Global Alert and Response (GAR)

China confirms SARS infection in two previously reported cases – update 4

29 April 2004

The Chinese Ministry of Health has today reported diagnostic confirmation of SARS infection in two patients previously under investigation in Beijing. Confirmation is based on the results of laboratory tests, clinical symptoms, and a history of close contact with a known case.

Both patients are relatives – the mother and an aunt – of a 20-year-old nurse who treated what is thought to be the index case in the outbreak. The nurse subsequently developed respiratory symptoms and was hospitalized on 7 April. She was visited the next day by family members, including the mother and aunt.

The 44-year-old mother is now in critical condition. The 36-year-old aunt, who was diagnosed with bilateral pneumonia earlier this week, remains in stable condition.

Both patients are part of a third generation of cases that includes the nurse’s father and two other patients hospitalized on the same ward, including one patient who shared a room with the nurse.

The number of SARS cases either clinically confirmed or under investigation remains nine: seven in Beijing and two (including the single fatality) in Anhui Province.

In Beijing, all seven SARS cases are now being treated in isolation at Ditan Hospital. This is a risk reduction strategy aimed at preventing further spread through the hospital system.

According to WHO guidelines for the global surveillance of SARS, classification as a confirmed case at the start of an outbreak requires independent verification of results by an external international reference laboratory. Such procedures are considered necessary in view of the implications that confirmed SARS cases can have for international public health.

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