Severe Acute Respiratory Syndrome

Origin of the crisis:

Health officials declared in July 2003 that the global epidemic of severe acute respiratory syndrome was over, but in December 2003 and January 2004, China confirmed four new cases of SARS in southern Guangdong province. Those patients recovered, but on April 22, 2004, China confirmed two more suspected cases of the disease, one in Beijing and one in Anhui, a province in eastern China.

The first case of SARS appeared in November 2002. It killed 800 people around the world, including 44 in Toronto. The disease killed 350 in China. That country later ordered the killing of some 10,000 civet cats, suspected to be carriers of SARS. The weasel-like mammals are considered a delicacy in Guangdong and are served in wild-game restaurants.

Investigations and reports:

Two inquiries into the political and medical reaction to the SARS outbreak released reports in April 2004.

On April 20, an interim report by Ontario Justice Archie Campbell's inquiry offered 53 recommendations including the establishment of a provincial centre for disease control. Campbell observed that Ontario's health system had been unable to manage the crisis because it was "broken." The province's medical infrastructure was pushed to its limits and the region's hospitality industry was also paralyzed by of the outbreak.

A day after that report, an independent expert panel on SARS presented another 50 suggestions. The panel observed that local officials, who are the first to observe an infectious outbreak and are best poised to contain it, had the least resources available to them.

Both reports focused on the need to improve public health spending on infectious disease prevention, identification, control and containment – and the importance of clear communication and cooperation among all levels of government and health care providers.

Main Symptoms:

* High fever (>38 C or 100.4 F);
* Dry cough;
* Shortness of breath or breathing difficulties; Changes in chest X-rays indicative of pneumonia also occur;
* SARS may be associated with other symptoms, including headache, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhea.
source:www.cbc.ca

Severe acute respiratory syndrome

Severe acute respiratory syndrome or SARS is a respiratory disease in humans which is caused by the SARS coronavirus. There has been one major epidemic to date, between November 2002 and July 2003, with 8,096 known cases of the disease, and 774 deaths (a mortality rate of 9.6%) being listed in the WHO's April 21, 2004 concluding report.[1

Outbreak in Mainland China
The epidemic of SARS appears to have originated in Guangdong Province, China in November 2002. The first case was reportedly originated from a rural area in Foshan, Guangdong in Nov 2002, and the patient, a farmer, was treated in the First People's Hospital of Foshan. The patient died soon after, and no definite diagnosis was made on his cause of death. ("Patient #0" -- first reported symptoms -- has been attributed to Charles Bybelezar of Montreal, Canada) and, despite taking some action to control it, Chinese government officials did not inform the World Health Organization of the outbreak until February 2003, restricting media coverage in order to preserve public confidence. This lack of openness caused delays in efforts to control the epidemic, resulting in criticism of the People’s Republic of China (PRC) from the international community. The PRC has since officially apologized for early slowness in dealing with the SARS epidemic.[3]

The first clue of the outbreak appears to be November 27, 2002 when Canada's Global Public Health Intelligence Network (GPHIN), an electronic warning system which is part of the World Health Organization's (WHO) Global Outbreak and Alert Response Network (GOARN), picked up reports of a "flu outbreak" in China through internet media monitoring and analysis and sent them to the WHO.[4] [5] Subsequently, the WHO requested information from Chinese authorities on December 5 and 11.[5] Importantly, while GPHIN's capability had recently been upgraded to enable Arabic, Chinese, English, French, Russian and Spanish translation, the system was limited to English or French in presenting this information. Thus, while the first reports of an unusual outbreak were in Chinese, an English report was not generated until January 21, 2003.[4]
source:en.wikipedia.org

Basic Information About SARS

SARS
Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained. This fact sheet gives basic information about the illness and what CDC has done to control SARS in the United States. To find out more about SARS, go to CDC's SARS website and WHO's SARS website.

The SARS outbreak of 2003
According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died. In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world with SARS. SARS did not spread more widely in the community in the United States. For an update on SARS cases in the United States and worldwide as of December 2003, see Revised U.S. Surveillance Case Definition for Severe Acute Respiratory Syndrome (SARS) and Update on SARS Cases --- United States and Worldwide, December 2003.

