Timeline of the SARS outbreak - wikipedia Timeline of the SARS outbreak This article does not follow Wikipedia 's guidelines on the use of different tenses. Please consider copy editing to past tense if historic, present tense if not time - based ( e.g. fiction ), or future tense if upcoming. ( February 2016 ) This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. ( November 2012 ) The areas affected by SARS The following is a timeline of the 2002 -- 04 outbreak of severe acute respiratory syndrome ( SARS ). Contents 1 November 2002 2 January 2003 3 February 2003 4 March 2003 5 April 2003 6 May 2003 7 June 2003 8 July 2003 9 September 2003 10 October / November 2003 11 December 2003 12 January 2004 13 April 2004 14 May 2004 15 See also 16 Notes 17 References November 2002 On November 16, 2002, an outbreak of what is believed to be severe acute respiratory syndrome ( SARS ) began in the Guangdong province of China, which borders on Hong Kong. The first case of infection was speculated to be a farmer in the Shunde district of Foshan County. The People 's Republic of China ( PRC ) notified the World Health Organization ( WHO ) about this outbreak on February 10, reporting 305 cases ( including 105 health - care workers ) and 5 deaths ; it was later reported that the outbreak in Guangdong had peaked in mid-February, but that appears to be false, as later 806 infections and 34 deaths were reported. Early in the epidemic, the PRC discouraged its press from reporting on SARS and lagged in reporting the situation to the World Health Organization, delaying the initial report. Initially, it did not provide information for Chinese provinces other than Guangdong, the province where the disease is believed to have originated. For example, a WHO team that travelled to Beijing was not allowed to visit the Guangdong province for several weeks. This resulted in international criticism, which seemed to have caused a change in government policy in early April. January 2003 The first super-spreader, Zhou Zoufeng would bring the disease to the international stage. He checked in to the Sun Yat - sen Memorial Hospital in Guangzhou on January 31. This was the same hospital where Dr. Liu Jianlun was treating the disease. The virus was soon spread to nearby hospitals while Liu would later spread the disease to Hong Kong. February 2003 9th floor layout of the Hotel Metropole in Hong Kong, showing where a super-spreading event of severe acute respiratory syndrome ( SARS ) occurred SARS arrived in Hong Kong in February 2003, when a doctor who had treated some of the cases of SARS at Sun Yat - Sen Memorial Hospital in Guangdong came to attend a family gathering. Dr. Liu Jianlun, Hong Kong 's first patient, checked into the Metropole Hotel on February 21, with a room on the ninth floor, specifically room 911. Even though he was already feeling somewhat ill he visited with his family and traveled around Hong Kong. By February 22, he was sick enough to seek care at Kwong Wah Hospital. He died there in the Intensive Care Unit on March 4th. He is believed to have been a superspreader, as he spread the virus to many other guests on his hotel floor. Dr. Liu 's brother - in - law sought medical treatment in late February, entered the hospital on March 1st, and died on March 19th. Twenty - three other guests from the Metropole developed SARS, seven of them from the ninth floor, and it is estimated that around 80 % of the Hong Kong cases were due to Dr. Liu. The virus was carried to Hanoi, Vietnam by a fellow guest on the Metropole 's ninth floor. A Chinese - American resident of Shanghai, Johnny Chen, had roomed across the hall from Dr. Liu at the Metropole. He traveled on to Hanoi, fell ill there, and on February 26, was admitted to the French Hospital of Hanoi where he infected at least 38 of the staff there. Even though he was evacuated to Hong Kong, he died on March 13. Dr. Carlo Urbani, a WHO infectious disease specialist, was among the staff who examined Chen. Urbani observed that other hospital staff were already becoming ill and realized that he was dealing with a new and dangerous disease. He himself became infected and died on March 29th. On February 23rd, an elderly woman, Kwan Sui - Chu returned to Toronto from Hong Kong after being infected by Liu Jianlun at the Metropole Hotel. She died at home on March 5, after infecting her son Tse Chi Kwai, who