The health ministry has tightened surveillance at entry points, particularly for air travellers from countries with a high number of suspected cases of severe acute respiratory syndrome (Sars).

"If (suspected Sars cases) slip through the surveillance net at the departure airport, then air crew have been directed to set aside two rows at the back of the airplane for (them). Before landing, the captains are required to notify us so that a health team is at hand when they arrive," Health Minister Chua Jui Meng told the Dewan Rakyat today.

"At the Kuala Lumpur International Airport, visitors from six locations - China's Guangdong Province, Hong Kong, Singapore, Hanoi, Taiwan and Toronto would also be required to exit through a special wing so that they can be further monitored before they enter the country," he said.

The minister said the foreign affairs ministry had also been notified to reduce the issuance of tourist visas to groups from affected countries.

During a debate o­n the ministry's supplementary estimates, Chua said several other measures that have been taken include preparation of special sections in airports for additional surveillance of travellers from specific countries, as well as designating specific hospitals to quarantine suspected Sars patients.

Suspected vs probable

Facing strong criticism from various MPs o­n his ministry's handling of the Sars situation, Chua emphasised that not o­nly had the ministry's earlier surveillance measures been praised by the World Health Organisation but that additional measures yesterday far exceeded WHO requirements.

The minister said present surveillance guidelines had already exceeded WHO recommendations as health officers are required to identify persons based o­n o­nly two criteria if they have high fever and if they had travelled to affected areas.

Based o­n WHO terminology, a suspected Sars case in o­ne where a person after Feb 1, 2003, records a medical history of high fever above 38 degrees Celsius, and o­ne or more respiratory symptoms including cough, shortness of breath and difficulty in breathing.

The individual should also have had close contact with a diagnosed Sars patient or visited an area affected by Sars.

A probable case, o­n the other hand, refers to a person with the above symptoms and has chest X-ray findings of pneumonia.

On preparations at local medical institutions, Chua said the ministry had identified at least o­ne hospital in each state specially to quarantine suspected Sars patients.

"We will also apply for additional funds from the finance ministry to purchase equipment for all separation wards in the hospitals," he said.

Media misreported

Quizzed by opposition MPs about the lack of information o­n suspected Sars cases prior to yesterday's admission, Chua said the confusion could have been due to misinterpretation of technical terms by the media.

According to him, the ministry's Director-General Dr Mohamad Taha Arif had said there were no probable cases in Malaysia. This did not mean that there were no suspected cases, he added.

Speaking to reporters at the Parliament lobby later, Chua maintained that to date, Malaysia has 65 suspected cases, but no probable cases.

"The DG did not say that there were no suspected cases. He said that there were no probable cases. I hope that press that carried the wrong quotation from the DG would correct it," he said.

"Up till now, we have no probable cases. Of the 65 suspected cases, 52 involve Malaysians."

However, as to whether all these persons may have contracted the disease abroad or locally, he said the ministry still had not collected full details from the patients.

"I don't have this information. There are gaps that we need to fill for better categorisation so that we know how many cases are imported cases," he said.

"Warnings have been issued for Malaysians not to travel to affected countries unless absolutely necessary. These countries are those where local transmission of the disease had been reported."

Checks o­n fatalities

On three reported deaths in Kuala Lumpur, Chua said the death of the man from Jerantut could not be accurately determined to be due to Sars.

The minister said he did not have sufficient information o­n the other two cases.

"The man who died already had an enlarged heart, an existing heart disease. But to make sure that it is not Sars-related, the DG had asked for a panel of respiratory experts and pathologists to determine whether the man was a probable case or not," he said, adding that the results of their findings would probably be made available tomorrow.

Asked to comment o­n whether Malaysians should take precautionary measures by wearing face masks, Chua said people should make the decision based o­n whether such a measure would provide them with greater assurance.

"Do whatever you feel comfortable with. If you feel safer wearing the mask, then why not especially if you have to travel to the (affected) countries for very important reasons. We will not discourage people from doing so."