Symptoms of SARS
In general, SARS begins with a high fever (temperature greater than 100.4°F [>38.0°C]). Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry cough. Most patients develop pneumonia.

How SARS spreads
The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.

What does “close contact” mean?
In the context of SARS, close contact means having cared for or lived with someone with SARS or having direct contact with respiratory secretions or body fluids of a patient with SARS. Examples of close contact include kissing or hugging, sharing eating or drinking utensils, talking to someone within 3 feet, and touching someone directly. Close contact does not include activities like walking by a person or briefly sitting across a waiting room or office.

CDC response to SARS during the 2003 outbreak
CDC worked closely with WHO and other partners in a global effort to address the SARS outbreak of 2003. For its part, CDC took the following actions:

* Activated its Emergency Operations Center to provide round-the-clock coordination and response.
* Committed more than 800 medical experts and support staff to work on the SARS response.
* Deployed medical officers, epidemiologists, and other specialists to assist with on-site investigations around the world.
* Provided assistance to state and local health departments in investigating possible cases of SARS in the United States.
* Conducted extensive laboratory testing of clinical specimens from SARS patients to identify the cause of the disease.
* Initiated a system for distributing health alert notices to travelers who may have been exposed to cases of SARS.
source:www.cdc.gov

Fact Sheet for SARS Patients and Their Close Contacts

Severe acute respiratory syndrome (SARS) is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was recognized as a global threat in March 2003, after first appearing in Southern China in November 2002. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia. Although the 2003 global outbreak was contained, it is possible that person-to-person transmission of SARS-CoV might recur. This fact sheet gives information about the illness and important instructions for preventing the spread of SARS. To find out more about SARS, visit CDC's website or the SARS website of the World Health Organization (WHO).

Symptoms of SARS
The illness usually begins with a fever (measured temperature greater than 100.4°F [>38.0°C]). The fever is sometimes associated with chills or other symptoms, including headache, general feeling of discomfort, and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry, nonproductive cough or feel short of breath. These symptoms might be accompanied by or progress to a ondition in which the oxygen levels in the blood are low (hypoxia). Most patients develop pneumonia.

How SARS spreads
The main way that SARS appears to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes. Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that SARS-CoV might be spread more broadly through the air (airborne spread) or by other ways that are not now known.

What does “close contact” mean?
In the context of SARS, close contact means having cared for or lived with someone with SARS or having a high likelihood of direct contact with the respiratory secretions and/or body fluids of a patient known to have SARS. Examples include kissing or embracing, sharing eating or drinking utensils, talking to someone within 3 feet, physical examination, and any other direct physical contact between people. Close contact does not include activities such as walking by a person or briefly sitting across a waiting room or office.

Steps to protect yourself and the people around you
If you have SARS, or you have close contact with someone who does, follow these instructions:

If you think you (or someone in your family) might have SARS, you should:

* Call your healthcare provider as soon as possible. Call ahead and alert the healthcare provider before your visit so that precautions can be taken to keep from exposing other people.
* Cover your mouth and nose with a tissue when coughing or sneezing.
* Be careful not to expose others. If you have been exposed to SARS and become ill with any symptoms, limit your activities outside the home. Avoid public transportation (e.g., bus, taxi). Do not go to work, school, out-of-home child care, church, or activities in other public areas until after you are told that you do not have SARS.
* Follow any other instructions provided by local health authorities.

If you have SARS and are being cared for at home, you should:

* Follow the instructions given by your healthcare provider.
* Limit your activities outside the home except as necessary for medical care. For example, do not go to work, school, or public areas. If you must leave the home, wear a mask, if tolerated. Do not use public transportation.
* Wash your hands often and well, especially after you blow your nose.
* Cover your mouth and nose with a tissue when you sneeze or cough.
* If possible, wear a surgical mask when around other people in your home. If you can't wear a mask, the members of your household should wear one when they are around you.
* Don't share silverware, towels, or bedding with anyone in your home until these items have been washed with soap and hot water.
* Be sure that surfaces (counters, tabletops, door knobs, bathroom fixtures, etc.) that have been contaminated by your body fluids (sweat, saliva, mucous, or even vomit or urine) are cleaned with a household disinfectant used according to the manufacturer's instructions. Be sure that the person who cleans the surfaces wears disposable gloves during all cleaning activities. Disposable gloves should be thrown out after use and should not be reused.
* Follow these instructions for 10 days after your fever and respiratory symptoms have gone away or until the health department says you can return to normal activities.

