Expert panel: Hong Kong University Professor Yuen Kwok-yung, the WHO's Dr Mike Ryan, Secretary for Health, Weflare & Food Dr Yeoh Eng-kiong, the WHO's Dr Mark Salter, and Chinese University Professor Joseph Sung round up the two-day SARS Clinical Management Workshop.

The international community, including Hong Kong, has reacted in an exemplary fashion to speedily bring SARS under control, the WHO's Dr Mark Salter said today.

His view was shared by fellow WHO representative Dr Mike Ryan who said the difficulty of controlling SARS in a densely-populated city like Hong Kong is immense.

He said he is impressed with Hong Kong's work in combating the virus.

"In fact, it is a model for the world. The leadership shown by Dr Yeoh and the teams in the public health sector has been exemplary.

"The expertise of the doctors, the expertise of the nurses and the people of public health, and the public health measures that have been taken, we have been impressed by this since our arrival," Dr Ryan said.

Rounding up the two-day SARS Clinical Management Workshop, Dr Salter said Hong Kong has been effective in containing the disease through rapid implementation of infection control measures, such as the screening system at immigration control points.

He described the meeting as "constructive", with over 160 clinicians from around the globe sharing experiences in combating SARS.

Topics discussed included typical and atypical presentations of SARS patients, in particular pregnant women, children and the elderly; treatment modalities; and the most current mode of infection and control measures.

The experts will further develop some of these points during the meeting in Kuala Lumpur over the next few days to devise an appropriate research mechanism and processes. This will help the world react quicker should SARS or other similar diseases appear in future.

He admitted there were heated discussions on treatment modalities, an area where a great deal of work still has to be done and looked at in a systematic manner. He said experts will start developing protocols and carrying out trials.

Commenting on the combined use of keletra and ribavirin, Hong Kong University Professor Yuen Kwok-yung said the chance of survival for the 134 SARS patients using this treatment is higher than those using other treatment protocols.

However, he stressed that more trials need to be carried out to establish the effectiveness of the combined treatment.

Chinese University Professor Joseph Sung said there is a need to revisit the WHO's case definitions after reviewing the some 1,700 cases in Hong Kong.

He said 10% of the patients did not have fever presentation, and 30% of elderly patients did not show signs of fever.

Moreover, one-third of the SARS patients got diarrhoea, and some had other organ problems.

Dr Ryan said the incubation period for most cases is less than 10 days, adding that the mode of transmission is usually personal contract.

Secretary for Health, Welfare & Food Dr Yeoh Eng-kiong said while Hong Kong has put SARS under steady control, people should remain cautious.

There is still room for improvements, he said, adding that a review is being conducted to further strengthen infection control facilities in hospitals.