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Canada: WHO to review advisory

A poster in Toronto's airport warns about the threat of SARS.
A poster in Toronto's airport warns about the threat of SARS.

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TORONTO, Ontario (CNN) -- Canadian health officials say the World Health Organization has agreed to review early next week its travel advisory urging all but essential travel to Toronto be delayed until the SARS outbreak has abated.

Dr. Colin D'Cunha, Ontario's chief medical officer of health, expressed optimism Friday that the review would result in the advisory's repeal, even as he announced two more deaths from SARS in the past day, bringing Canada's total to 18.

One of the latest deaths involved a man who was otherwise healthy, they said. The 44-year-old from York "is unfortunately and tragically the first person we've had who died who is younger in age and does not have comorbid conditions," said Dr. James Young, commissioner of public security for Ontario.

"Despite this bit of sad news, we are encouraged that many people are recovering from the disease," D'Cunha said, noting that 84 remain hospitalized, down from 114 a week ago.

Forty-nine of the 84 are classified as "probable" cases and 39 as "suspect."

"I need to stress that Toronto continues to be a safe place to visit," he said.

Concern over safety led the WHO on Wednesday to issue the advisory, which led tourists to cancel planned trips to the area, provoked furor among politicians and is at odds with the recommendation of the U.S. Centers for Disease Control and Prevention in Atlanta.

D'Cunha said WHO officials offered Friday morning in a conference call to revisit the issue of the advisory.

"I think what they didn't give us credit for was the integrity and the strength of the Ontario public health system," D'Cunha said. "We are not some rinky-dink Third World country, and I say that with respect as somebody who grew up in the Third World."

Ontario public health workers "chased every contact, and chased them and chased them tirelessly," he told reporters.

WHO officials told the Canadian health workers that communication had been a problem when it issued the advisory, D'Cunha said. "They noted that WHO doesn't have an office in Toronto or Canada, and they are very keen to rebuild the excellent relations that Canadian public health officials have with them," he said.

In defending the move, Dr. Julie Hall, head of the WHO's global outbreak and alert response unit, had said Thursday that the advisory would remain in place until the area had gone three weeks with no new cases or new exports to other countries.

Ontario has been traced as the source of SARS cases in the United States, Australia and the Philippines, and the WHO is investigating a possible case spread to Bulgaria.

But D'Cunha Friday expressed optimism the WHO would give them a second chance sooner than that.

"We've committed to share our data daily through the weekend," he said. "My understanding, when I left the call, was that a new risk assessment incorporating all the current data is to be presented to senior [WHO] management and the director general on Tuesday.

"I can assume that some sort of review will be made and the data will speak for itself."

So far, those data identify April 9 as the last day a case of community-acquired SARS was identified, he said. Tuesday would represent 20 days since then -- equivalent to two 10-day incubation periods from time of exposure to onset of symptoms and just a day short of the three weeks sought by Hall.

D'Cunha expressed optimism that the decision would be reversed. "If the decision is scientifically based, in my view, if there is no demonstration of community transmission in the next three days -- I've counted down two incubation periods -- and from a scientific standpoint there's no doubt in my mind," he said.

CNN was not able to confirm D'Cunha's account with the Geneva-based disease agency, but Dr. Michael Ryan, coordinator of WHO's global outbreak and alert response network, told reporters earlier Friday, "We are constantly reviewing these travel recommendations and will be reviewing these over the coming days and weeks with the Canadian authorities."

As of Friday, Health Canada was reporting 341 probable or suspect cases of SARS in the country in addition to the 18 deaths -- up from 327 probable or suspect cases and 16 deaths Thursday.

Another 663 Canadians were in quarantine.

All cases that have occurred in Canada since April 9 have affected health workers who were contacts of known cases, even though the health workers are typically equipped with face masks, goggles, double-thickness gloves and double-thickness gowns.

The doctors' news conference came a few hours after Prime Minister Jean Chretien took steps to demonstrate that his government has the SARS outbreak under control.

The Canadian government will contribute $10 million toward a marketing campaign to boost the image of Toronto, where tourism has been crippled by fears of Severe Acute Respiratory Syndrome, he told reporters in Ottawa.

Then, in an acknowledgment that public relations alone cannot solve the problem, he said he will demonstrate "in a very public way our commitment" to reassuring the public that Toronto is safe.

Chretien said his Cabinet will meet Tuesday in Toronto instead of its customary location in Ottawa, and his wife, Aline, will fly Thursday from Ottawa to Toronto, where she will spend the day and dine in a restaurant. The prime minister himself will overnight Monday in a Toronto hotel, "and I'll sleep very, very, very well," he predicted.

Fallout over the advisory has come from all over. The president of Toronto's major league baseball team Friday called WHO's recommendation "very irresponsible" and predicted it would hurt the city's economy.

Ontario has declared a public health emergency over the outbreak, but Toronto's medical officer of health, Dr. Sheela Basrur, noted that the illness has not spread into the city's neighborhoods and business areas.


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