spread the disease at Scarborough Grace Hospital and died on March 13. On February 25th, a businessman who had traveled in Hong Kong and the Guangdong Province returned home to Taipei. This marked the beginning of the outbreak on the island of Taiwan. Another person who was at the Metropole also returned to Singapore. Almost all of those infected had been either medical staff or family members of people who had fallen ill. It is believed that, at the time of exposure, affected medical staff were not using respiratory precautions, a safety protocol intended to fully protect medical workers. The various cases around the world were directly or indirectly traceable to people who had recently visited Asia. March 2003 On March 1, 26 - year - old Esther Mok was admitted to Tan Tock Seng Hospital after visiting Hong Kong, starting the Singapore outbreak. She recovered as various family members died. On March 4, a 27 - year - old Hong Kong man who had visited a guest in Metropole ( on the 9th floor ) 11 days earlier was admitted to Prince of Wales Hospital. At least 99 hospital workers ( including 17 medical students ) were infected while treating him. On March 11, Carlo Urbani travelled to Bangkok to attend a medical conference. On the flight, he fell ill and upon arrival in Bangkok told an awaiting friend not to touch him and to call an ambulance to take him to a hospital. He was isolated in an intensive care unit. A similar outbreak of a mysterious respiratory disease was reported among healthcare workers in Hong Kong. On March 12, WHO issued a global alert about a new infectious disease of unknown origin in both Vietnam and Hong Kong. On March 15, WHO issued a heightened global health alert about the mysterious pneumonia with a case definition of SARS as after cases in Singapore and Canada are also identified. The alert included a rare emergency travel advisory to international travelers, healthcare professionals and health authorities. CDC issued a travel advisory stating that persons considering travel to the affected areas in Asia ( Hong Kong, Singapore, Vietnam and China ). On March 17, an international network of 11 leading laboratories was established to determine the cause of SARS and develop potential treatments. CDC held its first briefing on SARS and said the first 14 suspected SARS cases were being investigated in the U.S. On March 20, WHO reported that several hospitals in Vietnam and Hong Kong were operating with half the usual staff, because many workers stayed home out of fear of getting infected. WHO raised the concern that substandard care of the infected patients may contribute to the spread of the disease. On March 25, Hong Kong authorities said nine tourists came down with the disease when a mainland Chinese man boarded the same plane on a March 15 Air China flight to Beijing. SARS started to hit Amoy Gardens Block E heavily. The Singapore Government enforced compulsory quarantine of any infected person. On March 27, Arthur K.C. Li, the head of the Hong Kong Education and Manpower Bureau, announced class cancellation of all educational institutions. The Ministry of Education of Singapore announced that all primary schools, secondary schools and junior colleges were to be shut until April 6, 2003. Polytechnics and universities were not affected. On March 29, Dr. Urbani died in Bangkok of a massive heart attack. On March 30, Hong Kong authorities quarantined estate E of the Amoy Gardens Apartment due to a massive ( 200 + cases ) outbreak in the building. The balcony was completely closed for all uses and guarded by the police. The residents of the building were later transferred to the quarantined Lei Yue Mun Holiday Camp and Lady MacLehose Holiday Village on April 1 because the building was deemed a health hazard. Most of the cases were tied to apartment units with a north - western orientation that shared the same sewage pipe. According to government officials, the virus was brought into the estate by an infected kidney patient ( type of kidney illness was not specified ) who after he was discharged from Prince of Wales Hospital, visited and thus infected his elder brother living in a flat on the seventh floor. Through excretion, the virus spread through drainage. One speculated theory that supported airborne transmission was that the virus was spread through dried up U-shaped P - traps in the drainage