WHO says China doctors still under-reporting SARS

The World Health Organisation said yesterday some confused Chinese doctors were under-reporting Severe Acute Respiratory Syndrome (SARS) infections, as Taiwan announced a record one-day rise in cases of the deadly virus.

Singapore may be just a day away from being declared SARS-free and the WHO expressed confidence that Hong Kong too had the virus under control, but 34 new infections in Taiwan took the global tally to at least 7,770, with 610 deaths.

The WHO said it was still too early to say if China - the worst hit country with 282 deaths and 5,209 cases - was past its peak of SARS cases, because doctors were not fully reporting cases because of misunderstanding about the symptoms.

The WHO criticised China in April for dramatically under-reporting cases of SARS and the world's most populous country responded by sacking its health minister and the mayor of Beijing for negligence.

After visits by WHO officials to Beijing hospitals, the UN health agency said it was concerned that some cases were being excluded because patients had no known contact with a SARS victim or because they had mild symptoms that cleared up.

"They fit the case definition but because they get better in a few days they are not seen as probable cases," Daniel Chin, the head of the WHO's Beijing team of SARS experts, said in a statement.

The patients were being sent home or moved out of isolation wards to general wards, where they could infect others, he said.

"Clinicians are making this decision because there's an assumption that SARS patients must be very sick. But there's a spectrum of severity for SARS," Chin said.

The WHO warned travellers to avoid China's Hebei province, extending its travel advice because of the scale of the SARS outbreak in the region. It already recommends that people consider postponing all but essential travel to several areas of China, namely Beijing, Guandong, Inner Mongolia, Shanxi and Tianjin.

Taiwan, the third worst affected area after mainland China and Hong Kong, said yesterday its cases had jumped by 34 to 308. The death toll stood at 35.

"If the spread of SARS lasts for several more months, I don't know if we can stand it," said Wu Ah-chung, a restaurant chef. With patrons too scared to dine out, he said, sales had fallen by a third.

Such reluctance to go out has hit Asian economies hard. Airlines have been worst affected, with most ground staff and air crew at Hong Kong's Cathay Pacific agreeing to take four weeks unpaid leave as the airline grounds planes in the face of a two-thirds fall in passenger traffic.

Taiwan's health minister quit on Friday to take responsibility for the spread of the virus through hospitals.

Face masks are a common sight in Taipei streets. Passengers on the city's mass rail network are required to wear them, as are restaurant workers.

Singapore, where SARS has killed 28 people, is set to be taken off the World Health Organisation's list of SARS-affected regions by today if no new infections are reported.

The city-state has been counting down to today but got a fright when there was a suspected outbreak at a mental hospital. But the government said that had turned out to be common flu, not SARS.

"Singapore is in a very good position," WHO official Stephen Lambert told a news conference.

The WHO says 20 days of no new cases - or two incubation periods - are needed before declaring SARS under control. Canada came off the list on Thursday and Vietnam last month.

Hong Kong reported four new cases and five more deaths yesterday, its 14th day of single-digit new cases, but the WHO said it could be several weeks before the city got to the point of declaring no new cases.

"We think that the outbreak has come under control in Hong Kong and that soon there will be no new cases," David Heymann, the WHO's head of communicable diseases, said.

Japan's health ministry stepped up its search for people who might have been infected with SARS by a Taiwanese doctor who visited Japan this month after treating SARS patients.

The 26-year-old doctor, whose name has not been released, visited Japan on a package tour that included trips to a hot spring bath and the Universal Studios Japan theme park in Osaka.