World health officials extend Sars travel warnings

9.30am

BEIJING - The World Health Organisation has advised against travel to two more provinces in China and the capital of Taiwan, as WHO experts headed to China's hinterland where they fear Sars is beginning to spread fast.

But health experts said while the death toll is mounting and mortality rates are going up, it is not because the virus itself is changing but because some patients who were lingering have started to die.

WHO extended its Sars-related travel warning to the provinces of Tianjin and Inner Mongolia as well as Taipei. The UN health agency had already advised against travel to Beijing, the provinces of Guangdong and Shanxi, and Hong Kong.

WHO experts say China is key to containing the global spread of severe acute respiratory syndrome, which has now killed more than 500 people and infected more than 7300.

More than 120 Chinese officials have been punished in the past month for covering up the extent of the Sars outbreak or failing to prevent its spread, Xinhua news agency said.

China's Health Ministry said five more people had died of Sars, including the first in its commercial capital of Shanghai, and another 146 had been infected -- roughly the same daily toll as in previous weeks.

China has had 4698 cases and its death toll stands at 224.

Taiwan reported 22 new cases, taking the island's infections to 360 with 13 deaths. The Taipei American School, which has 2100 students, closed for the year.

Hong Kong reported four more deaths and seven new cases -- the lowest number of new infections since the outbreak began.

Russia said it had closed some crossings on its long border with China to try to prevent the epidemic's spread and said it might stop "all air travel to airports in China, including Hong Kong and Taiwan."

WHO's head of communicable diseases, Dr David Heymann, said China still had a chance to stamp out Sars.

"If the government fully commits and commitment includes making the necessary resources available ... this disease can be contained and we are still hopeful it can be driven back into the box," he told a news conference.

WHO officials now praise China for its cooperation but Beijing has been criticized for holding back information about the epidemic, which is believed to have started in southern China in November and covered up until March.

In Washington, Ed Markey, a Democratic member of the House of Representatives from Massachusetts, suggested that China be punished by having its membership in the World Trade Organisation suspended.

"The actions of China in response to the emerging threat of Severe Acute Respiratory Syndrome make clear the need to link public health and trade in international commerce," Markey said in a letter to US President George W Bush.

Newspapers were full of headlines about how WHO had raised its estimates of SARS mortality from 6 per cent to 15 per cent overall and as high as 50 per cent in some groups.

But Dr Julie Gerberding, head of the US Centers for Disease Control and Prevention, said the numbers did not mean the virus has changed or become more deadly.

"As an epidemic is evolving, it takes time before we know whether or not a patient is going to recover or a patient is going to die," Gerberding told reporters.

"We are always catching up as new patients enter the ... equation," she added. "We have been saying all along that we expect the death rate to go up as we see the outcome or the conclusion of the sicker patients over time."

She also said it was "mixing apples and oranges" to compare mortality rates in one country to those in another. "If your country has a higher proportion of elderly people, you have a higher death rate," she said.

A report in the Lancet medical journal this week of mortality in Hong Kong only included patients in hospitals, she noted. "Naturally, people in the hospital are sicker than people being cared for at home, so naturally your death rate is going to be higher," she said.

While the virus had mutated in some cases, she said, there was no evidence to show the changes made it any more dangerous -- yet.

Reports that the coronavirus that causes Sars could live in stool, urine and on some surfaces also had to be read with caution, she said.

- REUTERS