Taiwan offers outbreak tips
Infrared sensors could spot travelers feverish from the SARS illness
When an outbreak of severe acute respiratory syndrome (SARS) occurred in Taiwan in 2003, authorities ordered that people's body temperature be measured before going into any public areas.
Infrared heat detectors also were installed at all airport and seaport entryways -- technology that could be utilized in Hawaii, state Health Director Chiyome Fukino said.
Dr. Ming-Liang Lee, now director of the Center for Health Policy Research and Development at the National Health Research Institutes in Taiwan, discussed Taiwan's experience with SARS in a meeting with state health officials Friday.
Lee also spoke about SARS and avian flu at a meeting Thursday of the Hawaii Chinese Chamber of Commerce.
He has written a series of papers describing Taiwan's SARS outbreak and critical issues related to an avian flu pandemic.
"Some of the work they did on SARS was just fascinating," Fukino said in an interview.
Information was disseminated across the island after scientists learned the characteristic symptom of SARS was fever.
"They actually had people take their temperature and report in when they were elevated and follow up with nursing and medical staff," Fukino said.
It would be helpful to walk people through an arch with a temperature gauge and segregate out those with symptoms, she said. "It would be a wonderful tool to assist us in rapidly assessing folks."
Lee said the deciding factors in how Taiwan's government and people stopped the spread of SARS were "information, identification and isolation."
Most afflicted patients were confined to hospitals, and efforts were made to isolate cases of SARS carriers, he wrote in one of his papers.
"Fever clinics" were established outside every major hospital so doctors could quickly identify and isolate affected patients.
But Lee stressed that the most important factor in combating an infectious disease is public awareness and public cooperation.
He said the early stages of the SARS outbreak created "an unprecedented social panic" stemming partially from incomplete medical information and distorted and exaggerated news reports.
The best defense against avian flu, he said, is not the production of vaccine or stockpiling of antiviral drugs.
"A sound public health infrastructure and a good surveillance and reporting system are essential," he wrote in a paper on management of a pandemic crisis. "It is crucial to provide the public the complete and accurate information regarding the pandemic."
The SARS outbreak began in late April 2003 in Taiwan and ended in early June of that year, causing a loss of $4.6 billion to the island, Lee said.
He said SARS infected 346 people in Taiwan and resulted in 73 deaths, "negligible" numbers compared with the island's high death rates from seasonal influenza and automobile accidents.
"The public's hysterical reaction to the SARS outbreak, however, was such that national security became imperiled."
He told Hawaii health officials that simple, clear and regular communications with the public about what was going on helped them to be calm.
"Though avian flu is certainly cause for concern, overreaction to the outbreak may be just as deadly as underreaction," he said.
Fukino said there might be some issues with the population here if quarantine is necessary. "Our people are just not used to being told they can't leave the house."
She said the DOH is working with public information offices in organizations and agencies that would be involved in an emergency to make sure "we have already established trust and protocols so everyone is giving the same message to the public."
Lee was interested in how the Health Department educates its staff and in the computer technology used to train people, Fukino said.