The number of people who may have been exposed to severe acute respiratory syndrome (SARS) in Taiwan is extremely large, said head of the US Centers for Disease Control and Prevention (CDC) at a recent news conference.
"Initially Taiwan did an excellent job of containing the first round of illness that appeared there, but unfortunately a traveler went to the country while ill and initiated a series of chains of transmission in various settings," said CDC Director Dr. Julie Gerberding.
Because of this, significant detective work has had to be done to track down those chains of transmission, and the number of people ultimately exposed, as the story was unfolding, was extremely large, she said.
In addition, she said, transmission was initiated in the health care setting, so that health-care providers who were not initially protected acquired SARS and, again, served as potential vectors for transmission to others.
It's an example of how quickly a situation can get out of hand if there is not an immediate detection and isolation mechanism, she said.
"Of course, Taiwan has some marvelous medical facilities and significant capacity to manage a public health emergency, " Gerberding said, "but this is a very large situation for them now, and they have requested technical assistance and other forms of assistance, and the World Health Organization and CDC are very happy to contribute what we can."
Gerberding, answering reporters' questions about Taiwan during a telebriefing, said the CDC has sent a team to Taipei to help determine why SARS is spreading.
"The CDC had a change of personnel there, just recently, because people come and go on our teams. We have sort of a revolving door, to some extend, to make sure that people are fresh and we bring in fresh sets of eyes to assist," she said.
Taiwan's government has asked for the CDC to provide technical assistance in some specific areas, including infection control and consultation.
"Again, a fresh set of eyes can often see something that you don't see when you're in the same situation, day in and day out," she said.
"Our team is also evaluating the spread of the problem in the country and assisting the government in looking for the chains of transmission that have resulted in the ongoing spread outside of the health care environment," she said.
Gerberding said the CDC personnel are there to provide whatever technical assistance is requested from the government and the CDC is also working on laboratory testing and trying to assist in getting accurate diagnoses of patients and a complete clinical picture of those sick in hospital.
She said it is a work in progress.
"I believe that our basic philosophy is that we would want to continue to provide technical assistance as long as it's useful and helpful to the government," she said.