Southeast Asia

Vietnam shows how to beat SARS
By Marwaan Macan-Markar

BANGKOK - Vietnam's success at curbing the spread of the deadly severe acute respiratory syndrome (SARS) is fueling optimism among international health experts that the latest killer disease can be put under control.

Vietnam has shown that the SARS outbreak can be contained by "detection and protection", David Heymann, an expert on communicable diseases at the Geneva-based World Health Organization (WHO), said here. "We believe that SARS has stopped spreading in Vietnam," he told media. "And it has the capacity to detect if SARS occurs again and to stop it from spreading."

Heymann's comments came in the wake of WHO's removal of Vietnam on Monday from the list of countries with local transmission of the atypical pneumonia, which has killed more than 300 people from 26 countries and infected more than 5,000 people across the world.

The United Nations health agency declared that Vietnam is the first country to stall the local transmission of SARS, which is said to have surfaced in November in China's southern province of Guangdong.

According to WHO, Vietnam's new classification is "significant", given that it was one of the four countries initially identified on March 15 as having local transmission of the deadly virus. The other places in the region named at the time were Singapore, mainland China and Hong Kong.

As of April 8, Vietnam had reported a total of 63 cases and five deaths, according to a WHO statement. But since then "there have been no new cases" or "no cases of spread to other countries".

The 20-day period of no reported cases of new SARS infections is "twice the maximum incubation period for this disease", said Heymann, the executive director at WHO's Communicable Diseases Cluster.

This Southeast Asian country's success has been attributed to a series of measures that health officials and workers pursued as soon as the alarm bells went off about the emergence of the atypical pneumonia.

These measures included the immediate identification of infected people, including whom they had met and where they had moved, isolating SARS patients in hospitals and those believed to have SARS, and providing protective gear to health workers treating the patients, states WHO.

In addition, the Vietnamese authorities screened international travelers leaving the country and had "timely and accurate reporting and sharing of information with other authorities and governments", WHO adds.

"With the WHO's assistance and the tenacity of the health workers in the hospital [in Hanoi], they pursued very effective control and prevention measures," said Mark Salter, a medical officer at WHO's department of communicable disease surveillance and control. "This stopped the spread of the virus within its borders," he added. "The virus died out, because there was no more people it could infect. But that does not mean we can sit back."

Vietnam was hit by the disease when a Chinese-American businessmen with a high temperature was admitted to the privately run French Hospital in Hanoi on February 26. The patient had flown in from Hong Kong. Subsequently, health workers who had treated the patient at this hospital fell ill with the same the same flu-like symptoms, which were subsequently identified as SARS. The businessmen and four health workers died as a result of the new virus.

"It's difficult to describe the pain and tiredness of SARS. I had a terrible stomach ache and my head felt like it would split open," Nguyen Thi Men, a nurse at the French Hospital, wrote in the April 18 issue of Vietnam News, an English-language daily. She is the only health worker to survive out of the first five of the hospital's staff who were infected.

In addition to WHO and domestic efforts, several donor organizations "moved in very quickly to set up a system that helped overcome the spread of SARS", said Bjorn Melgaard, WHO's representative in Thailand. The French government, for instance, announced in early April that it would grant more than US$100,000 to help sterilize the French Hospital, the epicenter of the killer virus in Vietnam.

Another hospital designated to handle SARS patients was the state-run Bach Mai hospital. Patients from the northern province of Ninh Binh have been admitted to this government facility.

Vietnam's ability to control SARS, even though its health system is unlike those in the more advanced city-state of Singapore or Hong Kong, stems from the fact that it was infected by just one case at the outset, the Chinese-American businessman.

On the other hand, Singapore, which was designated as a SARS-affected area at about the same time as Vietnam, has had to battle with the disease spreading from three infected women who arrived from Hong Kong. "That multiplied the problem, unlike Vietnam," said Melgaard.

Nevertheless, WHO is convinced that Hong Kong and Singapore, with their advanced health systems, are on the verge of putting SARS under control. "We believe that the outbreak has stabilized in Hong Kong and Singapore since April 11," said Heymann. "These countries are on the way to decreasing the epidemic."

(Inter Press Service)
Apr 30, 2003

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(Apr 26, '03)

SARS: How Singapore outmanaged the others
(Apr 9, '03)


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