US embassy cable - 03OTTAWA1876

Update 44 - Ontario SARS (July 2, 2003): WHO Removes Toronto from List of SARS Affected Areas

Identifier: 03OTTAWA1876
Wikileaks: View 03OTTAWA1876 at Wikileaks.org
Origin: Embassy Ottawa
Created: 2003-07-03 13:54:00
Classification: UNCLASSIFIED
Tags: AMED SOCI TBIO ECON CASC CA Health
Redacted: This cable was not redacted by Wikileaks.
This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 02 OTTAWA 001876 
 
SIPDIS 
 
STATE FOR WHA/CAN, CA/OCS, M/MED, and M/DASHO 
HHS FOR OFFICE OF THE SECRETARY, OFFICE OF 
INTERNATIONAL AFFAIRS (STEIGER), CDC FOR GLOBAL HEALTH 
OFFICE (COX) 
 
E.O. 12958: N/A 
TAGS: AMED, SOCI, TBIO, ECON, CASC, CA, Health 
SUBJECT: Update 44 - Ontario SARS (July 2, 2003): WHO 
Removes Toronto from List of SARS Affected Areas 
 
 
TORONTO SENDS 
 
Ref:  Toronto 1816 and previous 
 
World Health Organization (WHO) Removes Toronto from 
List of "Areas with Recent Local Transmission" 
--------------------------------------------- ------- 
 
1.In a move anticipated with measured optimism by 
Ontario Health Minister Tony Clement in a July 1 
televised interview, the WHO on July 2 "removed 
Toronto, Canada, from its list of areas with recent 
local transmission."  The WHO used as its measure the 
fact that 20 days  - double the known incubation period 
for SARS - have passed since a new SARS case surfaced 
in the Greater Toronto Area (GTA).  Twenty-two active 
probable cases remain in Toronto.  The WHO, however, 
according to spokesman Christine McNab, determined that 
the disease's risk to people in the community is 
"extremely low to zero." 
 
2. During Toronto's second bout with SARS, locally 
dubbed "SARS II," the WHO did not reinstate its earlier 
travel advisory on Toronto.  However, Toronto's 
presence during May and June on the WHO's "local 
transmission" list delayed public/private sector 
marketing programs to bring travelers back to Canada's 
largest city - programs which can now be launched with 
confidence. 
 
Keep up the Guard, Experts Caution 
----------------------------------- 
 
3. Despite the good news, both the WHO and Toronto 
experts such as Dr. Donald Low, Mount Sinai Hospital's 
chief microbiologist, are urging continued vigilance. 
The mechanisms of SARS' spread are still not fully 
understood, and modern hospital settings appear to be 
particularly vulnerable to SARS.  Toronto's most recent 
SARS fatality, for example, was a front-line nurse. 
The WHO's statement notes that the efficient spread of 
the virus in "sophisticated hospital settings may have 
contributed to the severity of Toronto's outbreak ... 
certain procedures, such as difficult intubation and 
use of nebulizers that are more common in sophisticated 
hospitals, also increas[e] the risk of infection." 
 
4. A combination of the CDC and Health Canada's review 
of hospital procedures, a just-underway Health Canada 
expert committee examination of infectious disease 
controls, and an Ontario provincial lessons-learned 
exercise should help to fine-tune the "new normal" of 
identifying, containing, and dealing with infectious 
diseases, implemented by Ontario's Health Ministry last 
month. 
 
June 30 Case Statistics (Ontario Ministry of Health) 
--------------------------------------------- ------- 
 
5. Summary: 
 
--22 active probable cases (hospitalized/under 
investigation), compared with 37 on June 17.  Of the 21 
hospitalized cases, 11 are in critical/ deteriorating 
condition. 
 
--2 active suspect cases, compared with 4 on June 17. 
Of the 2, both hospitalized, none are in 
critical/deteriorating condition. 
 
--316 cumulative discharges (probable and suspect), 
compared with 299 on June 17. 
--379 cumulative cases (probable/suspect/ fatalities) 
compared with 375 on June 17. 
 
Case Statistics: 
 
     Probable (Active): 
          21 hospitalized 
           1 under investigation 
           0 home 
         188 cumulative discharges to date. 
 
     Suspect (Active): 
           2 hospitalized 
           0 under investigation 
           0 home 
         128 cumulative discharges to date. 
 
Fatalities: 39 cumulative fatalities to date, compared 
with 33 on June 11. 
 
MARWITZ 

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