Knight Ridder Washington Bureau: World at risk if China doesn't curb SARS, official warns

May 7, 2003, Wednesday

BEIJING _ Successful efforts to combat the SARS virus in other countries will be undermined if China cannot quickly curb the spread of the epidemic, a World Health Organization official warned Tuesday.

"If we don't fix it in China, it will never be fixed anywhere," said Peter Cordingley, spokesman for the WHO's Western Pacific region. "China could re-seed the world."

Cordingley's warning came as a counterpoint to the hopeful downward trend in recent days of new SARS infections in several former hotspots. Vietnam has been declared the first nation to rid itself of the virus, and the numbers of new cases in Hong Kong, Singapore and Toronto have sharply declined.

"That has been incredibly encouraging," Cordingley said in a telephone interview from the WHO's regional headquarters in Manila. "But in the back of everyone's mind is a foreboding that China could wreck it for everybody."

New cases of SARS have not declined in China, the world's most populous nation, with 1.3 billion people.

China's Ministry of Health on Tuesday disclosed 138 new SARS cases, raising the total to 4,409, about two-thirds of the world's total. The ministry also reported 2,646 suspected SARS cases, many of which are certain to become confirmed cases in coming days.

Beijing, now the most SARS-infected city in the world, accounts for nearly half of all cases in China and exactly half of the nation's 214 SARS-related deaths.

Seventy new cases were reported in the capital on Tuesday, raising its total to 1,978.

Offering the first demographic profile of SARS patients in Beijing, a local Communist Party official, Cai Fuchao, on Tuesday said 73 percent of those who had fallen ill with the pneumonia-like disease have been between the ages of 20 and 50. Nearly 18 percent were over 50, and less than 10 percent were under 20. Only 8 percent of Beijing's SARS patients were preschool children.

Dr. James Maguire, an infectious disease specialist with the Centers for Disease Control and Prevention in Atlanta, told Knight Ridder in a recent interview that it was not yet known why children have been largely immune to the epidemic, or why children who do fall ill with SARS tend to be much less sick than adults.

The answer is not that children have been less exposed, he said.

Because there is not yet a diagnostic test for the virus, it is not known whether children have a resistance to infection. But Maguire said his best guess is that the virus does infect children, even though they may show none of the usual symptoms, which include fever, dry cough and shortness of breath.

He suspects that the virus has infected many adults, too, who have not become ill enough to be hospitalized and therefore have not been recorded as official SARS cases.

If Maguire is right that the known cases of SARS are merely the "tip of the iceberg," global efforts to eradicate the virus may already be doomed.

But some experts say there still is a chance to rid the world of SARS if it can be eliminated in China. The chances of that, however, seem to diminish with each passing day.

The SARS virus is believed to have jumped from animals to people in China's far southern Guangdong province and then spread.

At least 26 of Mainland China's provinces, municipalities and autonomous regions now have reported SARS cases. Many of those administrative districts have very small numbers of official cases, but WHO spokesman Cordingley said the actual numbers may be much higher.

"We think they (Chinese officials) don't know what's going on in the provinces, and we certainly don't," he said. "Some provinces are like black holes when it comes to information."

Until April 20, when the official number of SARS cases in Beijing shot from 37 to nearly 350, a government cover-up hid most cases in the capital. Cordingley said similar cover-ups may still be going on elsewhere in China.

He said the WHO hopes to soon send two teams of epidemiologists and infection control specialists to assess the SARS situation in some of the rural provinces that are especially vulnerable because of poverty and a lack of health care facilities.

Frightened residents in some rural areas have begun to resist the government's epidemic-control measures.

More than 300 residents of the eastern Zhejiang Province's Yuhuan county surrounded a government office and staged a protest Saturday after hearing that six people returning from a SARS-affected area would be quarantined nearby, according to published reports.

Several dozen protesters then allegedly forced their way into the office and beat three officials.

That followed a series of similar incidents late last month in Henan province in central China, according to local officials there.

In one of the incidents, about 50 local residents surrounded the Linzhou Station of Disease Prevention, blocking its gate and smashing its windows, according to a local official who identified himself only as Mr. Yang.

"Local residents were afraid that if the station was used for treating SARS patients near their houses, they might be infected with the disease," he said.

A local newspaper reported this week that police detained more than a dozen of the Linzhou protesters for disturbing the social order and destroying public property. It also reported that the Linzhou health bureau chief and the head of the Linzhou Station of Disease Prevention were removed from their posts for failing to control the situation.