Asia readies for swine flu
after hard past lessons
Before swine flu emptied
restaurants and cinemas and made surgical masks a common sight in
Mexico, similar scenes unfolded in Asia earlier this decade as it
dealt with the back-to-back health emergencies of SARS and bird
flu.
Both of those episodes offered
lessons that have helped China, Vietnam and other countries prepare
for the latest global health crisis, experts and officials
say.
Among the chief lessons: countries
must openly and honestly exchange information, vigilantly monitor
for illness, aggressively quarantine suspected patients and
thoroughly prepare emergency plans.
"If there's anything good that
came out from SARS and avian influenza, it's that we now have
better preparedness in China as well as in the rest of the world,"
said Hans Troedsson, the World Health Organization's representative
in China. "What is important is a transparency and an openness not
only with the WHO but also with the public."
Severe acute respiratory syndrome,
better known as SARS, began as a mystery illness that sickened
hundreds in the southern Chinese province of Guangdong in late 2002
and early 2003 with symptoms fever, coughing and shortness of
breath.
Chinese officials were flummoxed
by the disease and failed to inform the WHO of the outbreak for
weeks, restricting media coverage in order to preserve public
confidence.
The disease spread outside the
mainland in February 2003 when an infected 64-year-old doctor
checked into a Hong Kong hotel. He later died in a local hospital,
but not before he had infected 16 other hotel guests. Among them
were tourists from Singapore and Canada and an American businessman
who then traveled to other places, spreading the virus
internationally. Also infected was a Hong Kong resident, who spread
the virus to another 143 people.
Within weeks, SARS had spread
worldwide, infecting more than 8,000 people from 37 countries
before it disappeared. More than 770 people died _ 299 from Hong
Kong alone.
In the wake of that epidemic,
governments began sketching a playbook for dealing with disease
outbreaks. Hong Kong built a special hospital unit dedicated to
handling infectious diseases and improved isolation facilities and
ventilation at other hospitals. Thermal imaging equipment to detect
high body temperatures were installed at airports and
border-crossings across Asia and elsewhere.
SARS "gave us a lot of valuable
insight and practical experience in managing a large-scale outbreak
that eventually spread to other parts of the world. That certainly
has prepared us very well for what may come," Hong Kong
Undersecretary for Food and Health Gabriel Leung said at a press
conference Monday.
An increased awareness of personal
hygiene _ wearing masks and washing hands frequently _ during SARS
also contributed to a sharp decline in regular flu cases in 2003,
said Lo Wing-lok, a Hong Kong infectious diseases
expert.
In Canada, where SARS killed 44
people in Toronto, the government created the Public Health Agency,
whose mission is to prevent and control infectious diseases.
Thousands of hospitals, schools and churches now have pandemic
plans that they didn't have before SARS.
Countries have also built large
reserves of anti-viral drugs. Canada has a national stockpile of 55
million doses of anti-viral drugs. Hong Kong keeps 20 million
doses.
Governments moved more
aggressively when a second major epidemic hit Asia just months
later _ avian influenza. Governments slaughtered hundreds of
millions of poultry in a bid to contain the virus. Since then, near
yearly outbreaks of bird flu have spread to Europe, the Middle East
and Africa.
More than 250 people have died
from bird flu, mostly from direct contact with infected poultry,
but each human infection raises the chances that the virus will
mutate, becoming more easily passed among humans and unleashing a
global pandemic.
Not all lessons are applicable to
the swine flu outbreak. Yuen Kwok-yung, a Hong Kong microbiologist
who studied the SARS virus, said some people with swine flu may not
show symptoms in the early stages, making it hard to know who and
when to quarantine _ a tactic widely used in controlling
SARS.
Governments dealing with the swine
flu threat have drawn on these experiences and put in effect
emergency plans. Hong Kong, Singapore, Thailand, Japan, Indonesia
and the Philippines dusted off their thermal scanners to check for
signs of fever among arriving passengers from North America. South
Korea, India and Indonesia also announced screening.
Public health officials are being
more forthcoming with information.
"This is an illness that was
recognized in Mexico around April 15. We heard about it around the
world about 48 hours later," said Allison McGeer, director of
infection control at Mount Sinai Hospital in Toronto.
"We've identified the pathogen,
we've confirmed it, we've sequenced the virus and if you look at
what's happening now, every physician across Ontario and probably
every physician across Canada has had notification from their
public health unit about what's happening," McGeer said.
And in China, which was sharply
criticized internationally for suppressing information about the
SARS outbreaks and dragging its feet on bird flu, the State
Council, or Cabinet, reminded officials nationwide to use the
disease surveillance network and report any cases
promptly.
"Once a suspected case is found in
China, it must be made public in a timely way," according to a
State Council notice on state broadcaster CCTV. "We must be highly
vigilant and take strong monitoring and prevention
measures."
___
Associated Press reporters Tini
Tran in Beijing and Rob Gillies in Toronto contributed to this
report.
