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China May Execute SARS Quarantine Violators
Sat May 17 23:56:19 2003
208.152.73.3

China May Execute SARS Quarantine Violators


BEIJING (Reuters) May 15 - China has threatened to execute or jail for life anyone who breaks SARS quarantine orders and spreads the virus intentionally.

The Supreme Court and the top prosecutor laid down the punishments in an interpretation of laws on hindering the prevention or treatment of sudden disease outbreaks and other disasters, newspapers said on Thursday.

"Intentionally spreading sudden contagious disease pathogens, endangering public security or serious personal injury, death or heavy loss of public or private property will be punishable by from 10 years to life in prison or the death penalty," the official Xinhua news agency said.

The new rule came under immediate fire from rights activists.

"The measure is too extreme and the punishment too heavy," Hong Kong-based rights activist Frank Lu said by telephone.

"It violates the international human rights covenant and was not approved by the National People's Congress," Lu said, referring to China's parliament.

The interpretation is part of a government war on severe acute respiratory syndrome (SARS) after a slow start in handling the flu-like disease that first appeared in the southern province of Guangdong last year.

Several reports have surfaced in China, which has the worst outbreak of SARS in the world, of people breaking quarantine or refusing medical care for fear of the disease.

In the Inner Mongolian city of Linhe, Li Song, a 40-year-old physician infected with SARS, broke quarantine and smashed medical equipment last month after his wife and parents died from the disease.

People with contagious diseases, or suspected of having them, who refuse medical examinations, isolation or treatment and pass on the illness unintentionally can get 3 to 7 years in jail, the interpretation said.

Health officials found guilty of negligence and allowing a disease to spread can be imprisoned for up to 3 years, it said.

Hundreds of officials, including the health minister and Beijing mayor, have been fired for mishandling or covering up the disease.

Those found guilty of producing and selling fake drugs may be sentenced to 15 years to life in prison if their actions result in heavy losses, the report said. If they kill someone or cause serious physical damage, it is 10 years to life.

Using violence or threats to prevent state or Red Cross workers from doing disease and disaster prevention could result in up to a 3-year sentence.

State-owned companies or state employees who handle outbreaks or disasters irresponsibly, or misuse their powers, leading to heavy losses or bankruptcy are liable to serve up to 3 years in prison, it said.

Other crimes, like taking advantage of an outbreak to raise prices of goods, misusing aid funds, illegally administering medical care, false advertising, raising false alarms and fabricating news of attacks, can also result in prison terms.

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SARS - WORLDWIDE (109): ETIOLOGY
************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Fri 16 May 2003
From: Henry L Niman, PhD


SARS Mutations and Contact Tracing
----------------------------------
There are now 16 SARS coronavirus sequences at GeneBank, 14 of which were
analyzed in the paper published in Lancet last week, and 2 have been added
since. Moreover, some of the sequences have been revised, and the latest
updates paint an even clearer picture of the relatedness of the isolates
and show that they can be very useful in tracking the disease and
classifying new isolates.

[A synopsis of the The Lancet paper by Ruan et al., entitled: "Comparative
Full-length Genome Sequence Analysis of 14 SARS Coronavirus Isolates and
Common Mutations Associated with Putative Origins of Infection" can be
found in the ProMED-mail post "SARS - worldwide (101): etiology
20030510.1168". The full paper can be accessed at
http://www.thelancet.com/journal/vol361/iss9369/full/llan.361.9369.early_online_publication.25661.1 
Figures 4 and 5 of that paper provide an easily assimilable backdrop to the
supplementary information which is the subject of Dr. Niman's comment. -
Mod.CP]

The 16 isolates all fall into 2 groups on the basis of the [relationships]
of the patients as well as analysis of 5 loci that invariably segregate
into 2 groups, one associated with isolates linked to the Metropole Hotel
and the other linked to isolates from mainland China. Although each
isolate has a unique set of mutations, the 5 discriminating markers are
invariant.

The 5 loci are as follows, using the numbering for the Tor2 isolate. At
the nucleic acid level the 10 isolates with the Metropole Hotel lineage
have the following 5 mutations: C9404T, G17564T, A21721G, C22222T, C27827T,
which translate into the following amino acid changes. For orf1ab [open
reading frame 1ab, which generates the polymerase protein by a ribosomal
frameshift] A3047V, E5767D, for the Spike protein D77G, T244I, and for a
small 37 aa orf [amino acid open reading frame] R17C.

The 10 isolates in the Metropole Group are the following, with their
relationship to the index case and status of patient:

AY274116 (Tor2) Toronto (tertiary) died
AY278491 (HKU-39849) Hong Kong (primary) died
AY278741 (Urbani) Hanoi/Bangkok (tertiary) died
*AY282752 (CUHK-Su10) Hong Kong (secondary) died
AY283794 (SIN2500) Singapore (primary) survived
AY283795 (SIN2677) Singapore (secondary) unknown
AY283796 (SIN2679) Singapore (unknown) unknown
AY283797 (SIN2748) Singapore (secondary) unknown
AY283798 (SIN2774) Singapore (secondary) unknown
*AY291451 (TWA) Taiwan (unknown) survived

The 6 isolates in the Mainland China Group are:

AY278487 (BJ02) Beijing (from pooled samples) unknown
AY278488 (BJ01) Beijing (from same patient as BJ03) died
AY278489 (GZ01) Guangzhou died
AY278490 (BJ03) Beijing (from same patient as BJ01) died
AY278554 (CUHK-W1 (Shenzhen/Hong Kong) unknown
AY279354 (BJ04) Beijing died

[The 2 cases marked with an asterisk provide the 2 genome sequences
additional to those previously analyzed by Ruan et al. - Mod.CP]

For all completed sequences, all 5 segregating loci are found. For partial
sequences 3 or 4 are found. None of the 16 isolates have any detected
variations at these 5 loci.

In addition to the 5 loci dividing the isolates into 2 main groups, there
are mutations for subgroups. One mutation exclusive to Singapore is C19084T
in orf1ab I6274T. It is in the Singapore index isolate (SIN2500) as well
as all 3 primaries (SIN2677, SIN2748, SIN2774).

There are 3 mutations found only in Beijing isolates (BJ01, BJ02, BJ03,
BJ04), which are C9854T, A19838G, and C27827T, which translate into A3197V
for orf1ab and P57L for X3 (the A19838G mutation in orf1ab is silent). The
more complete sequences (BJ01, BJ02, BJ03) have all 3 Beijing mutations,
while only 2 have been detected in BJ04.

In addition to the widely shared mutations, there are many shared by 2 or 3
isolates:

C7919T - Urbani, BJ03
T8559A - GZ01, BJ04
G8572T - BJ01, BJ02, GZ01
T9479C - GZ01, CUHK-W1
A19064G - Urbani, CUHK-W1
A29279C - BJ02, GZ01

All of the 16 isolates also have their own unique mutations, except TW1,
which has only the 5 Metropole Hotel markers.

[The following is my paraphrasing of Dr. Niman's final paragraph. "Analysis
of 2 more genome sequences reinforces the conclusion of Ruan et al. that
conserved sequence features can be identified which may provide a reliable
method for tracking transmission. Such tracking seems particularly useful
for major outbreaks linked to "super-spreaders" including 15 Mar 2003
Flight CA-112, from which virus spread to Hong Kong, Taiwan, Beijing, and
Hohhot, or the latest explosion of cases in Taiwan." - Mod.CP]

--
Henry L Niman, PhD
Instructor in Surgery (Bioengineering)
Harvard Medical School
51 Blossom Street, Room 422
Boston, MA 02114 USA
henry_niman@hms.harvard.edu