region reported on February 19 [see previous
advisory at http://www.phac-aspc.gc.ca/tmp-pmv/2003/h5n1hk_e.html].
Source: World Health Organization
As of 16 April 2003, Health Canada has received reports of approximately
304 cases of SARS (126 probable and 178 suspect cases) in Canada. Thirteen
deaths have occurred due to SARS in Canada. To date, transmission has
been limited to specific transmission settings such as households, hospitals
and specific community settings.
A "suspect" case of SARS is a person who fits into one of the
following two categories: a person who develops fever and one or more respiratory
symptoms, including cough, shortness of breath or difficulty breathing, within
10 days of returning from travel to areas in Asia where SARS cases are being
reported, or a person who develops fever and one or more respiratory symptoms,
including cough, shortness of breath or difficulty, breathing, within 10 days
of having had close contact with a "probable " case of SARS (i.e.
within one meter).
A "probable" case of SARS is similar to a suspect case, but often
the case has a more severe illness, with progressive shortness of breath and
difficulty breathing, and in some cases, chest x-rays shows signs of atypical
pneumonia.
[The above descriptions of a probable and suspect case are provided for communication
purposes and not for scientific purposes]
At this time, the cause of the illness remains unknown, however national
and international laboratory testing and collaboration are ongoing.
No link has been established between cases of SARS in Canada and cases of
H5N1 influenza in Hong Kong.
Recommendations
Due to the mounting concern about transmission of the SARS agent in non-hospital
and community settings in the City of Hanoi, Vietnam; the People's Republic
of China including the Hong Kong Special Administrative Region; Singapore
and Taiwan, Health Canada recommends that persons planning to travel to these
areas should defer all travel until further notice.
Also, Health Canada recommends alternate routing be considered, when possible,
if a traveller is transiting through City of Hanoi, Vietnam; the People's
Republic of China including the Hong Kong Special Administrative Region; Singapore
or Taiwan.
Health Canada is aware that health authorities in these affected areas are
making concerted efforts to contain the spread of SARS in their populations.
Given the uncertainties of the current situation, Health Canada believes it
is prudent to await the outcome of national and international control measures
before undertaking travel to these destinations.
Travellers are advised that they will have to depend upon the local medical
services in the countries where they reside or visit and are reminded that
the health care services may be inadequate for the appropriate management
of SARS. In addition, medical evacuation of a patient with SARS may be very
difficult. Canadian Missions may not be able to assist Canadians with SARS
with medical transportation out of the region or back to Canada.
Persons who are travelling or have travelled to these areas should monitor
their health for 10 days following their departure from these areas. Should
a fever AND one or more of the following respiratory symptoms occur
- cough, shortness of breath or difficulty breathing - Health Canada recommends
that medical advice be sought as soon as possible. Ill persons should call
ahead to their personal physician or local public health unit/department
for information about the appropriate Emergency Department or established
SARS Centre they should visit for assessment. Travellers should inform their
personal physician when and where they travelled, and indicate whether there
was contact with someone who had these symptoms. While not all travellers
with these symptoms have developed SARS, it is nevertheless important to ensure
that if you do get these symptoms, you stay away from other people until you
have been assessed for SARS. These actions are very important for stopping
the spread of SARS.
Independent of the current international SARS outbreak, Health Canada routinely
recommends that Canadian travellers seek an individual risk assessment consultation
with their personal physician or a travel medicine clinic to determine their
individual risks for illness.
Canadian travellers are reminded to practice good personal hygiene (e.g.,
good hand-washing practices) while travelling. Disease-causing micro-organisms
can frequently be found on the hands. Hand-washing is the single most important
procedure for preventing infections.
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