(SARS) Severe Acute Respiratory Syndrome

Severe Acute Respiratory Syndrome (SARS) arrived new to the world late in 2002, was formally recognized by the World Health th Organization on March 12 , and was announced to be in Toronto on th March 14 . From that time until after the onset of the last case in th Ontario on June 12 , the entire health care system and the public health system of the province struggled with this very dangerous outbreak that resulted in 438 cases and 44 deaths across the country. The overwhelming majority of these cases occurred in hospitals in the Greater Toronto Area. Fortunately there were no SARS cases in Leeds, Grenville and Lanark. However, we did monitor a number of persons under investigation and contacts in quarantine.

SARS originated in Guangdong Province, China and spread to affect over 20 countries around the world, with a total of 8,422 cases and 916 deaths. This international epidemic was controlled and brought to an end using the traditional public health measures of case identification and isolation, and contact tracing and quarantine.

As a health unit we monitored for any possible cases in our district and took steps to ensure that family physicians and health care and other partner agencies of the district were responding well to the control measures of the provincial directives. We lent our support to those areas of the province most afflicted by providing staff to doing telephone followup of quarantined persons in York Region, and staff on site at Toronto Public Health and at York Region Health Services.

In Canada there have been three formal reviews on SARS. One of these, the Naylor Commission, is national in scope and its report recently has been released. The report includes the observation that the system was pushed to the limit and possibly would not have been able to manage a second concurrent emergency or an influenza pandemic. There is a need to increase public health resources at the federal, provincial and local levels, and to enhance communication and coordination.

Provincial directives and protocols are in place and continue to be developed calling for ongoing enhanced surveillance and infection control activities for acute care hospitals and health units. As a health unit we have continued our preparations for SARS and other emerging respiratory diseases.