Vietnam First to Contain SARS

The World Health Organization announced today that Vietnam has become the first country to contain SARS, even as other East Asian nations quarreled over increasingly draconian measures to halt the spread of the pneumonia-like illness.

The progress in Vietnam came after the country sealed off the Hanoi hospital where its main outbreak occurred. A total of 63 people have become ill with SARS in Vietnam, and five have died, but no new case has been reported there since April 12.

SARS, believed to have originated in southern China in November, has claimed the lives of more than 300 people and sickened about 4,800 others worldwide.

In Hong Kong on Sunday, a senior government official, Stephen Lam, protested Taiwan’s decision earlier in the day to impose a mandatory 10-day quarantine on anyone arriving from Hong Kong, mainland China or other nations listed by the World Health Organization as SARS-infected. Clearly upset by the move, Lam said it was “uncalled for” and against the commercial interests of Hong Kong and Taiwan.

He urged Taiwan to reconsider its action.

“Of course, I understand they have their concerns,” Lam told reporters at a brief news conference Sunday. “All I’m saying is, we’ve taken full and effective measures to prevent passengers who are sick from boarding the airplane.”

Travelers leaving from Hong Kong’s international airport are now subject to body temperature checks, with anyone indicating that he or she has a fever not permitted to fly.

Tensions between Taiwan and Hong Kong had already been heightened by news that Taiwan’s first victim to die of SARS apparently contracted severe acute respiratory syndrome after a visit by a brother from Hong Kong.

The Department of Health in Taipei said Sunday that the man had died late Saturday at a hospital in the central Taiwanese city of Taichung, more than three weeks after he was admitted with symptoms of the disease. Authorities said the brother lived in Hong Kong’s Amoy Gardens apartment complex, the set of buildings in the territory hit hardest by the virus.

The announcement of the man’s death came only hours after Taiwan’s government unveiled the quarantine measures. Anyone violating them could be fined up to $20,000 or face as many as two years in prison, authorities warned.

“The SARS virus is the new hidden enemy,” Taiwan Prime Minister Yu Shyi-kun declared. “The government will take any necessary measures and put in more resources to prevent its spread.”

Residents of Singapore and the Toronto area of Canada also are affected by Taiwan’s decision. Vietnam was another nation included in the Taiwan travel ban, and it was unclear early today whether the WHO announcement would prompt Taiwan to alter its policy.

Pascale Brudon, the WHO representative in Hanoi, said the success in Vietnam was attributable to “a range of factors, but the most important were the speed of action, leadership and transparency shown by the government.”

The last patient known to come down with SARS in Vietnam was isolated April 8, four days before his diagnosis was confirmed. That means no new SARS cases have emerged in 20 days -- twice the incubation period -- allowing doctors to declare the disease contained.

Health authorities attributed Vietnam’s success to early detection and isolation of SARS cases.

WHO doctor Carlo Urbani, who was based in Vietnam, quickly recognized the danger of the disease and health officials sealed off the Hanoi hospital, including its medical staff. The Italian doctor later died of the disease in a hospital in Bangkok, Thailand.

“To control SARS, it is essential to identify the cases very fast and isolate them properly so they cannot pass the disease on to others, and Vietnam did this very well,” said Brudon, the WHO representative. “It is also important to maintain excellent surveillance and response, as another case could enter Vietnam at any time.”

Health officials cautioned that Vietnam -- which borders southern China -- must remain vigilant and not allow new cases to enter the country undetected.

“The threat of SARS import through international travel is great,” Vietnam’s Health Ministry warned.

There is growing concern among officials in many regions of East Asia that they face an uphill battle as much to contain the psychological fallout from SARS as they do against the virus itself. In China, Beijing remains the focal point for SARS cases, with 126 of the country’s 161 new cases announced Saturday in the capital. Beijing now leads mainland China in fatalities, with 56 compared with 51 in the southern province of Guangdong, which borders Hong Kong.

