Summary of Severe Acute Respiratory Syndrome (SARS) Cases:
Canada and International

June 26, 2003

Canada

There are currently 23 active probable cases (ie, hospitalized, at home and currently ill, or current status unknown), 19 of which are from the recent cluster in Ontario and 4 are from the March-April cluster in same province. The most recent date of onset of illness for a probable case is June 12, 2003; this person was quarantined on June 4, 2003. The most recent date of isolation of a probable case is June 12, 2003; this person had onset of illness on June 8, 2003.

The total number of probable cases of SARS reported in Canada as of June 26, 2003, by reported symptom onset date and type of exposure, is provided below (Figure 1); a total of 251 probable cases of SARS have been reported in Canada, 111 of whom have been reported in the recent Ontario cluster. Since the last summary on June 23, the number of probable cases has increased by 2 overall. One suspect was upgraded to probable and 1 new probable case was identified through retrospective chart review (date of onset May 26, 2003).

Figure 1: Number of probable cases of SARS in Canada by symptom onset date and
exposure type: February 23 to June 26, 2003
(N=250*), excludes 1 for whom onset date is unknown

*Epi Curve may change as information on cases is updated by P/T Ministries of Health.
** The Other / Autres category includes 6 individuals associated with the Bukas LoobSa Diyos Covenant Community (BLD) group and 2 probable cases whose exposure is currently under investigation.

Source: Provincial-Territorial Ministries of Health

 

As of June 26, 2003, there have been a total of 442 probable and suspect SARS cases reported in Canada. The current status of all reported SARS cases in Canada are presented in Tables 1 and 2. Of the 442 probable and suspect SARS cases identified, 25 (23 probable and 2 suspect) are active, and 379 (86%) have been discharged from hospital or have recovered at home. There have been a total of 38 deaths (8.6%), 13 of which are associated with the recent cluster in Ontario.

Table 1: Current Status of Probable SARS Cases in Canada During the Previous 10 days

Probable Cases	June 17	June 18	June 19	June 20	June 21**	June 22**	June 23	June 24	June 25	June 26
Cumulative total*	246	245	245	246	-	-	249	250	251	251
Active cases (currently ill)
Hospitalized	36	36	31	29	-	-	24	25	24	23
At home, currently ill	0	0	0	0	-	-	0	0	0	0
Unknown	1	0	0	0	-	-	0	0	0	0
Total Active Probable	37	36	31	29	-	-	24	25	24	23
Historical cases (recovered and deaths)
Discharged from hospital and recovered, never hospitalized	176	175	180	182	-	-	188	188	190	191
Deaths	33	34	34	35	-	-	37	37	37	37
*Cumulative total of all active and historical probable cases with onset of symptoms on or after February 23, 2003, including cases who have recovered, died or are currently ill. **No numbers reported.

Table 2: Current Status of Suspect SARS Cases in Canada During the Previous 10 days

Suspect Cases	June 17	June 18	June 19	June 20	June 21**	June 22**	June 23	June 24	June 25	June 26
Cumulative total*	193	193	192	191	-	-	191	190	191	191
Active cases (currently ill)
Hospitalized	4	5	3	2	-	-	3	2	2	2
At home, currently ill	1	1	1	1	-	-	1	1	1	0
Unknown	0	0	0	0	-	-	0	0	0	0
Total Active Suspect	5	6	4	3	-	-	4	3	3	2
Historical cases (recovered and deaths)
Discharged from hospital and recovered, never hospitalized	186	186	187	187	-	-	186	186	187	188
Deaths	2	1	1	1	-	-	1	1	1	1
**Cumulative total of all active and historical suspect cases with onset of symptoms on or after February 23, 2003 , including cases who have recovered, died or are currently ill. **No numbers reported.

The total number of reported suspect cases has increased by 1 since June 23; this case was identified through retrospective chart review. Since June 23, 2003, no additional deaths were reported. Table 3 shows the cumulative number of probable and suspect SARS cases reported in Canada by Province or Territory.