If you are caring for someone at home who has SARS, you should:

* Be sure that you understand and can help the SARS patient follow the healthcare provider's instructions for medication and care.
* Be sure that all members of your household are washing their hands frequently with soap and hot water or using an alcohol-based hand rub.
* Wear disposable gloves if you will have direct contact with body fluids of a SARS patient. However, wearing gloves is not a substitute for good hand hygiene. After contact with body fluids of a SARS patient, remove the gloves, throw them out, and wash your hands. Do not wash or reuse the gloves.
* Encourage the person with SARS to cover his or her mouth and nose with a tissue when coughing or sneezing. If possible, the person with SARS should wear a surgical mask during close contact with other people in the home. If the person with SARS cannot wear a surgical mask, other members of the household should wear one when in the room with that person.
* Do not use silverware, towels, bedding, clothing, or other items that have been used by the person with SARS until these items have been washed with soap and hot water.
* Clean surfaces in the patient's room and the bathroom fixtures used by the patient daily, with a household disinfectant used according to the manufacturer's instructions. When cleaning, wear disposable gloves, and dispose of them after use. Or, use household utility gloves.
* Limit the number of persons in the household to those who are essential for patient support. Other household members should either be relocated or minimize contact with the patient in the home. This is particularly important for persons at risk of serious complications of SARS (e.g., persons with underlying heart or lung disease, diabetes mellitus, older age).
* Unexposed persons who do not have an essential need to be in the home should not visit.
* Follow these instructions for 10 days after the sick person's fever and respiratory symptoms have gone away or until the health department says the SARS patient can return to normal activities.
* For 10 days after your last exposure to the person with SARS, be vigilant for fever (i.e., measure your temperature twice daily), respiratory symptoms, and other early symptoms of SARS. Common early symptoms include chills, body aches, and headache. In some patients, body aches and headache may appear 12 to 24 hours before fever. Diarrhea, sore throat, and runny nose may also be early symptoms of SARS. If you do not have any of these symptoms, you do not need to limit your activities outside the home. You may go to work, school, out-of-home child care, church, or activities in other public areas.
* Follow any other instructions provided by local health authorities.
* If you start feeling sick, especially if you develop a fever, respiratory symptoms, or other early symptoms of SARS, contact your healthcare provider immediately, and tell the healthcare provider that you have had close contact with a SARS patient.
source:www.cdc.gov

Current SARS Situation

Currently, there is no known SARS transmission anywhere in the world. The most recent human cases of SARS-CoV infection were reported in China in April 2004 in an outbreak resulting from laboratory-acquired infections (see Laboratory Biosafety for more details). CDC and its partners, including the World Health Organization, continue to monitor the SARS situation globally. Any new updates on disease transmission and SARS preparedness activities will be posted at this site
source:www.cdc.gov

Guidance about SARS for Americans Living Abroad

The primary way that SARS-CoV (the virus that causes SARS) appears to spread is by close contact*, most commonly with family members and healthcare workers. Previous research has shown that SARS can be controlled and contained through early detection, isolation of possible cases, and tracing of patients' contacts. Guidance for the management of SARS exposures in healthcare settings and infection control precautions for SARS patients and their close contacts in household settings is provided in Supplement I, Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS).