and was blown by a maritime breeze to the ventilation of the estate 's balcony and stairwells. It was confirmed that the virus can spread via droplets, but this latest outbreak made the officials question the possibility of spreading through the air. April 2003 On April 1, the U.S. government called back non-essential personnel in their consulate office in Hong Kong and Guangzhou. The US government also advised US citizens not to travel to the region. On April 2, Chinese medical officials began reporting the status of the SARS outbreak. China 's southern Guangdong province reported 361 new infections and 9 new deaths, increasing the total Mainland China figures previously reported at end - February. The virus was also detected in Beijing and Shanghai. The WHO also advised travelers to avoid Hong Kong and Guangdong during a press briefing. ( 1 ) On April 3, a WHO team of international scientists landed in Guangzhou from Beijing to discuss with officials, but the team was yet to inspect any suspected origin or any medical facilities on progress of infection control. Fifteen of the quarantined Amoy Gardens residents at Lei Yue Mun Holiday Camp were relocated to the Sai Kung Outdoor Recreation Centre after an overnight protest on washroom sharing. The first medical worker infected with SARS died in Hong Kong. The doctor was survived by a daughter and his infected wife, who was also among the quarantined medical workers under intensive care. Hong Kong school closures were extended by two weeks to April 21. On April 4, the WHO team inspected the first infection case in Foshan County. The male infected four people. But, he did not infect his family. A 40 - year - old woman became the first local case in Shanghai. A Chinese health specialist admitted at a press conference of not informing the public early enough about the outbreak. The PRC Health Minister also claimed that the disease has been under control in most parts of mainland China. He also released the names of seven drugs which he claimed to be effective in curing SARS. WHO officials said that the information provided by the PRC about the disease has been `` very detailed ''. US government enforced compulsory quarantine of any infected person. On April 5, the Singapore government announced that school closures will be extended. Junior colleges will reopen on April 9, secondary schools will reopen on April 14 and primary schools and pre-schools will reopen on April 16. On April 6, a SARS case was found in Manila, a person who had returned from Hong Kong. On April 8, SARS starts to plague the Lower Ngau Tau Kok Estate near Amoy Gardens in Kowloon. Hong Kong health officials warned that SARS had spread so far domestically and abroad that it was here to stay. Nevertheless, WHO officials remained cautiously optimistic that the disease could still be contained. ( 2 ) On April 9, James Earl Salisbury died of SARS at a hospital in Hong Kong. An American Mormon and a teacher at Shenzhen Polytechnic, he had been sick for approximately one month before his death, but he was originally diagnosed with pneumonia. His son Michael `` Mickey '' Salisbury was with him in China and also contracted the disease, but he survived it. Salisbury 's death led to more open admissions by the Chinese government about the spread of SARS. On April 10, Dr. Jim Hughes, the head of infectious disease at the CDC, confirming the warnings of Hong Kong health officials, claimed that he believed that SARS could no longer be eradicated in the Far East. However, he remained hopeful that it could be prevented from spreading widely in North America. ( 3 ) On April 11, the World Health Organization issues a global health alert for SARS as it becomes clear the disease was being spread by global air travel. On April 12, Dr. Marco Marra, director of the Michael Smith Genome Sciences Centre, which is part of the British Columbia Cancer Agency, announced that scientists at his center had broken the genetic code of the virus suspected of causing the disease. ( 4 ) In Toronto, three more people die of SARS, bringing the Canadian death toll to 13. On April 16, the WHO issued a press release stating that the coronavirus identified by a number of laboratories was the official cause of SARS. The virus was officially named the SARS virus. ( 5 ) Doctors were surprised to discover the occurrence of at least two cases of SARS in