Table 3: Cumulative Number of SARS Cases Reported in Canada: June 26, 2003

Province/Territory	Persons Meeting the Criteria for:		Number of Deaths**
	Probable Case*	Suspect Case*
British Columbia	4	46	0
Alberta	0	6	0
Saskatchewan	0	1	0
Manitoba	0	0	0
Ontario	247	132	38**
Quebec	0	0	0
Nova Scotia	0	0	0
Newfoundland	0	0	0
New Brunswick	0	2	0
Prince Edward Island	0	4	0
Nunavut	0	0	0
North West Territories	0	0	0
Yukon	0	0	0
TOTAL	251	191	38
* Persons may be excluded from the probable or suspect case list if another cause is identified to fully explain their illness. Case numbers may change as cases are reclassified based on new information (e.g. disease progression or re-evaluation of the data). **37 of 38 deaths were probable cases, while 1 was a suspect case. Another death, not included in this total count occurred in a 46-year-old female who died in the Philippines on April 14, 2003. It is believed she may have contracted SARS while in Toronto.

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ONTARIO

As a result of the recent hospital-based cluster of SARS cases currently being investigated in Toronto, 111 probable and 11 suspect cases of SARS, including 13 deaths have been reported in Ontario. Of these, 19 probable and 2 suspect cases are active. These cases are in addition to the 136 probable and 121 suspect cases of SARS previously reported in Ontario, 4 of which are active probable cases.

Of the 122 probable and suspect cases in the recent cluster, 66% (n=80) are female. The majority of cases (64%; n=76) in this cluster are between 36 and 64 years of age (mean 51.2 years; range 11-96 years).

The list of potential SARS exposure sites in the province of Ontario can be obtained at the following address: http://www.health.gov.on.ca/english/public/updates/
archives/hu_03/sars/exposure_sites_070703.pdf

Further information regarding SARS in Ontario can be found on the Ontario Ministry of Health and Long Term Care website: http://www.health.gov.on.ca/english/public/updates/
archives/hu_03/hu_sars.html

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International

Since November 1, 2002, a cumulative total of 8,456 cases of SARS, including 809 deaths have been reported to the World Health Organization (WHO) (Table 4). Since June 23, 2 additional deaths have been reported worldwide. The new deaths occurred in mainland China (1) and the Russian Federation (1).

As of June 25, 2003, Toronto, Canada and Taiwan, China are the only two remaining SARS affected areas reported by the WHO.

Further information regarding international cases can be found on the WHO website:
<http://www.who.int/csr/sars/en/index.html>

Table 4: Cumulative Number of SARS Cases* and Deaths Reported to the World Health Organisation: November 1, 2002 to June 26, 2003

Country	Number of Cases	Number of Deaths
Australia	5	0
Brazil	3	0
Canada	251	37
China, mainland**	5327	348
China, Hong Kong Special Administrative Region	1755	296***
China, Macao Special Administrative Region	1	0
China, Taiwan	682	84
Colombia	1	0
Finland	1	0
France	7	0
Germany	10	0
India	3	0
Indonesia	2	0
Italy	9	0
Japan	1	0
Kuwait	1	0
Malaysia	5	2
Mongolia	9	0
New Zealand	1	0
Philippines	14	2
Republic of Ireland	1	0
Republic of Korea	3	0
Romania	1	0
Russian Federation	1	0
Singapore	206	32
South Africa	1	1
Spain	1	0
Sweden	3	0
Switzerland	1	0
Thailand	9	2
United Kingdom	4	0
United States	74*	0
Vietnam	63	5
TOTAL	8456	809
*Cumulative number of cases includes deaths. Case definitions vary from one country to another. Only probable cases are being reported by all countries. The US will no longer be reporting suspect cases under investigation as of April 21, 2003. **The start of the period of surveillance was changed to November 1, 2002 to capture cases of atypical pneumonia in China that are now recognised as being cases of SARS. ***One death attributed to Hong Kong Special Administrative Region occurred in a case medically transferred from Vietnam. Source: http://www.who.int/csr/sars/country/2003_06_26/en/ with updates from Canada.