The following recommendations are directed to embassies and to Americans living abroad in areas where SARS cases have been reported. These recommendations are based on the experiences to date and may be revised as more information becomes available. Embassies should recommend the following precautions to U.S. expatriates living in an area where SARS cases have been reported:

* As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand washing. Cleaning your hands often using either soap and water or a waterless, alcohol-based hand rub removes potentially infectious materials from your skin and helps prevent disease transmission.
* To minimize the possibility of infection, observe precautions to safeguard your health. This includes avoiding settings where SARS is most likely to be transmitted, such as healthcare facilities caring for SARS patients.
* On the basis of limited available data, it would be prudent for persons in China to avoid visiting live food markets and to avoid direct contact with civets and other wildlife from these markets. Although there is no evidence that direct contact with civets or other wild animals from live food markets has led to cases of SARS, viruses very similar to SARS-CoV have been found in these animals. In addition, some persons working with these animals have evidence of infection with SARS-CoV or a very similar virus.
* CDC does not recommend the routine use of masks or other personal protective equipment while in public areas.

Information for Persons Working in Healthcare Settings

Prevention of transmission in healthcare settings is based on adherence to appropriate infection control measures when in close contact with patients with SARS. Such close contact includes direct care of SARS patients or direct contact with the respiratory secretions and body fluids of SARS patients. For information on infection control measures, see Supplement I in Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS).

U.S. citizens, including those working for U.S. medical nongovernmental organizations (NGOs), with elective activities planned in inpatient healthcare settings in regions where SARS cases have been reported, may want to postpone activities in healthcare facilities caring for SARS patients. For additional information for healthcare providers and consular officials see this Department of State Public Announcement.
source:www.cdc.gov

New Rapid Test Developed For SARS

Microbiologists in Hong Kong have developed a simple and rapid non-invasive diagnostic test that can identify the newly discovered coronavirus associated with Severe Acute Respiratory Syndrome (SARS).

The test, described in a technical brief online in the journal Clinical Chemistry, is a real-time quantitative assay that can produce results in as little as three to four hours. It can detect the presence of the coronavirus in nasal swabs or throat cultures before an antibody response is detectable. Prior to the development of this new rapid test, diagnostic tests for SARS could detect the coronavirus antibodies that are produced after infection, which in some cases is within 14 days of illness onset, or as long as 21 days after onset of fever. By contrast, the new test is often positive early in the disease, and the procedure can be completed within a few hours.

A rapid method of prompt identification of SARS will help contain the spread of the disease and facilitate prompt treatment and improved outcomes. The scientists in Hong Kong aim to adapt this new test to a high-throughput format as testing of suspected cases is expected to increase rather than decrease with the rapid global spread of this disease.

As of April 19, 2003, a total of 3547 SARS cases with 182 deaths have been reported from 25 countries, including 220 cases in the United States. Asia remains the worst affected area on the globe.
source:www.labtestsonline.org

Severe Acute Respiratory Syndrome (SARS Virus) - VADS CORNER

This page is dedicated to Severe Acute Respiratory Syndrome (SARS). It was setup as a result of the recent outbreak in Canada, China, Hong Kong Special Administrative Region of China, Indonesia, Philippines, Singapore, Thailand, and Viet Nam.. This page will be updated when information is available. You are welcome to suggest links or comments related to this site by e-mailing directly to me or mentioning the link in the guestbook. I however have the right to moderate these links. Initial news indicated it may belong to a paramyxovirus group and the latest news now confirms it is a new Coronavirus. Please read the disclaimer.
source:www.vadscorner.com

How SARS Works

In February of 2003, newspapers began reporting a rapidly spreading atypical pneumonia. Identified as severe acute respiratory syndrome or SARS, this highly contagious condition is once again making international news.

According to the World Health Organization (WHO), the first cases of SARS emerged in mid-November 2002 in the Guangdong Province of China. Overall, a total of 8422 probable cases were reported from 29 countries during the outbreak. Approximately 11 percent of those infected, 916 people, died. According to WHO, the last chain of human transmission was broken in early July 2003. But, two confirmed cases have been recently reported.

In this article, we'll examine the symptoms, the treatment, and the communicability of SARS, and we'll find out what is being done to cure and control the condition.

First, let's take a look at what exactly scientists think SARS is.
source:health.howstuffworks.com

Severe Acute Respiratory Syndrome

Severe acute respiratory syndrome (SARS) is a respiratory illness caused by a virus. SARS was first reported in Asia in 2003. It spread worldwide over several months before the outbreak ended.

