Health
Looking back: Toronto’s 2003 SARS outbreak – Global News
A new coronavirus, which emerged in December from China, has drawn comparison to the 2003 outbreak of SARS.
Here, Global News looks at how SARS affected Torontonians nearly 20 years ago:
What is SARS?
The SARS coronavirus, or Severe Acute Respiratory Syndrome, is thought to be a virus from an animal reservoir that spread to other animals and first infected humans in Guangdong, China in 2002, according to the World Health Organization.
The epidemic resulted in more than 8,000 cases in 2003 and affected 26 countries, one of which was Canada.
In Canada, there were 438 probable and suspect SARS cases reported, which included 44 deaths.
Start of the virus and its transmission to Toronto
SARS first infected humans in the Guangdong province in southern China in 2002.
A 65-year-old doctor, who had treated atypical pneumonia patients in Guangdong, travelled to Hong Kong to attend his nephew’s wedding. When he checked into the hotel he was staying at, he didn’t feel well. The doctor ended up infecting at least 12 others from several different countries, including a 78-year-old Canadian woman.
The woman returned to Toronto from Hong Kong on Feb. 23, 2003. Two days after she got back home, she developed a high fever. She visited her family doctor five days later, and by that time, she was also complaining of muscle aches and a dry cough.
The woman’s condition continued to deteriorate, and she died at home on March 5, 2003. Two days later, her 44-year-old son went to the Scarborough Hospital, Grace Division’s emergency department to complain of a high fever, a severe cough and difficulty breathing.
The man was kept in the open observation ward of the emergency department for 18 to 20 hours, but by the next day, his condition had deteriorated significantly, and he was admitted to intensive care.
The woman’s son died on March 13, 2003, and by this time, several other family members were also sick.
“It was then clear that there was a cluster of illness in that family, and at about the same time, the outbreak was recognized in Hong Kong,” said Allison McGeer, an infectious disease consultant at Sinai Health System, who was at the forefront of the Toronto outbreak.
On March 12, 2003, the World Health Organization issued a global alert about “cases of atypical pneumonia.”
In Toronto, the virus continued to spread to others, including hospital staff
Public health response
On March 13, 2003, Health Canada was notified of the Toronto cluster.
SARS continued to spread throughout the Scarborough Hospital, which led to it closing its emergency and intensive care services on March 23 and to refusing new patients and transfers from other hospitals. Anyone who entered the hospital after March 16 was asked to adhere to a 10-day home quarantine.
On March 25, 2003, the Ontario government designated SARS as a reportable, communicable and virulent disease under the Health Protection and Promotion Act, which allowed public health officials to track infected people and issue orders to prevent them from engaging in activities that might transmit the illness.
One day later, Ontario’s then-premier Ernie Eves declared SARS a provincial emergency. Overnight, the province’s ministry of health and long-term care required all hospitals to create units to care for SARS patients. The province also activated its multi-ministry provincial operations centre for emergency response.
All hospitals in the Greater Toronto Area and Simcoe County were instructed to activate “Code Orange” emergency plans, which meant that the involved hospitals suspend non-essential services.
They were also required to limit visitors, create isolation units for possible SARS patients and to implement protective clothing for exposed staff. Four days later, officials implemented the access restrictions on all hospitals in Ontario.
Looking back and forward
Looking at Toronto’s 2003 SARS outbreak, McGeer said officials got a lot of things right in the sense that they were able to control it.
“They clearly did enough right things to control the outbreak,” McGeer said. “Some of the things that were done were not necessary, but there was no way of knowing at the time that they were not necessary.”
According to the doctor, one thing that wasn’t necessary was quarantine.
“When we learned more about the disease, it turns out that SARS is among the unusual infections that was not infectious before people got sick,” McGeer said.
“Retrospectively, we needn’t have quarantined all of those people who were exposed.”
McGeer said officials could have just told people who exhibited SARS symptoms to separate themselves from others.
Another thing that was unnecessary, according to the doctor, was the extent of hospital closures. If officials had data on likely patterns of spread between hospitals, they probably could have managed a different system that would’ve resulted in less hospitals being closed, causing less of a disruption to general care, McGeer said.
“These are not things where I would say the government should not have done them, but with the wisdom of hindsight, now that we’ve had the chance to look at it afterwards, you can say we didn’t need to do them,” McGeer added.
© 2020 Global News, a division of Corus Entertainment Inc.
Health
Quebec successfully pushes back against rise in measles cases – CBC.ca
Quebec appears to be winning its battle against the rising tide of measles after 45 cases were confirmed province-wide this year.
