Download SARS outbreak in Taiwan

SARS and the Realization
That Diseases Know No Border
Division of Emerging Infectious Disease
Center for Disease Control, Taiwan
1
SARS was the first disease
that attacked the whole
world since the globalization.
2
What is SARS?

This disease was known as atypical
pneumonia before WHO formally named
it as severe acute respiratory syndrome
(SARS) in March, 2003.

But SARS are more severe than atypical
pneumonia caused by known bacteria or
viruses.
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Where does SARS come from1?

The origins of SARS virus are uncertain, but
it is believed to come from China.

From November 2002, an atypical
pneumonia (SARS) outbreak occurred in
Quangdong Province.

Evidence showed that the outbreak in Hong
Kong started from an infected professor,
traveling from Quangdong to Hong Kong.
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Where does SARS come from2?

In February 2003, this man arrived in Hong
Kong and transmitted the disease to staffs
and other guests in the hotel he stayed.

A nosocomial transmission occurred in the
hospital that the man stayed.

Then the disease was transmitted globally
by infected index patients in Hong Kong.
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SARS outbreak
in the world
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Distribution of Global Probable SARS Cases
Probable Case No.
China
5327
Hong Kong
1755
Taiwan
346
Canada
251
Singapore
238
Viet Nam
63
Legend
Number of probable case
1-5
6 - 14
15 - 29
30 - 251
252 - 5327
26 Sep. 2003
Number of Global
Probable SARS Cases

Total : 8,098 probable cases

Death: 774 cases

Major hot spots:

China: 5,327 cases (349 death)

HK: 1,755 cases (299 death)

Taiwan : 346 cases (37 death)

Canada: 251 cases (43 death)

Singapore: 238 cases (33 death)
26 Sep. 2003 WHO
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Areas with Local Transmission
of SARS, WHO
Date of areas with local transmission
Country
Area
Started
Lifted
Toronto
16 Mar
14 May
60
Guandong
16 Mar
13 Jun
90
Beijing
11 Apr
24 Jun
75
Hong Kong
16 Mar
21 Jun
98
Taiwan
21 May
5 Jul
46
Singapore
16 Mar
30 May
76
16 Mar
28 Apr
44
Canada
China
Viet Nam
Hanoi
Duration（Day）
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SARS outbreak
in Taiwan
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Diagram of SARS Transmission
In the East Asia
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Probable SARS Cases in Taiwan
Probable SARS Cases
n = 664*
Virus PCR or Ab (+)
n = 346 (52.1%)
survival
n = 273
Both negative
n = 317 (47.8%)
deceased (n = 73)
CFR = 21.1%
directly due to SARS
n = 37
CFR = 10.7%
* one case without specimen
CFR: Case Fatality Rate
SARS related
n = 36
CFR = 10.4%
survival
n = 210
Deceased (n = 107)
CFR = 33.8%
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30
(4)
(1)
25
病例數 (Case Number)
(2)
(1) 和平醫院事件
(5)
(2) 仁濟醫院事件
(3)
(3) 台大醫院事件
20
(4) 高雄長庚事件
(5) 關渡醫院事件
15
(6) 陽明醫院事件
10
(6)
5
0
2/25
3/4
3/11
3/18
3/25
4/1
4/8
4/15
4/22
4/29
5/6
5/13
5/20
5/27
6/3
6/10
台灣地區SARS可能病例流行曲線 (資料公布時間: 6月25日 9:00)
Epidemiological curve of SARS probable cases in Taiwan
6/17
6/24
發病日
onset
SARS Transmission in Health
Care Facilities, Taiwan
March 14-Apr.22
China
HK
NTUH
4/9
Hoping
Hospital
151
5/2 NTUH
52
MK
17
Apr. 21
May 15
May 31
Closed
JG
End
Nursing
Jen Chi
4/30
32
K. H.
ChangGung
Junghsin Memorial
2
Hospital
Apr. 23
44
K.H.
Med Univ.
PengHu.
7
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Lessons We Learned
in the SARS Outbreak







Delayed alert & reporting
Hospital infection
Ineffective command channel
Logistic exhaust
Quarantine cost too high
Social panic: poor media communication
Travel and economy cost: NT$150 billions
(3.75 billions Euro)
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SARS Control in Taiwan
in the Post-SARS Period
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Challenges for SARS Control
in the Winter, 2003-2004

Influenza and SARS might occur at the same
season in the winter of 2003-2004.

It is difficult to differentiate initial clinical
symptoms and signs between influenza and
SARS.

Highly infectious influenza will occupy medical
resources for SARS treatment.
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SARS Control Programs
in Taiwan








Fever Patients Surveillance
Influenza Immunization
Isolation of Fever Patients
Reporting and Alert System
Collection of International Outbreak Information
Border and Home Quarantine
Hospital Infection Control
National Medical Care System of
Communicable Diseases
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Conclusion

Better knowledge and experiences in SARS
prevention, diagnosis and treatment

More stringent disease control strategies

Improved international collaboration
SARS will come again, but will not
become a significant threat
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Thank You for
Your Attention
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