Dinnur, a village near Bangalore, India. Poor hygiene and a lack of adequate trash disposal seemed to have hastened the spread of the deadly disease. On April 19, Premier of the People 's Republic of China Wen Jiabao announced that there would be severe consequences for local officials who do not report SARS cases in a timely and accurate manner, signalling at a major change in policy. ( SARS had also been gaining prominence in the mainland Chinese media ; by late April, it had jumped from virtual invisibility onto the front - page, with daily reports from all provinces on new cases and measures. ) On April 20, Beijing mayor Meng Xuenong and health minister of the PRC Zhang Wenkang were replaced respectively by Wang Qishan from Hainan and the former deputy health minister Gao Qiang. They are the first two high rank officials in the PRC to be dismissed because of the fallout of the epidemic. In the news conference chaired by Gao Qiang several hours earlier, the PRC admitted that in Beijing there are more than 300 cases, as opposed to the previous figure of only 37. One day later the figure has increased to 407. Chinese officials also admitted to major underreporting of cases, which were attributed to bureaucratic ineptitude. On April 22, schools, in Hong Kong, start to reopen in stages. On April 23, Beijing announced that all primary and secondary schools will be closed for two weeks. A few days before, some colleges in Peking University had been closed because some students had been infected. The WHO issues travel advisories against Beijing, Toronto, and Shanxi Province. ( 6 ) On April 25, Taipei city government closed Taipei Municipal Hospital Hoping branch, and quarantined its 930 staffs and 240 patients for 2 weeks. Later, people were relocated and the building sanitized. On April 24, the Hong Kong Government announced a HK $11.8 billion relief package designed to assist Hong Kong 's battered tourism, entertainment, retail, and catering sectors, consisting of a waiver of tourism - and transport - related licence fees, and HK $1 billion allocated for tourism promotion overseas. The package also includes a salaries tax rebate, and reduced rates. On April 26, Wu Yi was named Zhang Wenkang 's replacement as PRC health minister. On April 26 -- 27, Chinese authorities closed down theaters, discos, and other entertainment venues in Beijing as the death toll in Beijing continued to rise, threatening to become the worst hit area of the country, eclipsing the Guangdong province. Authorities are bolstered by the fact that the infection rate seems to have declined, with the Guangdong region only exporting three new infections over the weekend. The economic impact is becoming dramatic as shops, restaurants, markets, bars, universities, schools, and many other businesses have closed, as well as some government ministries and large state banks are working with minimal staff levels. On April 28, WHO declared the outbreak in Vietnam to be over as no new cases were reported for 20 days. On April 29, leaders of member countries of ASEAN and the PRC premier held an emergency summit in Bangkok, Thailand in order to address the SARS problem. Among the decisions made were the setting - up of a ministerial - level task force and uniform pre-departure health screening in airports. On April 30, the World Health Organization lifted the SARS travel warning for Toronto. The decision was made because `` it is satisfied with local measures to stop the spread of SARS ''. Canadian officials say they will step up screenings at airports. ( 7 ) May 2003 On May 3, the 2003 FIFA Women 's World Cup was abruptly moved to the United States due to the outbreak. China would automatically maintain its automatic qualification and then hosted the Women 's World Cup 4 years later. On May 4 the newly infected number of people in Hong Kong drops to a single digit. On May 19 the WHO Annual Meeting is held in Geneva. Hong Kong pushes for the Tourism Warning to be lifted. On May 20 the WHO refuses to lift the Tourism Warning for Hong Kong and Guangdong. On May 23, after a re-count of the number of SARS patients in hospital, WHO lifts the Tourism Warning from Hong Kong and Guangdong. On May 24, the number of newly infected patients is zero for the first time in Hong Kong, since the outbreak in the country in March. On May 24, a new cluster of about 20 suspected patients is