Reacting to the spread of the new infectious disease Severe Acute Respiratory Syndrome (SARS) the World Health Organization has advised against travel to Hong Kong and Guangdong province of China.
Wednesday, 2 April, 08:30 Palais des Nations
World Health Organization
Dr David Heymann, Executive Director, Communicable Diseases
Dr Guenael Rodier, Director, Communicable Disease Surveillance and Response
Mr Dick Thompson, Communications Officer
Mr Dick Thompson
This will be an abbreviated press briefing. You will have an opportunity to ask a few questions, but not many. The reason is that they are getting on a flight to attend Carlo Urbani's funeral in Italy.
Statement from Dr David Heymann
Good morning. Thank you for coming this morning. We have two different types of information to offer to you this morning. The first is that China is now a full partner with WHO. The teams have been asked to immediately go to Guangdong. Guangdong has reported the number of cases that have occurred during the month of March, which is 361 cases and 9 deaths, which mean that the epidemic is still going on in Guangdong, and they have promised that later today they will provide all of the information that they have obtained from their national disease surveillance system looking for SARS. So we are very pleased to announce that China is now a full partner with other international partners, in fact with the rest of the world, in collaborating on stopping this epidemic and in finding out the various aspects that we need to find out.
The second [type of information] is that since control measures have begun in Hong Kong, which began on 15 March, just after we made our announcement, and in other parts of the world, control measures have been successful in stopping the disease. For example, in Viet Nam the disease has been stopped we believe. In Singapore and Toronto, activities are going on and they are having good success.
I would like to focus now on Hong Kong, however, where since 15 March there have been 9 people, travellers, tourists or businessmen, from Beijing, from Taiwan, and from Singapore, who have returned home from Hong Kong infected with SARS. In addition in Hong Kong, they have found that transmission does not seem to be only by close contact from person to person. It appears that there is something in the environment that is transferring virus, which is serving as a vehicle to transfer the virus from one person to another. We do not believe this is the air. We believe that it is something else in the environment and we have talked about that in past press conferences. It is possibly an object that people are touching and getting infected from, where there has been a SARS patient who has coughed, or possibly a sewage system or a water system or some type of environmental vehicle that takes the virus from a sick person to others. So we see clusters of cases where there is one case, for example, living in an apartment building, where other people in that apartment building have been infected.
So for these two reasons, because of the fact that we do not completely understand the means of transmission in Hong Kong, and because since the 15 March tourists and businessmen have returned from Hong Kong to their countries with infection, we have decided to make a recommendation that people who are planning travel to both Hong Kong and Guangdong, which as you know is adjacent to Hong Kong, consider postponing their travel until another time. We will be working daily with the Hong Kong authorities, and we have daily conference calls with them and now we will begin also with Guangdong authorities, to determine if there are any reasons that we can stop that recommendation. In other words, the recommendation will be reevaluated every day and we will make a decision every day whether or not that needs to be changed. So now what we have is from all sites where there is a SARS outbreak that is causing chains of transmission, we have requested that tourists or travellers understand about the disease, that airports screen passengers who are returning to their countries from these sites, and now, in addition, we are telling travellers who are planning to go to Hong Kong and Guangdong that they consider postponing their travel. So what we have is a system in place now which will, we hope, stop the spread from the sites where SARS is occurring internationally and at the same time help passengers, tourists or businessmen who are planning to go to Hong Kong or Guangdong decide better whether or not they should go. We are recommending that they reconsider their travel plans and postpone if possible their travel to Hong Kong or Guangdong.
It is noteworthy that SARS has not been contained in China. The Chinese claimed they had it under control. Instead it has been spreading. China appears to finally be cooperating with the WHO. But the Chinese authorities have been quite irresponsible up to this point. The disease first showed up in Guangdong province China in November 2002. If the world's infectious disease experts had been notified at that time we'd be about 5 months further along in the learning curve about this disease and containment measures to stop international spread would have been begun much sooner and with much greater success.
Some countries are taking more drastic action. If travelling from Hong Kong to Thailand you will be placed in quarantine when you reach Thailand.
Q. Yes, Dr Heymann, can you explain a little bit about the process prior to issuing this advice? While it probably makes sense from the health perspective, it will have economic, social, political impact in the region. I’m wondering if you have consent from authorities in Guangdong, Hong Kong, or China?
A. Dr David Heymann: We’ve spoken first of all with IATA, which is the International Air Transport Association, and they have understood this and they have given their agreement that this is the recommendation which should be made at this point. We’ve discussed with the various different countries in the region, with our regional office and through our regional office, and we find that in those countries there are already much more strict recommendations than this is. For example, in Thailand, the government has announced that all returning passengers from Hong Kong will be quarantined. So we understand that there are very serious measures already being taken in many countries. So we made this decision with countries, with WHO and, more importantly, with our expert group of advisers on travel and health. We’ve spoken with many of our advisers, you know we have various advisers around the world, we have talked with them as well. And through all of these discussions, which went on all day yesterday and the day before, we’ve come to this conclusion.
The economic consequences of SARS could grow very large. Of course the tourist industry will be hit. But also various business meetings that facilitate international trade will not take place.
Update: This WHO recommendation is unprecedented. The World Health Organization has never before in its history totally recommended against travel to a specific geographic area.
This is the first time in the history of WHO that such travel advice has been issued for specific geographical areas because of an outbreak of an infectious disease.
Since 1958, WHO has issued weekly lists of areas infected with quarantinable diseases so that national authorities can decide whether to apply public health measures to arriving travellers. During the last years of the smallpox eradication campaign cases spread internationally by land. Controls at borders between neighbouring countries were relied on to prevent international spread. No global recommendations were necessary.
Here is the World Health Organization press release for the travel advisory: Update 17 - Travel advice - Hong Kong Special Administrative Region of China, and Guangdong Province, China
The SARS situation in Hong Kong Special Administrative Region has developed features of concern: a continuing and significant increase in cases with indications that SARS has spread beyond the initial focus in hospitals. These developments have suggested environmental routes of transmission from a SARS infected person which may be related to contamination of common systems that link rooms or flats together. Despite the implementation of strict measures to control the outbreak, there have continued to be a small number of visitors to Hong Kong who have been identified as SARS cases after their return from Hong Kong. The epidemic in Guangdong Province of China, situated adjacent to Hong Kong, is the largest outbreak of SARS reported and has also shown evidence of spread in the wider community. As a measure of precaution WHO is now recommending that persons travelling to Hong Kong and Guangdong Province of China consider postponing all but essential travel. This temporary recommendation will be reassessed in the light of the evolution of the epidemic in the areas currently indicated, and other areas of the world could become subject to similar recommendations if the situation demands.
Please note that this recommendation applies only to travellers entering Hong Kong Special Administrative Region of China and Guangdong Province of China, not to passengers directly transiting through international airports within those areas.
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