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ASEAN SENIOR OFFICIAL MEETING &
ASEAN HEALTH MINISTER MEETING
ON SARS
Putra Jaya, Malaysia
25-26 April 2003
1- EPIDEMIOLOGY
2- CASE DEFINITION
3-
CUMULATIVE NUMBERS
4- AFFECTED AREAS
5- PUBLIC HEALTH
MEASURES
6- SITUATION IN
CAMBODIA
7- INFORMATION OF
CASES AND CONTACTS
8- SHARING OF
LABORATORY EXPERTISE
9- SCREENING OF TRAVELERS ON
PRE DEPARTURE AND ARRIVAL
10- CONTACT PERSONS
11- RECOMMENDATION
EPIDEMIOLOGY
nSevere
Acute Respiratory Syndrome(SARS) is an atypical pneumonia caused by
a new coronavirus
nWHO
is coordinating international investigation with the assistance of
the Global Alert and Response Network and work closely with health
authority of affected countries to provide epidemiological, clinical
and logistical support as required
nWHOs
global alert issued on 12 March 2003θheightened surveillance for
cases of SARS.
nQuick
identification of cases and isolationθlocal transmission is stopped
in most countries
nWHO
and a network of 13 of the world top laboratories are zeroing in the
cause of SARS and a diagnostic test is being developed
nThis
will help distinguish those who are infected and those who are free
of the disease
n16
April 2003: official announcement of the new pathogen, a member of
the coronavirus family never before seen in human as
the cause of SARS
nSo
far, no certain treatment or vaccine
CASE
DEFINITION
(revised 1 April 2003)
* Suspect case:
1- A person
presenting after 1 Nov. 2002 with the history of high fever(>38
degree C), and cough or breathing difficulty and one or more of the
following exposures during the 10 days prior to the onset of the
symptoms:
-close
contact with a suspect or probable cases of SARS
-history of
travel to an affected area
-residing
in an affected area
2-
A person with unexplained acute respiratory illness resulting in
death after 1 November 2002 but on whom no autopsy has been
performed and one or more of the following exposures during the 10
days prior to the onset of the symptoms:
-close
contact with a suspect or probable cases of SARS
-history of
travel to an affected area
-residing
in an affected area
*
Probable cases:
1- A suspect case
with radiologic evidence of infiltrates consistent with pneumonia
or respiratory distress syndrome (RDS) on chest X-ray
2- A suspect case
with autopsy findings consistent with the pathology of RDS without
an identifiable cause
CUMULATIVE NUMBERS
AS OF 22 APRIL 2003
nReport
from 27 countries and regions
nNumber
of reported probable cases: 3,947
nIncrease
from previous update: 80
nNumber
of deaths: 229
nRecovered:
1595
nThere
is so far no reported case in Cambodia
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AFFECTED AREAS
AS OF 22 APRIL 2003
nCanada
(Toronto)
nSingapore
(Singapore)
nChina
(Guangdong province, Hong Kong SAR, Shanxi province, Beijing, Taiwan
province, Inner Mongolia)
nUnited
States of America*
nUnited
Kingdom (London)*
nVietnam
(Hanoi)
* Area with limited local
transmission and no evidence of international spread since 15 March
2003 and no transmission other than close person-to-person contact
reported
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PUBLIC HEALTH
MEASURES
nPublic
awareness
nEnhanced
surveillance
nProcedure
for arrival from affected areas,
ncontact
tracing and follow up
ncommunity
based isolation of close contact of probable SARS cases
nHospital
infection control measures (identification of local facilities for
admission, isolation and barrier nursing of possible SARS cases)
nStockpiling
of barrier nursing supplies (PPE)
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SITUATION IN
CAMBODIA
*Administrative measures:
- A special task
force to coordinate the prevention and control of SARS
-5 meetings since
mid March 2003
-Inter-ministerial meeting (MFA)
- 4 joint press
releases between MOH and WHO
-Directives to
airports, seaports and border posts and the health system including
the private sector and military hospitals
- Creation of a
hot line
- Update for the
public and travel agencies, hotels
- Supervision at
airports
*Technical
measures:
Strong technical
support from WHO
Use of WHO
guidelines for airports
Use of health
declaration cards for travelers
Assign reference
centers
Special ambulance
for referral of cases
Set up
investigation and training teams
Imminent threat
even there is so far no reported case in the country
Example of strong
collaboration between WHO and IPC and other partners
One month since
its designation as reference center, Calmette Hospital treated 12
patients (all discarded)
4,078 travelers
filled out Health Declaration Cards (13-23April 2003).