China now claims to have identified nearly 3,000 people infected with the disease. China’s official tally also includes 131 deaths and 1,921 suspected cases. About 1,300 Chinese SARS patients are reported to have recovered.

On Sunday, authorities in Beijing moved to close all commercial places of recreation in the city -- such as movie theaters, karaoke parlors and discos -- as part of their efforts to halt the spread of the disease. Hundreds of workers also labored to put up a 1,000-bed “field hospital” north of the capital where SARS patients can be isolated.

Also Sunday, Beijing’s official task force began to release figures on quarantined residents, declaring that the city had quarantined 7,672 people -- either SARS patients or those believed to have been in contact with them. Some had been individually isolated, others in groups.

One construction site, four residential compounds and at least three hospitals had also been quarantined, according to official Beijing media reports. On Friday, a Beijing health official had estimated the number of quarantined at about 4,000.

Chinese authorities also announced a raft of measures aimed at ensuring social stability during the crisis. The Public Security Ministry has organized special police teams to deal with SARS, state media reported, including coercing citizens who refuse or try to escape from quarantine.

The Justice Ministry, for its part, warned law enforcement officers to prevent an outbreak of SARS in jails and labor camps and sent out teams of inspectors to investigate facilities in areas hard hit by the disease. And authorities in several cities arrested eight people suspected of “spreading rumors and deceiving the masses” via the Internet in 11 separate incidents.

Authorities in Hong Kong reported an additional 12 SARS-linked deaths Sunday, the highest number in a week. The majority of the victims were in their 70s or older, and eight had suffered from a chronic illness before contracting SARS.

Hong Kong officials also said there were 16 confirmed cases of the disease newly reported during the 24 hours until 1 p.m. Sunday local time. Thirty-six people were discharged from hospitals after being declared recovered.

Singapore’s government reported two more deaths, raising the city-state’s total number of SARS-related fatalities to 21 on Sunday. Health officials said hospitals would turn away visitors. Authorities also said they would close dozens of food markets today for a mass cleaning.

And in the Malaysian state of Sarawak on the island of Borneo, about 280 patients and staff at a psychiatric hospital in the capital, Kuching, were said to be under quarantine after three patients there developed SARS-like symptoms.

It was uncertain how the patients might have come into contact with the disease, and late Sunday the diagnoses remained unconfirmed, although the decision to quarantine the facility reflected a new mood of governments in the region -- to do more, not less, than might be needed.

To help calm panicky residents in Taiwan, the island’s president, Chen Shui-bian, spoke on national TV Sunday.

“Taiwan has experienced many tough tests, including wars, floods, typhoons and earthquakes,” he said. “With the cooperation from people in all walks of life, I believe that we will successfully overcome the challenges brought by SARS.”

There have been signs that the outbreak could have political implications for the already complicated relations between Taiwan and mainland China.

Tsai Ying-wen, chairwoman of Taiwan’s Mainland Affairs Council, said Friday that portions of a long-awaited political assessment of the benefits of establishing direct transportation, communication and postal links between Taiwan and mainland China would need to be reviewed in the wake of the outbreak.

So far, 339 cases of confirmed, possible or suspected SARS have been reported in Taiwan.

Conditions were said to have eased Sunday at Taipei Municipal Hoping Hospital, whose entire patient and staff population was placed under quarantine without warning last week. Two representatives of the U.S. Centers for Disease Control and Prevention helped calm angry staff, and 34 suspected SARS patients were transferred to other hospitals to ease the staff’s workload.

According to officials from the Taipei city government, eight quarantined patients had died in the hospital in the last four days, including three suspected -- but not confirmed -- SARS-related cases.

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Times staff writers Marshall and Paddock reported from Hong Kong and Singapore, respectively. Special correspondent Kuhn reported from Beijing. Special correspondent Tsai Ting-I in Taipei contributed to this report.