A LAUNDRY worker in a Taiwan hospital who developed Sars had the disease undiagnosed for six days and may have exposed 10,000 other people to the virus.

The worker, who died on April 29, has created an epidemic in Taiwan that has so far infected 570 people and killed 72.

Julie Gerberding, the head of the US Centres for Disease Control and Prevention in Atlanta, described the situation in Taiwan as “serious and sobering”. An expert from the centre who flew to Taiwan to help to control the epidemic has been sent home by air ambulance after catching the disease. Taiwan yesterday reported 22 more infections and 12 more deaths.

In China there were seven more deaths yesterday, 33 fresh cases in Canada, where 800 people are in quarantine, and four more deaths in Hong Kong — making it clear that the disease is far from beaten. Epidemiologists reported at the end of last week that Sars is controllable, but that there is little room for error.

Chris Dye, of the World Health Organisation (WHO), and Nigel Gay, of the UK Health Protection Agency, said that the main message of two papers in Science were that Sars “is sufficiently transmissible to cause a very large epidemic if unchecked, but not so contagious as to be uncontrollable with good, basic public health measures”.

Taiwan, like Canada, acquired its first Sars cases by travel from China. Between March 14 and April 21 it reported 28 cases, all but four among travellers. By early April WHO reclassified Taiwan from an affected area to one with “limited local transmission”. It moved too soon. On April 12 the 42-year-old laundry worker at Hoping Hospital in Taipei reported symptoms of fever and diarrhoea. He was checked by the hospital’s emergency department on April 12, 14 and 15, but it was not until April 18 that Sars was finally diagnosed. Over those six days he continued working, sleeping in the hospital basement and spending his free time socialising with patients, staff and visitors.

Eighty-one people are believed to have been infected by him, and outbreaks at eight other Taiwan hospitals have been linked to his contacts. Usually these outbreaks occurred when people in whom Sars symptoms had yet to appear were transferred to other hospitals or discharged.

The Taiwan outbreak shows that even when the mode of transmission of a disease is understood it can still spread, says Morbidity and Mortality Weekly Report, published by the Centres for Disease Control. In this case, the delay in diagnosis and the fact that patients in Taiwan hospitals are often looked after by “personal attendants” hired by their families may have contributed to the spread.

Taiwan yesterday refused an offer of help from China. Last week Beijing blocked an attempt by Taiwan to join WHO, on political grounds. China does not recognise Taiwan as an independent country, and considers it part of Chinese territory. In a letter to its Chinese counterpart, Taiwan’s quasi-official Straits Exchange Foundation recommended that Chinese authorities keep their medical supplies for their own battle against Sars.

The latest figures from WHO show that 8,141 cases of Sars have been reported, and 696 people have died.

Explore World News

• World Agenda

• Iraq News

• US & Americas News

• Europe News

• Middle East News

• Asia News

• Africa News

• Ireland News

Times Recommends

• Rio Tinto four held as China prepares case
• Diplomats must keep heads down and trousers up
• When in Rome should one make like Berlusconi?