SARS can be life-threatening. Symptoms include

* A high fever
* Headache
* Body aches
* A dry cough
* Pneumonia, later on

SARS seems to spread mainly by close person-to-person contact. When an infected person coughs or sneezes, they send droplets of mucus or saliva that contain the virus through the air. You could get SARS if the droplets land on your mouth, nose or eyes. Kissing, touching, sharing utensils for eating and drinking, or talking with an infected person can also put you at risk. Frequently washing your hands with soap and water might help prevent infection if you travel to countries with SARS. There is no treatment for SARS. Scientists are testing treatments and vaccines.
source:www.nlm.nih.gov

Frequently Asked Questions on Severe Acute Respiratory Syndrome (SARS)

Q : What are the symptoms of SARS ?

A : The main symptoms of SARS are high fever (> 38° Celsius), dry cough, shortness of breath or breathing difficulties. Changes in chest X-rays indicative of pneumonia also occur. SARS may be associated with other symptoms, including headache, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhoea.

Q : How contagious is SARS ?

A : Based on currently available evidence, close contact with an infected person is needed for the infective agent to spread from one person to another. Contact with aerosolized (exhaled) droplets and bodily secretions from an infected person appears to be important. To date, the majority of cases have occurred in hospital workers who have cared for SARS patients and the close family members of these patients. However, the amount of the infective agent needed to cause an infection has not yet been determined.

Q : How should SARS patients be managed?

A : Patients should be placed in an isolation unit. Strict respiratory and mucusol barrier nursing is recommended. It is very important that suspected cases are separated from other patients and placed in their own hospital room. Health care workers and visitors should wear efficient filter masks, goggles, aprons, head covers, and gloves when in close contact with the patient. Hospital Infection Control Guidance

Q : What is the treatment for SARS ?

A : While some medicines have been tried, no drug can, at this time, be recommended for prophylaxis or treatment. Antibiotics do not appear to be effective. Symptoms should be treated by adequately protected health professionals. As a result of good supportive care, some patients in Hanoi have been transferred from critical care wards to regular wards.

Q : When will this disease be identified ?

A : An international multicenter research project to expedite identification of the causative agent was established on Monday 17 March. Eleven top labs in ten countries are consulting daily and are working together to identify the causative agent. Various specimens have been collected from cases and post-mortem examinations. Laboratory tests are ongoing and a candidate causative infectious agent is under investigation.

Q : How fast does SARS spread ?

A : SARS appears to be less infectious than influenza. The incubation period is short, estimated to range from 2-7 days, with 3-5 days being more common. However, the speed of international travel creates a risk that cases can rapidly spread around the world.

Q : Where and when was the first case of SARS reported ?

A : On 26 February, a man was admitted to hospital in Hanoi with high fever, dry cough, myalgia (muscle soreness) and mild sore throat. Over the next four days he developed increasing breathing difficulties, severe thrombocytopenia (low platelet count) and signs of adult respiratory distress syndrome requiring ventilator support.

Q : How many cases of SARS have been reported to date ?

A : From 1 February to 24 March, 456 cases including seventeen deaths have been reported. In the early stages the symptoms are similar to those of many diseases including influenza. Heightened awareness about the disease, and the vigilance of health authorities around the world, have resulted in a close watch for suspected cases and rapid and thorough reporting. Not all of these suspected cases may prove to be SARS. There are many reports and rumours coming in from around the world, but quite a few of these will turn out to be normal wintertime activity of diseases like influenza whose early symptoms are similar. The cumulative number of cases and deaths is continuously updated on the WHO web site .

Q : How many countries report cases of SARS ?

A . As of 24 March, cases had been reported from thirteen countries. Of these, four countries have only imported cases with no documented local transmission, indicating that the disease is not spreading in these countries and residents are not at risk.

Q : Is the outbreak in Guangdong Province, China linked ?

A : Extensive investigation is under way to better understand the outbreak of atypical (unusual) pneumonia that began in Guangdong province in November 2002. Findings from this investigation should help clarify possible links with cases of SARS.

Q : Could this result from bioterrorism ?

A : There is no indication that SARS is linked to bioterrorism.

Q : Should we be worried ?

