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Taiwan health chief resigns in SARS crisis
TAIPEI, Taiwan (CNN) -- Taiwan's top health official announced his resignation Friday over continued criticism of the way authorities are handling the SARS outbreak. Health Minister Twu Shiing-jer's decision came following numerous complaints about disorganization, lack of effective crisis management planning and political bickering. He made the announcement on Taiwanese television. Taiwan ranks just below mainland China in the number of new cases reported since Wednesday, according to the World Health Organization's Web site. The total number of SARS cases in Taiwan rose by 10 to 274, the country's health officials said. The new death toll included the first two doctors on the island to die of SARS. Two hospitals, one in Taipei and another outside the capital, reported clusters of SARS patients in the past day, health officials said. Hundreds of doctors and patients have been quarantined. Dozens of cases have also been reported in Chang Gung Memorial Hospital in the southern city of Kaohsiung. The cases didn't come to light until last weekend. In the face of concerns that many people may have been infected, officials said they wouldn't know for sure what the outcome will be until a 10-day incubation period is complete. Sources close to the battle against SARS said Taiwan is at a crossroads. They said unless officials move quickly to contain the outbreak in hospitals and do a more effective job of tracing contacts of suspected patients, the epidemic risks taking a further turn for the worse, with potentially serious consequences for the country's health-care system. WHO cites progress in containing SARSMeanwhile, the WHO's chief SARS expert said he sees progress in efforts to contain the disease and holds out hope that severe acute respiratory syndrome may never emerge as a worldwide epidemic. WHO removed Canada this week from its list of countries where local transmission of the disease is occurring. Vietnam previously was deleted from the list. "So that brings us to two countries that have interrupted transmission as the outbreak containment continues," David Heymann, WHO's chief of communicable diseases, told reporters Thursday in a conference call. SARS emerged in November in China's Guangdong Province and has spread to 30 countries, with more than 7,600 cases worldwide and nearly 600 deaths, according to WHO. "We are seeing that we are beginning to tighten in on the disease," Heymann said. "... Eventually, we hope that it can be contained throughout the world and not become an epidemic or an endemic disease." The desire to stem the spread of the recently recognized coronavirus that causes SARS led WHO to issue guidelines Thursday addressing when patients who have recovered from SARS or who had suspected cases can donate blood. Though no probable SARS case has been blamed on transmission via blood products, "there is a theoretical risk," the agency said on its Web site. During the early 1980s, transfusions of contaminated blood caused the spread of AIDS, which then was only newly recognized. WHO's proposed guidelines include asking people who have traveled to SARS-affected areas to defer donating blood and seeking better reporting by past donors if they are diagnosed later as suspect or probable SARS cases. The same recommendations could be used as screening criteria for organs, tissues and cells for transplantation, WHO said. Screening test for the virus in the worksCreation of a dependable screening test could obviate the need for such guidelines, but current tests for coronavirus in the blood are not sensitive enough, Heymann said. "The only thing we have to go by right now is history [of travel and possible exposure to SARS] and fitting the case definition," he said. However, a test may not be far off, according to a pharmaceutical firm. A spokesman for the Basel, Switzerland-based Roche Pharmaceuticals said the company expects to produce by August a test that would screen for the SARS virus. But even if the company succeeds, its test -- which would look for bits of the coronavirus in blood -- would require at least 18 more months before it could gain approval by the U.S. Food and Drug Administration, said Roche spokesman Daniel Piller. Until then, "it will be for research purposes only," Piller said. Until such a test is available, Heymann said, "The most appropriate method [of screening blood] will be deferral of blood donors, as was done early in AIDS and is still done in AIDS, as a matter of fact." Though SARS is thought to be transmitted largely by close contact with an infected person, transmission via animals has not been ruled out. Studies carried out in Hong Kong indicate that cats can become "transiently" infected with the coronavirus that causes SARS, Heymann said, but the animals "didn't seem to be able to transmit it because they didn't harbor it." Some scientists have theorized that SARS could have spread from animals in the Guandong Province. "There are some feelings that possibly live game markets might have been associated with some of the earlier cases, but this is only hypothesis," Heymann said. Studies have shown that cockroaches might serve as another possible mode of transmission, Heymann said. "They found that they could get the virus to adhere to cockroaches physically with the possibility then that it would be deposited somewhere else," he said. CNN's Mike Chinoy contributed to this report.
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