THISDAYonline

On February 13, Kwan Suichu flew from Toronto to visit her relatives in Honh Kong. Then days later, she returned to Toronto. And on March 5, she died. On March 13, her 44-year-old son, Chi Kwai Tse, who was among those she visited in Hong Kong, died too.

This incidence between mother and son s now seen as the genesis of SARS, the latest disease that is keeping the world community uncomfortable and anxious.

The World Health Organisation (WHO) last Friday welcomed the call by African health ministers for "appropriate responses" to the disease. He pledged continued support to African countries, many of which have already taken measures to detect and curb the spread of the disease. At their April 26-30 meeting in Tripoli, Libya, the first under the auspices of the African Union (AU), the ministers had called for more intensive advocacy on SARS, the mobilisation and deployment of resources to keep the disease at bay, and collective action through regional cooperation because failure by one country to control SARS could put the entire continent at risk.

Speaking in Brazzaville on the outcome of the Tripoli meeting, the WHO Regional Director for Africa, Dr Ebrahim Samba, welcomed the stand taken by the ministers. He said WHO would continue to provide the necessary support to member-states to detect and contain SARS.

A round table with the theme "Investing in Health for Africa's Socio-economic Development" was organised as part of the five-day meeting which agreed that the disease would be "a major problem for African countries" if it should spread to the continent which has so far recorded only one probable case (in South Africa).

The ministers also noted that if SARS were to take hold in Africa, it would overstretch already over-burdened health systems. For instance it could cause panic and social unrest; divert resources and attention away from other health and development programmes, and aggravate existing crises facing many countries such as chronic poverty, hunger, HIV/AIDS and other communicable diseases.

Delegates to the meeting stressed that awareness-creation, rapid information dissemination and exchange, quarantine facilities at airports as well as land and sea transit points were key to detecting and preventing the disease. Training of health personnel to deal with cases at designated hospitals and other health facilities is also key, as is free medical assistance to affected people.

"WHO is determined to track down every possible case of SARS.

Since the Severe Acute Respiration Syndrome (SARS), a respiratory illness that primarily affects the lungs reared its head about six months ago in Southern China, it has spread to about 26 countries with about 5500 cases mainly through air travelers. Although the dreaded disease has not been noticed in the country, the fear of it gripped many Nigerians when it was learnt that it has spread to the United States of America (USA) and the United Kingdom (UK), two countries where Nigerians visit often.

The news of the continuos spread of the disease probably jolted the Nigerian government and penultimate week President Olusegun Obasanjo directed posting of health experts to the international airports in Lagos, Port-Harcourt, Kano and Abuja and the immediate installation of equipment for detecting SARS at the airports.

Also the federal government has ordered security agencies and other agencies concerned to take extra measures to prevent the disease from getting into the country.

A medical doctor, Dr. Bill Lovelock noted in a press briefing recently on the disease, "the only way it can get to Nigeria is if a traveler from one of the infected countries, and who is himself infected comes into Nigeria.

The Minister of Information and National Orientation, Professor Jerry Gana briefing state house correspondents at the end of the Federal Executive Council meeting (FEC) penultimate Wednesday gave a hint on how the agencies and personnel concerned would arrest SARS before it gets in to the country.

He said "there is a mechanism where people's temperature can be tested if they have fever so that such person can be watched and possibly be quarantined for sometimes to ensure that they do not share the deadly fever". He explained that all agencies and parastatals related to the healthy Ministry would be involved in the initiative.

Apart from a high fever of over 38.0讈 (100.4躘) other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms. After two to seven days, SARS patients may develop a dry cough and have trouble breathing; about 10 to 20 per cent require a ventilator. Some also get severe diarrhea.

SARS spread through cough and sneezes. It can also be spread by touching the skin of other people or objects that are contaminated with infectious droplets and then touching one's eye (s), nose, or mouth. This can happen when someone who is sick with SARS coughs or sneezes droplets onto themselves, other people, or nearby surfaces. It is also possible that SARS can be spread more broadly through the air or by other ways that are currently not known.