A : This illness can be severe and, due to global travel, has spread to several countries in a relatively short period of time. However, SARS is not highly contagious when protective measures are used, and the percentage of cases that have been fatal is low. Since the WHO global alert issued on 15 March, only isolated cases have been identified and no secondary outbreaks have occurred.

Q : Is it safe to travel ?

A : WHO has not recommended restricting travel to any destination in the world. However, all travellers should be aware of the main symptoms and signs of SARS, as given above. People who have these symptoms and have been in close contact with a person who has been diagnosed with SARS, or have a recent history of travel to areas where cases of SARS have been spreading, should seek medical attention and inform health care staff of recent travel. Travellers who develop these symptoms are advised not to undertake further travel until fully recovered.

Q : What is the purpose of a global travel advisory ?

A : The purpose of the advisory WHO issued on 15 Marchis to tell people what SARS looks like and what they need to report to a physician. The WHO alert does not recommend cancellation of, or change in, travel plans. Trade and tourism should not be restricted. The purpose of the alert is to heighten the awareness of travellers, health authorities, and physicians, not to restrict travel.

Q : Could this be the next flu pandemic ?

A : Tests have not yet conclusively identified the causative agent of SARS. The possible involvement of an influenza virus was an initial concern.

Q What does WHO recommend ?

A : WHO recommends that global surveillance continue and that suspected cases are reported to national health authorities. WHO urges national health authorities to remain on the alert for suspected cases and followed recommended protective measures. SARS patients should be isolated and cared for using barrier nursing techniques and provided with symptomatic treatment.

Q : How can the public keep apprised of the situation ?

A : The public is advised to consult the home page of the WHO website: for daily updates on the outbreak and relevant press releases. More information is available on the WHO SARS web page which is easily accessed through the WHO home page or through: Severe Acute Respiratory Syndrome (SARS) Many national authorities have also established web sites with excellent information for both the general public and the medical profession.

Q : What is WHO doing ?

A : WHO, through the Global Outbreak Alert and Response Network, is working with its partners to track the global dimensions of this outbreak and coordinate efforts to quickly identify the causative agent, improve diagnostic precision, and provide advice on recommended treatment. WHO works closely with health authorities in the affected countries to provide epidemiological, clinical and logistic support as needed.

A WHO/Global Outbreak Alert and Response Network team of epidemiologists, case management, infection control and laboratory experts is assisting national health authorities particularly in Vietnam. The Hanoi team has received personnel and supplies from a number of organizations throughout the world. WHO epidemiologists are also supporting investigations in Hong Kong and China.

Q : What are the objectives of the international response to the multi-country SARS outbreak ?

A : The overarching aims of the international response, coordinated by WHO, are to:

* Contain and control the outbreak
* Identify the causative agent
* Identify effective treatment regimes
* Support health care infrastructure in affected countries by coordinating supplies and additional health care workers if needed
* Provide information to health officials and address public concerns

Q :Are there any positive developments ?

A : A significant number of cases in Viet Nam, as a result of good supportive care, have improved. In addition, the global surveillance system has proven to be a very sensitive and rapid means of reporting of suspected cases. Health authorities around the world are now alert to the risk of SARS. Information on cases compiled over the last three weeks is expected to shed new light on the behaviour of this disease. Secondary outbreaks have to date been avoided since global surveillance was put in place and rapid isolation of cases undertaken.

source:www.who.int

Owner claims VAT returns submitted and payments made

ONE of the Eastern Cape’s most established burial societies is embroiled in a legal dispute with the South African Revenue Services.

SARS has claimed more than R5million in VAT from Chitibunga Prepaid Funeral Services.

Chitibunga, which disputes the claim, has applied to the courts to adjudicate.

After several failed attempts at resolving the matter with SARS, Mqokeleli Herdboy Kepe, co-owner of Chitibunga, lodged a civil application earlier this month with the Transkei Division of the High Court.

In his court papers, Kepe said SARS’ claim of R5263874 – of which R3652018 is additional tax, penalties and interest – will not only affect the needs and rights of his business, but also those of thousands of “poor, rural black” people in the country.

Kepe wants the court to rescind the judgment taken against his company in April ordering them to pay the outstanding R5m.

