Radiation protection page

of the Organisation for Economic Cooperation and Development (OECD)

Argonne National Laboratory’s website for the US Department of Environment –

– Depleted Uranium Links

22 February: Dr. Liu Jianlun, a 64-year-old medical professor from Guangdong province, is admitted to hospital in Hong Kong. He fell ill while staying at the Metropole Hotel, where he infected a number of other guests, including those believed to be responsible for the initial outbreaks of SARS in Canada, Singapore and Vietnam. He dies in a Hong Kong hospital on March 4.

26 February: Johnny Chen, a 48-year-old American businessman who was a guest at the Metropole Hotel, is admitted to Hanoi’s French Hospital after falling ill while on a business trip to Vietnam. Dozens of French Hospital staff begin falling sick and Chen is evacuated to Hong Kong, where he dies on March 13.

5 March: Kwan Sui-chu, 78, who stayed at the Metropole Hotel at the same time as Dr. Liu, the Guangdong medical professor, dies in Toronto, the first SARS death in Canada. Her 43-year-old son, Tse Chi-kwai, dies on March 13 of the disease.

12 March: The World Health Organization (WHO) issues a rare “global alert” to health authorities worldwide about a severe form of pneumonia following the outbreaks of the disease in Hong Kong, southern China and Vietnam.

13 March: Singapore’s Ministry of Health reports the first cases of atypical pneumonia in the city-state – three people who stayed at the Metropole Hotel in Hong Kong.

15 March: The WHO issues an emergency travel advisory due to the outbreak of the disease, which it calls Severe Acute Respiratory Syndrome for the first time, providing guidance for travellers and airlines.

A Vietnamese nurse at Hanoi’s French Hospital dies, the first SARS death in Vietnam. Jean-Paul Derosier, 65, a French anaesthetist who treated the first SARS patient in Vietnam, dies of the disease four days later.

26 March: Singapore reports its first death from SARS, closes schools and issues quarantine orders to 740 people.

27 March: The WHO recommends that countries most affected by SARS screen international passengers at airports, a measure since taken up by a number of governments around the world.

Hong Kong shuts schools and invokes a quarantine law.

28 March: The WHO says what is believed to have been the first case of SARS has been traced back to November 16 in Foshan city in Guangdong province.

29 March: Dr. Carlo Urbani, a Hanoi-based communicable disease expert with the WHO, dies of SARS in a Bangkok hospital. Urbani, 46, treated the first SARS patient in Vietnam and alerted the WHO to the new respiratory disease.

1 April: The Swiss government bans traders from China, Hong Kong and Singapore from taking part in the World Watch, Clock and Jewellery Fair 2003, one of the first measures taken against people from SARS-affected areas.

The United States says it will pay for US diplomats and their families to leave southern China and Hong Kong because of SARS and advises US citizens to consider deferring non-essential travel to Guangzhou, China and Hong Kong.

2 April: The WHO issues an advisory against non-essential travel to Hong Kong and Guangdong province due to the SARS outbreak, the first such warning in its 55-year history because of an outbreak of infectious disease.

3 April: A four-member team of WHO infectious disease experts begin a visit to Guangdong after finally receiving permission from the Chinese authorities to visit the province at the origin of the SARS outbreak.

5 April: Malaysia announces its first SARS death – a 64-year-old man who died in a Kuala Lumpur hospital on March 30 after returning from visits to China and Singapore.

8 April: Canada reports six more deaths from SARS, taking the global death toll from the disease to more than 100.

9 April: South Africa announces its first probable SARS case and the first in Africa – a 62-year-old businessman hospitalised in Pretoria after returning from a trip to Hong Kong. He dies of a heart attack on April 29 but doctors say his death is unrelated to SARS.

12 April: The Michael Smith Genome Sciences Centre in Vancouver, British Columbia, announces that researchers there have cracked the genetic code of the coronavirus thought to have caused SARS, the first step toward developing a diagnostic test and a possible vaccine.

14 April: A 46-year-old Filipino woman who worked as a nursing assistant in a retirement home in Toronto dies in a Manila hospital, the first confirmed SARS death in the Philippines.

16 April: The WHO confirms that SARS is caused by the coronavirus, a family of viuses that causes the common cold.

18 April: With China under mounting pressure to provide accurate information about the extent of the SARS outbreak, President Hu Jintao warns officials “not to withhold any information and delay its release.”

20 April: China admits there are hundreds more cases of SARS in Beijing than previously reported and sacks Health Minister Zhang Wenkang and Beijing mayor Meng Xuenong. Week-long May Day holidays are cancelled.

Hong Kong reports 12 deaths from SARS, the most in a single day in the territory since the outbreak began.

23 April: The WHO extends its warning against non-essential travel to include the Canadian city of Toronto, the Chinese capital Beijing, and Shanxi province in northern China. Toronto authorities denounce the move.

Hong Kong chief executive Tung Chee-hwa announces a 1.5 billion dollar package of measures designed to ease the economic impact of the SARS outbreak.

27 April: In Beijing, authorities order the closure of the capital’s entertainment venues

28 April: Vietnam becomes the first country to successfully contain an outbreak of the disease. The WHO removes it from the list of SARS-affected countries.

29 April: The Association of Southeast Asian Nations and China hold an emergency summit in Bangkok and agree to screen travellers, step up the exchange of information, establish an international SARS hotline and pool research.

The WHO lifts its travel advisory against Toronto, saying there has been no local transmission of the disease for 20 days.

The Greek European Union presidency announces plans to hold an emergency meeting of EU health ministers in Brussels on May 6 to discuss the SARS crisis.