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INFORMATION OF
CASES AND CONTACTS
nUse
of Severe Acute Respiratory Syndrome Case Reporting Form of WHO
including:
- Reporting
details
- Demographic
details
- Signs and
symptoms
- Chest X-ray
- Hospital
admission history
- History of
exposure
- Contact tracing
- Initial,current
and final case classification
- Final status
Health Declaration of Travelers
Date (dd/mm/yy):
Port of Entry:
..
Flight No and seat
No Ship Car
Bus
Type of
transportation:
!
!
!
Family Name and First name:
..
Sex:
........ Date of Birth (dd/mm/yy):
.
Nationality
Passport Number:
..
Country of residence and permanent address:
.
..
Country(ies) and cities visited during the last 2 weeks (please list
all the countries visited with date of arrival and date of
departure)
Country/city Date of
arrival Date of departure
-
..
How long will you stay in
Cambodia?....................................................................................................
Contact address in Cambodia for the subsequent 14 days (address, tel,
contact person):
Do you have any of the following symptom (tick all that apply)?:
Fever:
!
Cough:
!
Difficulty in breathing:
!
Chills:
!
Other
(specify):
None:
!
Have you been in contact within 14 days with a person who has been
diagnosed with SARS? (tick)
Yes
! No
!
dont know
!
I declare the information given above is true and correct
______________________
Passenger
signature
*Once completed give this part to
the health authority/quarantine officer on arrival
SHARING OF
LABORATORY EXPERTISE
nNIPH
and Pasteur Institute- Cambodia are designated SARS laboratories for
Cambodia
nAvailability
of P2+ facility (using P3 practices) and some PCR kits from Hamburg
and adapted by Pasteur Institute in Paris
nNetworking
with other laboratories
nNeed
for more test kits, especially antibody tests for SARS to facilitate
case investigations
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SCREENING OF TRAVELERS ON
PRE DEPARTURE AND ARRIVAL
*Instruction on public health
measures to be taken at international airports: (additional measures
decided on 4 April 2003)
1- Arriving
passengers: fill out SARS Health Alert Card
2- Immediate
isolation of suspected cases
3- Transfer to
designated facilities by ambulance
4- Follow up of
close contact in the next 14 days
5- Airport
authority to check whether arriving passengers from affected areas
have been screened at departure
6- Provision of a
copy of passenger seating list
8- Aircraft that
has carried suspected caseθdisinfections according to WHO Guide to
Hygiene and Sanitation in Aviation
9- Guidelines for
Fire Station Ambulance
10- Personal
Protective Equipment (PPE) for Health Officer or Airport staff
entering in contact with suspected cases of SARS
CONTACT PERSONS
nHE.
Prof. Eng Huot, Director General for Health, Tel. 855 16 813 151
nDr.
Sok Touch, Director of Communicable Disease Control Department, Tel.
855 12 856 848, Fax: 855 23 882 317, Email: touch358@online.com.kh
nDr.
Ly Sovann, Acting Chief of Disease Surveillance Bureau, Tel. 855 12
825 424, Fax: 855 23 882 317 Email:
sovann_ly@yahoo.com
RECOMMENDATION
nConsideration
of international travel
nHeighten
surveillance for pre-departure and transit passengers
nStrengthen
regional surveillance (MBDS, ASEAN Disease Surveillance)
nStrengthen
border health cooperation
nStrengthen
laboratory network
nStockpiling
of equipment
nHealth
and economic impact of SARS
nEmergency
Fund for Outbreak response from Government and Donors
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