He claims it will be in the best interest of his approximately 100000 policyholders that the courts adjudicate Chitibunga’s liability for the payment of VAT, if any.

He claims SARS erroneously registered Chitibunga Prepaid for VAT and calculated faulty VAT amounts.

He further pointed out in his court papers how, due to the high success and rapid expansion of Chitibunga Prepaid, the business encountered several problems with fraud, corruption and stealing.

He said each month millions of rands in cash passed through the hands of his clerks and that further “problems” experienced included theft of these monies by the clerks.

A subsequent forensic investigation, at a cost of R68400, found several irregularities including its drivers using business vehicles as transport services for their own benefit and that they serviced their own, friends and families’ vehicles and claimed the costs as expenses incurred by Chitibunga.

It also found that the company had failed to pay VAT due to the inefficiencies of at least two financial managers.

Kepe is adamant that VAT returns were submitted and the necessary payments were made.

SARS has not yet filed a reply to Kepe’s claims, but its spokesperson, Adrian Lackay, said they had filed a notice of intention to “vigorously” oppose it.

“The previous judgment was correct as SARS followed all due processes,” he said.

No court date has yet been set.
source:www.dispatch.co.za

SARS hunts for "R43m tax dodger"

A warrant has been issued for the arrest of a businessman for allegedly failing to pay R43m in value added tax (VAT) to the SA Revenue Service (SARS), officials said today.

Earlier, Sapa was told the 38-year-old man had been arrested in Pietermaritzburg this morning, but officials said this was not the case.

The man was thought to be in Durban.

However, warrants to seize the man’s property were being executed in KwaZulu-Natal and Gauteng.

Properties and vehicles - valued at R90 million - were seized in dawn raids by the National Prosecuting Authority’s Asset Forfeiture Unit and Special Tax Unit, and SARS investigators and police.
source:/www.sundaytimes.co.za

SARS allows two more days for amnesty

THE South African Revenue Service (SARS) had by yesterday received more than 90000 small business tax amnesty applications. SARS spokesman Adrian Lackay said the Receiver expected the national tax register to increase 27%.

“This is very encouraging for SARS,” Lackay said. “The small business amnesty has met our expectations.” Because of the flood of applications still being received, SARS had decided to extend the deadline to Saturday, Lackay said.

Some tax analysts are not entirely convinced by SARS’ efforts. Edward Nathan Sonnenbergs tax director Beric Croome said it was disappointing that the tax register would be increased only 27%.

Although tax collection had soared in recent years, the tax gap — the total amount of uncollected tax — ran into billions of rands. About 4,1-million working South Africans did not pay tax.

Des Kruger, a tax director at Mallinicks Attorneys, said that it was “unfortunate that SARS did not do more in its efforts” to increase the register.

Perhaps SARS should have extended the amnesty still further, Kruger said. “ There are many businesses not paying taxes.”

SARS had identified 50000 taxi operators last weekend who might be eligible for the amnesty. It had notified operators by way of SMS, said Lackay. This was done in conjunction with the transport department.

SARS expected to receive about 100000 applications today. Lackay said SARS was receiving 4000 to 5000 applications daily.

The amnesty started in August and expires today.

It allows for the scrapping of outstanding taxes with no prosecution against businesses with annual turnover s less than R10m.

SARS offices across the country had been inundated with enquiries from businesses which wanted to meet the deadline and so SARS offices across the country would accept applications tomorrow and Saturday. Forms submitted on these days would be deemed to have been received by today, said Lackay.

Croome said it was unfortunate that further amendments to the Small Business Tax Amnesty and Amendment of Taxation Laws Act were publicised only at the beginning of this month.

Those amendments seek to clarify the position regarding companies owned by trusts.

The proposed amendments, which still have to be passed by Parliament, clarif y that SARS will have reference to the recipients of awards made by the trust in the past two years.

Recently, it became apparent that SARS recognises that certain charities are conducting trading activities and that such organisations are in need of amnesty because the organisation may not have complied with income tax or value- added tax obligations.

“It would have been far preferable if the correct legal framework for the amnesty was in place at the time that it commenced,” said Croome.
source:www.businessday.co.za