“We’ve had no locally transmitted measles cases since March 25, so that’s good news,” said Dr. Paul Le Guerrier, responsible for immunization for Montreal Public Health.
There are 17 patients with measles in Quebec currently, and the most recent case is somebody who was infected while abroad, he said.
But it was no small task to get to this point.
Le Guerrier said once local transmission was detected, news was spread fast among health centres to ensure proper protocols were followed — such as not letting potentially infected people sit in waiting rooms for hours on end.
Then about 90 staffers were put to work, tracking down those who were in contact with positive cases and are not properly vaccinated. They were given post-exposure prophylaxis, which prevents disease, said Le Guerrier.
From there, a vaccination campaign was launched, especially in daycares, schools and neighbourhoods with low inoculation rates. There was an effort to convince parents to get their children vaccinated.
Vaccination in schools boosted
Some schools, mostly in Montreal, had vaccination rates as low as 30 or 40 per cent.
“Vaccination was well accepted and parents responded well,” said Le Guerrier. “Some schools went from very low to as high as 85 to 90 per cent vaccination coverage.”
But it’s not only children who aren’t properly vaccinated. Le Guerrier said people need two doses after age one to be fully inoculated, and he encouraged people to check their status.
There are all kinds of reasons why people aren’t vaccinated, but it’s only about five per cent who are against immunization, he said. So far, some 10,000 people have been vaccinated against measles province-wide during this campaign, Le Guerrier said.
The next step is to continue pushing for further vaccination, but he said, small outbreaks are likely in the future as measles is spreading abroad and travellers are likely to bring it back with them.
Need to improve vaccination rate, expert says
Dr. Donald Vinh, an infectious diseases specialist from the McGill University Health Centre, said it’s not time to rest on our laurels, but this is a good indication that public health is able to take action quickly and that people are willing to listen to health recommendations.
“We are not seeing new cases or at least the new cases are not exceeding the number of cases that we can handle,” said Vinh.
“So these are all reassuring signs, but I don’t think it’s a sign that we need to become complacent.”
Vinh said there are also signs that the public is lagging in vaccine coverage and it’s important to respond to this with improved education and access. Otherwise, microbes capitalize on our weaknesses, he said.
Getting vaccination coverage up to an adequate level is necessary, Vinh said, or more small outbreaks like this will continue to happen.
“And it’s very possible that we may not be able to get one under control if we don’t react quickly enough,” he said.
Health
Pregnant women in the Black Country urged to get whooping cough vaccine – BBC.com
Pregnant women urged to get whooping cough vaccine
Pregnant women in the Black Country are being urged to get vaccinated against whooping cough after a rise in cases.
The bacterial infection of the lungs spreads very easily and can cause serious problems, especially in babies and young children.
The Black Country Integrated Care Board (ICB) is advising pregnant women between 16 and 32 weeks to contact their GP to get the vaccine so their baby has protection from birth.
The UK Health Security Agency warned earlier this year of a steady decline in uptake of the vaccine in pregnant women and children.
Symptoms of the infection, also known as “100-day cough”, are similar to a cold, with a runny nose and sore throat.
Sally Roberts, chief nursing officer for the ICB, which covers Wolverhampton, Dudley, Walsall and Sandwell, said anyone could catch it, but it was more serious for young children and babies.
“Getting vaccinated while you’re pregnant is highly effective in protecting your baby from developing whooping cough in the first few weeks of their life – ideally from 16 weeks up to 32 weeks of pregnancy,” she said.
“If for any reason you miss having the vaccine, you can still have it up until you go into labour.”
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Health
Measles cases stabilize in Montreal – CityNews Montreal
The number of measles cases has stabilized, according to the Montreal Public Health.
Since March 25, there have been no contaminations reported within the community.
“Our teams have identified all contact cases of measles,” said media relations advisor Geneviève Paradis. “It’s a laborious task: each measles case produces hundreds of contacts.”
All community transmission cases since February 2024 have been caused by returning travelers who were either unvaccinated or partially vaccinated.
Currently, there are 18 measles cases in Montreal – with 46 total in Quebec. This according to the April 18 figures from the provincial government.
“With the summer vacations approaching, if you’re travelling, it is essential to check if you are protected against measles,” explained Paradis.
According to Montreal Public Health, a person needs to have received two doses after the age of 12 months to be immunized against the virus.
They’ve launched a vaccination campaign throughout the region, and currently, 11,341 people have been vaccinated against measles in Montreal between March 19 and April 15.
Vaccination is also being provided in schools and at local service points.
“The vaccination operation is under the responsibility of the five CIUSSS of the territory,” concluded Paradis.
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