Most cases of SARS have involved people who cared for or lived with someone with SARS, or had direct contact with infectious material (for example, respiratory secretions) from a person who has SARS. There is still no known cure for the disease, but patients are given supportive care for their symptoms, such as ventilators to aid breathing and fluids to prevent dehydration.

Gana stated that " there is no need for public alarm, we are just taking preventive measures. we are sure there is no case of SARS yet in Nigeria".

He further noted that "we are a huge population and a thing like that if it comes to Nigeria today, it will be a disaster. So we must do everything to prevent it from coming into the country".

Some public hospitals in Nigeria have begun enlightening staff on the treatment of the disease. The University of Nigerian Teaching Hospital (UNTH) Enugu, has organised a sensitisation workshop for its workers.

The Chief Medical Director of the hospital, Dr. Anthony Mbah, urged Nigerians to suspend their trips to Asian countries.

The Lagos State Commissioner for Health, Dr. Leke Pitan advised that though there has been no reported cases of the virus in the country, there is need to sensitise the general public on the killer disease and how to prevent it.

He explained that the authorities in Lagos State public hospitals have been told to look out for possible cases.

He said actions taken so far include monitoring the progressive spread of the disease, establishing SARS communication line and maintaining constant touch with all stakeholders and inform all experts about the disease.

As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand hygiene. Cleaning your hands often using either soap and water or waterless alcohol-based hand sanitizers removes potentially infectious materials from one's skin and helps prevent disease transmission.

According to Dr. Lovelock it is important to use handkerchiefs or tissue papers to cover the nose when sneezing, and following good sanitary practice.

Doctors and nurses who may have to care for SARS patients are advised to take proper safety precautions and wear masks, gloves and gown.

The United States based Center for Disease control (CDC) advises that travellers in a SARS-affected area should wash their hands frequently to protect against SARS infection. In addition, CDC advises that travellers may wish to avoid close contact with large numbers of people as much as possible to minimize the possibility of infection.

WHO said a cumulative total of 5500 probable SARS cases with 321 deaths have been reported from 26 countries.

The cause of SARS has been traced to a previously unknown virus in the coronavirus family. Scientists have detected this unrecognised coronavirus in patients with SARS. Coronavirus often infect animals and until now caused only mild illness in people.

Meanwhile, WHO plans to hold an international scientific meeting in Geneva between June 17 and 18 to review the epidemiological, clinical management and laboratory findings on SARS and to discuss global control strategies. Key participants in the response to the current outbreaks and other public health authorities will be invited to attend the meeting.

The slow reaction to the SARS epidemic is also due to the reluctance of the Chinese government to admit to the severity of the disease. In April the government finally admitted that SARS is a problem and allowed in a WHO team to investigate it.

However, WHO official said last Monday that he believes the worst of SARS is over in Vietnam, Canada, Singapore and Hong Kong but that the disease continues to spread in mainland China.

"We believe the outbreak has come to a peak in these areas because of information that ministries of health have given us," said Dr. David Heymann, WHO's executive director of communicable diseases.

"The governments have reported cases, and we see in each of these areas, the case reports are decreasing and becoming more stable so we believe the epidemic may have peaked in these countries."

WHO has given Vietnam a clean bill of health for being the first nation to contain severe acute respiratory syndrome.

"WHO congratulates Vietnam in being the first country in the world to contain SARS," said Pascale Brudon, WHO representative in Vietnam. "Such success can be attributed to a range of factors, but the most important were the speed of action, leadership and transparency shown by the government."

WHO has also announced the lifting of its SARS-based advisory against travel to Toronto.

Meanwhile, Asian leaders adopted a six-point plan to try and control the outbreak of the deadly respiratory virus.

The leaders of China, Hong Kong and the 10 members of the Association of Southeast Asian Nations agreed to an action plan during a summit in Bangkok, Thailand, aimed at creating regional unity and cooperation in the fight against severe acute respiratory syndrome.