reported in Toronto. By May 29, more than 5000 people were quarantined in Canada by authorities seeking to control the potential spread of this new SARS outbreak. On May 31, Singapore is removed from WHO 's list of ' Infected Areas '. June 2003 On June 23, Hong Kong is removed from WHO 's list of ' Affected Areas '. The three places left on the list are Toronto, Beijing, and Taiwan. On June 27, the World Health Organization said the world population should be SARS - free within the next two to three weeks, but warned the disease could emerge in China next winter. July 2003 On July 5, WHO declared the SARS outbreak contained and removed Taiwan from the list of affected areas. There have been no new cases for 20 days although around 200 people are still hospitalized with the disease. September 2003 On Sep 8, Singapore announced that a post-doctoral worker in a SARS research lab in the National University of Singapore contracts the disease while working on the West Nile virus but recovered shortly thereafter. It was suspected that the two viruses mixed while he was doing his research. October / November 2003 The Hong Kong Harbour Fest was organised and held from 17 October to 11 November 2003 as part of a HK $1 billion program to revive the economy of Hong Kong after the SARS. It was a government underwritten event organised by InvestHK, under the auspices of the Economic Relaunch Working Group, in collaboration with the American Chamber of Commerce. December 2003 On Dec 10, a researcher in a SARS lab in Taiwan came down with SARS after returning from Singapore attending a medical conference, 74 people in Singapore were quarantined but none of them were infected. On Dec 27, China announced the first suspected case of SARS in six months in Guangdong, from the area the virus originated and in an individual who was not a SARS researcher. January 2004 January 2 : Shenzhen 's bid for the 2009 Summer Universiade was cancelled, and announced bid for the 2011 Summer Universiade by FISU. January 5 : China confirms that the case reported in December is a case of wild source SARS. The Philippines announced a possible case in a person just returned from Hong Kong. January 7 : The Philippines announces that their possible SARS case is just pneumonia. China culls civets in markets, thought to be a reservoir for the disease. January 10 : A restaurant worker in Guangzhou province is confirmed as the second wild source SARS since the outbreak was contained. Guangzhou was also the site of the first case in December and is thought to be the origin of the virus in the original outbreak. Three Hong Kong television reporters who visited SARS related sites in Guangzhou were declared free of the disease. January 17 : China announced a third case of SARS in Guangzhou. WHO official urged more testing to bring the three recently announced cases into line with their standards ; however they also announced SARS virus had been detected by a WHO team in civet cages at the restaurant where the second case works and in civet cages in the market. January 31 : China announced a fourth case of SARS as a 40 - year - old doctor from the southern city of Guangzhou, and gave his family name as Liu. He was discharged when the announcement was made. April 2004 On April 23, China announced first SARS death since June. A 53 - year - old woman died on April 19. Two other cases, both health care workers, one of which was the deceased woman 's daughter. A fourth case was suspected in another health care worker. The outbreak originated from a researcher working on the SARS virus in a lab at the Institute of Virology in Beijing, who inadvertently caught the disease and ended up spreading it to the nurse taking care of him. May 2004 May 1 : Two additional confirmed cases of SARS and three additional suspected cases are reported in Beijing, all related to a single research lab. The total number of cases is six, with four in Beijing and two in Anhui Province. May 2 : China announced the three suspected cases as genuine cases of SARS, bringing the total cases in recent outbreak to nine. 189 people were released from quarantine. May 19 : As no new infections are reported in a three - week period, WHO announced China as free of further cases of SARS. See also List of medical professionals who died during the SARS outbreak Notes Jump up ^ World Health Organization. Severe Acute Respiratory Syndrome ( SARS ) -- multi-country outbreak -- Update 6. Available at http://www.who.int/csr/don/2003_03_21/en/index.html Jump up ^ Cyranoski, David ( 3 April 2003 ). `` China joins investigation of mystery pneumonia ''. Nature. 