A preliminary Hong Kong study shows that SARS is less severe in young children and they may also be less infectious.

30 April: Beijing’s acting mayor Wang Qishan warns that the SARS situation in the Chinese capital, where there have been 66 deaths and 1,347 infections, is “severe” and there is a shortage of hospital beds. Shanghai and Shenzhen stock exchanges are closed until May 12.

Hong Kong and China announce a total of 17 SARS deaths, taking the global death toll to 372 and the number of probable and confirmed infections to 5,660.

7 May: The most detailed epidemiological analysis to date, published online in The Lancet, suggests that half of people over 60 who contract SARS are likely to die.

14 May: In Beijing, the lower number of new daily cases remains constant below 60 for a fifth day, but the WHO warns that a resurgence is still possible.

The global death toll from SARS reaches 588, with 7629 probable and confirmed infections.

The first case named SARS started on 26 February, when a 48-year-old American businessman, Johnny Chen, was taken sick in Hanoi following a trip to Hong Kong and Shanghai. He was flown back to Hong Kong for treatment but died. Carlo Urbani, an infectious disease expert called to Hanoi from the World Health Organisation’s Asian office in Bangkok, realized Chen had a hitherto unknown condition and named it SARS. But Urbani caught the disease and later died in Bangkok.

Before that there had been an unexplained outbreak of pneumonia in the southern Chinese province of Guangdong, which began in the city of Foshan in November. It was subsequently found to be the same as the infection in Hanoi. In April, after pressure from world governments and the WHO, China finally admitted it had over a thousand cases, and started cooperating in international control efforts.

Chen picked up his infection in Hong Kong, from a Chinese doctor who had been treating the Guangdong outbreak and was staying in the same hotel. Hong Kong has been the next hardest hit territory after China.

SARS is the first truly air-borne epidemic in history, as air travel has carried it worldwide in weeks. Other guests at Chen’s Hong Kong hotel carried the infection to Singapore and Canada, where it continued to spread. Meanwhile travelers from the region carried the infection around the world; it now affects 24 countries officially, plus more where it has not yet been confirmed. There are fears that when it reaches poor countries with limited health care systems – this includes much of China – it will spread out of control.

What causes the disease?

In an unprecedented collaboration of laboratories around the world, scientists were able to prove by 16 April that SARS is caused by a previously unknown member of the coronavirus family. This family includes viruses that were known to cause common colds in people, but more serious diseases – including severe pneumonia and diarrhoea – in animals.

Southern China, the location of the first SARS cases, has long been feared to be a hotspot for emerging infectious diseases that jump from animals into people. The SARS virus genome suggests it is a recombinant of a bird bronchitis virus and a mouse hepatitis virus, one which has been around for a long time, probably in an animal host, but which only recently acquired the ability to infect humans.

What are the symptoms?

The main symptoms are flu-like: high fever (more than 38°C, 100.4°F), myalgia (muscle aches), chills, headache and sore throat. Other symptoms include dry cough and breathing difficulty. These develop into pneumonia, and in 10-20 percent of cases lead to acute breathing problems needing artificial respirators. In some recent cases, however, the first symptoms have been severe diarrhoea. The mortality rate was originally reported as 4 percent, but this turned out to be the sort of underestimate often made early in disease outbreaks. The WHO now admits that the overall mortality rate is 15 percent. But that varies profoundly with age: children seem unlikely to die, while the death rate among people over 60 is estimated at 50 percent.

What is the incubation period?

It ranges from 2 to 10 days, although Chinese records suggest that it can be as long as 16 days.

How is the disease spread? What can we do to combat this?

It seems that close contact with an infected person, or contact with exhaled droplets and bodily secretions, even after they have been deposited on objects such as door handles, can spread the virus. So far SARS does not seem to spread in tiny airborne droplets as influenza or measles do, which would cause exponential spread.

An explosion of cases in a Hong Kong housing block led local health investigators to conclude that the disease might have been spread by droplets from contaminated faeces that were blown into other apartments through faulty sewage systems.

Because of the droplet spread, people in the Far East have begun wearing surgical face masks in public. But it is perhaps even more important to wash hands frequently with soap or an alcohol wash. Coronaviruses can spread when an infected person touches a surface, leaving a virus that can survive for several hours; it is then picked up by others, who infect themselves by touching their eyes, nose or mouth.

Hotspots such as Toronto and Singapore have tried to contain the infection by keeping people who have been in contact with SARS patients in quarantine for 10 days. But not everyone has obeyed – police had to track down a number of families from the affected apartment complex in Hong Kong and move them to a temporary quarantine camp, while Singapore uses electronic tags such as those used for prisoners.

The WHO has issued emergency guidelines for airlines and air travelers. People with SARS symptoms, or who have had close contact with someone diagnosed with the infection or who have recently returned from a SARS “hotspot”, should seek medical advice. Airlines are screening passengers from the worst-affected places, and border officials are testing people’s temperature at entry points in affected areas.

How long does someone with SARS remain infectious to others?

No one knows yet. Evidence indicates that patients are most infectious while they have symptoms such as a cough or a fever, but there are starting to be indications that, as with animal coronaviruses, the virus can spread before symptoms really start.

What is the treatment for SARS?

Currently there is no known cure. Some patients respond to a combination of non-specific anti-viral drugs and steroids; otherwise they are simply kept on life-support in the hope their own immunity will clear the virus. Some critically-ill patients in Hong Kong have reportedly responded to antibodies from recovered patients. Countries including the US have launched a campaign to develop vaccines or specific anti-virals for the disease.

Could this be the result of bioterrorism?

So far nothing whatsoever suggests a link to bioterrorism