Asia pacific Inter-city SARS Forum in Taipei, September 28-29. Prevention from SARS (Severe Acute Respiratory Syndrome) epidemics in Japan. Noboru Ishii, M.D., Ph.D. Department of Disaster and Emergency medicine, Kobe University Graduate School of Medicine. Background.
Noboru Ishii, M.D., Ph.D.
Department of Disaster and Emergency medicine,
Kobe University Graduate School of Medicine
Electron Microscope Photo
of SARS virus
site in MHW
Reinforced activities at quarantine
Ministry of Health, Labour and Welfare: (MHW) in JapanSevere Acute Respiratory Syndrome (SARS) Action Plan (June 2, 2003)
1. Provision of Information on SARS to Public
2. Advisory to Travelers Visiting Hong Kong, Guangdong (China), and other SARS-Affected Areas.
3. Reinforcement of Activities at Quarantine Stations
4. Preparation for a Possible Outbreak in Japan
5. Promotion of International Cooperation
* Provision of up-to-date information through the Ministry’s web site. (March 17)
* Publication of SARS Q&A (Also available on web page).
* Telephone consultation service at local public health departments and prefectural governments.
WHO Kobe Center SARS Information Support Desk
Automatic Answering Telephone System in Japanese since May 2003
＊All travelers visiting Beijing, Tianjin, Taiwan, Shanxi Province, Neimenggu and Hebei Province are advised to reconsider their plans and postpone unnecessary visit to the region.
Information on SARS is provided as the following methods.
Health care centers and consultation offices in each prefecture also provided.
Introduce the way of its treatment, occurrence condition, and FAQ
○the website of National Institute of Infectious Diseases（http://idsc.nih.go.jp/others/urgent/update.html）
○MHW quarantine website（http://www.forth.go.jp）
２ Inquiry from the public
Inquiries on heath information of overseas at the nearest quarantine.
The contact list on the website （http://www.forth.go.jp）
３ Inquiry on diagnostic examination from the medical specialists
(open from 9:00 to 17:00)
○Information Center of National Institute of Infectious Diseases Tel: 03-5285-1111
４ Inquiry on administrative response by the government officers
○Department of Infection Control and Prevention Tuberculosis and Infectious Disease Control Division in MHWTel：03-5253-1111(ex. 2382)
* Dispatching medical doctors from national hospitals and other medical institutions to quarantine stations to assist their activities.
* Distributing the health status questionnaire and monitoring body temperature of all passengers on all flights from Hong Kong, China, Taiwan, and Canada. If necessary, the health status of passenger will be followed up for 10 days
* Monitoring body temperature of all passengers on all international flights at all airports. (May 26).
The Law Regarding Infectious Disease Prevention and Medical Care for the Patients(Established on September 28, 1998, enforced on April 1, 1999)
*Number of Negative pressure room
Occupancy of ICD or ICN in Type 2 hospitals: ca.70%
1.Started after November 11, 2002
・ high fever（>38℃）cough, respiratory distress
・10 days before the start of symptoms: *either having close contact with the people in suspected or potential case, or traveling to or living in affected area.
2.Died from a unknown acute respiratory illness after November 1st, 2002. No pathologic autopsy; relevant act(*) was recognized within 10 days before the symptoms
1.When the suspected case have findings of ARDS or pneumonia on chest radiograph
2. When the suspected case are positive in more than one SARS examination or are diagnosed RDS by autopsy and no other cause
WHO (Ver.3), May 2003
All cases were negative of SARS reported by the Special Committee of SARS
Reported suspected cases of SARS in Japan ( July 15, at 17:00)
Standard Precaution ＋Droplet Transmission Precaution
Contact Transmission Precaution
Airborne Transmission Precaution
March 18：Start SARS response planning at the Infection Control Division according
to the Notice of MHW
March 19：Discussion at the Committee of Infection Control in Kobe University
March 24：Delivery “SARS Response Manual(Ver.1)” to the staff in hospital
April 7：Information of SARS Response Manual available on the web site of Kobe
April 17：The 1st Practice of simulation for SARS response
April 22： The First team meeting for response to the SARS patients
May 6：The second team meeting for response to the SARS patients (Revised
“SARS Response Manual”)
May 7：Emergency meeting for SARS to the all hospital staff
May 21：Second revised “SARS Response Manual”
May 27：Attending the meeting for SARS response information in Kobe city
June 10：The third team meeting for response to the SARS patients
June 17,19： The second Practice of simulation for SARS response
Set up in front of the hospital
* Dispatching medical doctors to affected countries and cooperating on researches in diagnosis and treatments.
1.Deep understanding of information
・Information system offering by TV, Radio and etc.
・Common ownership of scientific and objective information
2.Improvement of detective methods for SARS patients
・High detailed investigation for person contacted to SARS
・ Common ownership on investigative methods for outbreak of SARS
3.Establishment of In-Hospital infection control system
・key point; success of in-hospital infection control
4.Flexibility of early detective system
・early detection of aged patients without fever and severe symptoms
5.Cooperation of implementation for international discretion