NZ updates Sars travel warnings to include Canada

3.00pm

The Health Ministry is asking people to reconsider non-essential travel to Toronto in Canada, because of the risk of severe acute respiratory syndrome (Sars).

The ministry said the request was in line with World Health Organisation (WHO) recommendations issued on Wednesday.

Sars has killed 16 people in the Toronto area, the only country outside Asia where people have died from the highly contagious sickness.

Globally, more than 260 people have died of the virus and about 4400 have been infected.

The ministry has been issuing advice about Sars-risk countries, rating the risk from one; the most severe, to three; less severe but still a risk.

It has downgraded travel advice on Hanoi in Vietnam from level two to three.

Mainland China and Hong Kong remain on level one which means non-essential travel should be avoided.

Level two advice, for moderate-risk areas and which applies to Toronto and Singapore, has been changed to recommend that people should consider postponing non-essential travel to these countries.

In Canada the health ministry has asked the military to send medical personnel to help Toronto's badly-stretched health workers cope with the outbreak of Severe Acute Respiratory Syndrome (SARS) there.

The request was confirmed by Dr Paul Gully, senior director general at the federal health ministry .

Defence department spokeswoman Lieutenant Diane Grover told Reuters the military would dispatch a critical care nurse and two doctors to Toronto next week but is unable to send more.

"We're dealing with a shortfall of medical officers in the armed forces, partly as a result of assignments and partly because of problems with recruiting and retention," she said.

Canada's largest city, fighting for its reputation after the World Health Organisation (WHO) told travellers to stay away, insisted today it is getting the SARS illness under control and won backing from the US Centres for Disease Control for its handling of the outbreak.

SARS has killed 16 people in the Toronto area, the only part of the world outside Asia where people have died from the highly contagious sickness.

But the WHO recommendation, issued on Wednesday, placed the city virtually off limits for many travelers, forcing the cancellation of conventions and emptying shops and hotels.

City officials said the outbreak appears to be nearing an end. New cases were reported last weekend among health workers -- the group most at risk from the flu-like virus -- but the illness was not spreading to the broader community.

"The outbreak will be over when 20 days have elapsed with no new cases," said Sheela Basrur, Toronto's medical officer of health told the city council. "It's been about a week so far, at least, since we've had a new case in the community. So in my view the clock is already ticking on the 20 days."

The Atlanta-based Centres for Disease Control and Prevention dismissed the WHO advice and said the risk of contracting SARS is no greater in Canada than in other nations with cases of the deadly disease. It said there is no need for people to avoid travelling to Toronto or other Canadian cities.

"US citizens travelling to Canada are not at risk for SARS if they avoid hospitals and take common-sense precautions," Dr. Julie Gerberding, director of the CDC, told reporters in Atlanta.

In Geneva, however, WHO spokesman Jon Linden said there was no reason for the WHO to change its advisory, which was valid for three weeks.

"The reason is that Toronto fits the three criteria for such a warning -- that there is an increase in cases, that there is a geographic spread in cases and that there is an export of cases," he said.

"To say that Toronto has very good health service and that the likelihood is not high of getting the disease if you get to Toronto is fine, but it does not change the basic criteria for our travel advice."

Canada has formally challenged the advisory and its federal health minister spoke with WHO head Gro Harlem Brundtland about the issue.

Toronto Mayor Mel Lastman, who has also condemned the WHO's travel advisory, said people's lives were being hurt by the world's perception of the disease.

"This isn't a city in the grip of fear and panic," said Lastman. "It's 16 (deaths) out of 5 million people in the (Toronto area).

"It's not the disease that's doing the damage, it's the public perception about SARS that's hurting Toronto's tourism industry and it's getting worse."

About 10,000 people have gone into voluntary quarantine in the Toronto area since the outbreak began in March, turning the city into one of the epicenters of the SARS virus.

SARS is taking a heavy toll on business in Toronto, which accounts for about a fifth of Canada's economic output, and it is weighing on the Canadian dollar.

"Whether the people in Canada see it as much of a threat, the fact of the matter is it's really discouraging anybody from outside Canada to even venture into Canada because of it," said David Ebata, managing analyst at Thomson IFR, a research firm in Boston.

There were 330 probable or suspect cases in Canada as of Wednesday.

Industry watchers say the decline in tourism has been devastating. Conventions have been cancelled, restaurants are empty and some hotels are operating at 10 per cent to 20 per cent occupancy rates -- levels not seen since the September 11 attacks.

The outbreak has led to accusations that the Canadian government and politicians at all levels are not doing enough. "From an industry perspective we need damage control," said Jason Bond, managing director of a Toronto tourism company.

- NZPA, REUTERS