422 : 459. doi : 10.1038 / 422459b. PMID 12673214. Jump up ^ Rosenthal, Elisabeth ; Altman, Lawrence K. ( March 27, 2003 ). `` China Raises Tally of Cases and Deaths in Mystery Illness ''. The New York Times. Retrieved March 11, 2009. Jump up ^ `` IDEESE Case : SARS ''. Retrieved 20 April 2015. Jump up ^ Abraham, Thomas ( 2004 ). Twenty - first Century Plague : The Story of SARS. ^ Jump up to : Khan, Ali S. & Patrick, William. ( 2016 ). `` The Next Pandemic. '' New York : PublicAffairs. Jump up ^ Low, Donald ( 2004 ). Learning from SARS : Preparing for the Next Disease Outbreak : Workshop Summary. Jump up ^ Yeoh, En - Lai ( 2003 - 04 - 09 ). `` Singapore Woman Linked to 100 SARS Cases ''. Associated Press. access - date = requires url = ( help ) Jump up ^ `` Update : Outbreak of Severe Acute Respiratory Syndrome -- - Worldwide, 2003 ''. Retrieved 20 April 2015. Jump up ^ `` Church Member Dies of SARS '', lds.org. Jump up ^ `` Panic as China 's SARS toll rises ''. Retrieved 20 April 2015. Jump up ^ Doctor accuses China of covering up SARS outbreak Jump up ^ Reported on CBS 's The Early Show American Family Affected By SARS Jump up ^ `` American SARS boy back home ( SOUTHCN.COM ) ''. Retrieved 20 April 2015. Jump up ^ `` CNN.com - Timeline : SARS outbreak - Apr. 24, 2003 ''. Retrieved 20 April 2015. Jump up ^ Chang Yun - ping ( 2003 - 04 - 25 ). `` SARS epidemic : Taipei City closes down hospital ''. Taipei Times. Jump up ^ Cohen, Tom ( 29 May 2003 ). `` Canada Broadens Definition of SARS Cases ''. Kansas City Star. Associated Press. Archived from the original on 30 October 2004. References CDC Morbidity and Mortality Weekly Report -- SARS section SARS : An Open Scar SARS : Timeline of an Outbreak Health in China Healthcare Health Disease surveillance Healthcare system reform Women 's health Health informatics Tobacco Control Association Barefoot doctor Patriotic Health Campaign China Welfare Institute Hospitals in China Medical schools Organ transplantation Medicine and pharmaceutical Medicine Traditional Chinese medicine Pharmacy Pharmaceutical industry Biotechnology Diseases Avian influenza Blue - ear disease Cardiovascular disease Chronic diseases Enterovirus 71 ( EV71 ) Fujian flu Hepatitis B HIV / AIDS Iodine deficiency lead poisoning scandal Leprosy Mental health Obesity Pneumonic plague SARS ( outbreak progress ) Stroke Swine influenza outbreak Tuberculosis Disease - related deaths Government National Health Commission Chinese Center for Disease Control and Prevention China Drug Administration State Administration of Traditional Chinese Medicine Hong Kong Department of Health * Macau Secretariat for Social Affairs and Culture * General Administration of Customs Other related issues Demographics Dust storms Environment Food safety Illegal drug trade Pollution Poverty Prostitution Smoking Vegetarianism Violence against doctors in China Yi Nao Water supply and sanitation Studies China - Cornell - Oxford Project ( The China Study ) China Health and Nutrition Survey China Family Panel Studies China Health and Retirement Longitudinal Study * Of special administrative regions Retrieved from `` https://en.wikipedia.org/w/index.php?title=Timeline_of_the_SARS_outbreak&oldid=842957606 '' Categories : Medicine timelines Severe acute respiratory syndrome Disaster timelines Health disasters in China 21st - century epidemics 2000s medical outbreaks 2002 health disasters 2003 health disasters 2004 health disasters 2002 disasters in China 2003 disasters in China 2004 disasters in China Hidden categories : Pages using citations with accessdate and no URL All articles with dead external links Articles with dead external links from May 2017 Articles with permanently dead external links Wikipedia articles with incorrect tenses Articles needing additional references from November 2012 All articles needing additional references Talk Contents About Wikipedia Deutsch 中文 Edit links This page was last edited on 25 May 2018, at 21 : 04. 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Question: where did the new form of pneumonia sars start
Answer: in the Guangdong province of China, which borders on Hong Kong