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Flu - Bird flu and Sars
When's a Sars case a Sars case?
Last updated: Monday, January 12, 2004
Does the patient have Sars? Is it a confirmed case? Or is it merely a suspected case? Is it a possible suspected case or an officially confirmed possible suspected case? And who is doing the confirming, exactly?

 
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As China's second season of fighting severe acute respiratory syndrome (Sars) kicks into gear, the chances for misunderstanding are greater than ever.

No clear distinction
"It's not clear to us how they're arriving at a decision to identify a suspected case," said Bob Dietz, a World Health Organisation spokesman in Beijing.

In Guangdong, in Hong Kong and in telephone interviews with various low-level Chinese medical officials, the terms are even more elastic than that. Some say "confirmed" when they mean "suspected", some say "suspected" when they mean "possible", and some say "possible" when they refer to a guy with a slight dry cough.

Last week, the central Chinese government pronounced its first officially suspected case of the season to be a confirmed case - meaning authorities were certain the 32-year-old television producer was infected.

Later in the week, a second "suspected case" - a 20-year-old waitress - was identified by the central government. She had been hospitalised, and symptoms and early tests were pointing to Sars.

More complications
Things got more complicated from there, though, and attempts by foreign reporters to clear things up were met with "I don't know," "I'm not sure how we're defining suspected" and the always popular "You'll have to call the relevant officials, but I can't give you their numbers."

From all indications - and indications are often all that's available in China, given officials' propensity for being afraid to talk on the record - provincial health officials in Guangdong have a different standard than the central government does in defining a "suspected case".

This produced confusion on Sunday. Guangdong province - through a health official in Hong Kong, to make things even more intricate - said it had another person hospitalised that it believed had Sars. That man was referred to as a "suspected case".

Case definitions problematic
But by the evening, the Ministry of Health in Beijing said that, while it knew of the case, it didn't consider the 35-year-old man a "suspected case" under its criteria. The tests, it said, were still inconclusive.

"There's always been a problem with case definition with Sars - actually identifying a case," said Dietz, the WHO spokesperson. "So we want to understand clearly the basics that Guangdong is using." – (Sapa-AP)

Read more:
Sars vaccine on the horizon
Pollution and Sars death risk

 
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