The World Health Organization has extended its SARS-related travel warning to Taipei, the capital of Taiwan, the Chinese city of Tianjin and the Chinese province of Inner Mongolia. The latest figures show there have more than 500 SARS-related deaths around the world, the vast majority of them in China. Taipei, Tianjin and Inner Mongolia joined Hong Kong, Beijing, and the provinces of Guangdong and Shanxi as no-go areas. The head of WHO's communicable diseases program, David Heymann, said people should postpone all but essential travel to these places.
"This is because in these areas, the outbreaks are going on. They are increasing rapidly, and we are not able to do the assessment to make sure that these places are safe," he said. "In fact, the assessment shows that these places might be of concern to travelers. And, that assessment, as you remember is based on the magnitude of the outbreak, the local transmission pattern and whether or not there are cases of disease being exported from that area."
Dr. Heymann said the epidemic appears to have peaked in Hong Kong, Singapore, and Toronto. He said these places are showing a steady decrease in cases and fewer cases of local transmission.
He said 10 other countries - including Vietnam, Brazil, South Africa and Thailand - have not had a new case of SARS in 20 days, which is two times the incubation period. He said China is making remarkable progress in coming to grips with the disease. Nevertheless, he acknowledged that China remains an area of great concern.
The World Health Organization reports the worldwide fatality rate from SARS has nearly doubled from six percent when the epidemic first started. Dr. Heymann added that death rates from the disease differ widely, from below one percent among young healthy people to more than 50 percent among people older than 65.
"What we are seeing now is an epidemic which has gone from reasonably healthy young working populations to populations which are more representative of the general public, including the elderly, who many times have pre-existing health conditions," said Dr. Heymann. "So, we have seen the case fatality rate has increased as the epidemic continues, the overall case fatality rate which we now quote at 14 to 15 percent."
In another sign of WHO's concern about the spread of SARS, the organization is barring certain people from attending its annual World Health Assembly, which begins on May 19.
Dr. Heymann said WHO has informed ministries of health around the world that participants should not come to the assembly in Geneva if they have had contact with a SARS case or have been in a hospital that has had a SARS case in the last 10 days.