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5 More Countries Eyed for Deadly Respiratory Illness

World health officials investigating possible cases in England, France, Israel, Slovenia and Australia; Hong Kong toll now 111

TUESDAY, March 18, 2003 (HealthDayNews) -- Five more countries may have possible victims of the deadly respiratory illness that has sickened hundreds around the world.

World Health Organization (WHO) officials were investigating suspicious cases in England, France, Israel, Slovenia and Australia, the Associated Press reported Tuesday.

If confirmed, that would make at least 13 countries to which the illness, known as severe acute respiratory syndrome (SARS), has spread, mostly by plane passengers. The number of cases, including four deaths, now stands at 219 after Hong Kong revised its victims' list upward to 111 on Tuesday.

In addition, U.S. health officials announced Monday that they are looking at four out of 14 possible cases within the country, although they stressed they were skeptical that any would be verified.

Meanwhile, in Frankfurt, Germany, doctors confirmed Tuesday that a Singapore surgeon and his wife, who have been quarantined since the weekend, both have SARS.

The surgeon, who reportedly had treated two patients suffering from SARS in Singapore, had attended a medical conference at the Crowne Plaza Hotel in New York City before he, his wife and mother-in-law flew out on a Singapore Airlines plane Friday night.

In what could prove to be a breakthrough, a lab in Germany isolated a paramyxovirus in specimens taken from the surgeon and his mother-in-law, according to wire reports Tuesday. Paramyxovirus is the family of microbes that cause measles, mumps and canine distempter, and there is no treatment for that.

The suspected cases in the five new countries include: a British man returning from Hong Kong, hospitalized in what could be the United Kingdom's first case; two people in Paris, hospitalized after an Asia trip; two women in Australia, hospitalized after a China trip; a Slovene woman hospitalized after returning from Vietnam 10 days ago, and a 33-year-old man quarantined in Tel Aviv after a Hong Kong trip.

And in Hong Kong, health officials now say they have 28 new cases that are confirmed, and 12 additional suspected cases, according to The New York Times. The total number of victims, 111, makes Hong Kong at this point the hardest-hit, outside of a possible mainland China epidemic earlier this year.

The good news, health officials say, is that there have been no more fatalities since WHO and the U.S. Centers for Disease Control and Prevention (CDC) issued emergency health and travel alerts over the weekend.

Some of the victims traveled to or from southeast Asia, and most of the rest apparently are friends, family and medical workers who came in contact with them.

Health officials continuing their scrambling to determine the source had been focusing on the possiblity of a virus before the German lab report appeared Tuesday.

WHO's communicable diseases chief, Dr. David Heymann, said on Monday that SARS doesn't seem to spread as quickly a flu.

"It isn't contagious at the level of many other infectious diseases, he told the AP. "A normal influenza would be very contagious to people sitting in the same room."

The world agency is now coordinating scientists from 11 laboratories in 10 countries in search of the cause, according to the Times. So far, scientists at five laboratories have failed to identify any known infectious agent.

The illness takes a few days to develop and often begins with a high fever and flu-like symptoms such as a headache and sore throat. Its victims develop coughs, pneumonia, shortness of breath and other breathing difficulties. Death results from respiratory failure.

It is still not clear whether any of the Hong Kong cases are connected to the death March 6 of the Singapore-based American businessman, who apparently infected at least 37 hospital worker in Hanoi, where he was treated before being moved to Hong Kong. One of the Hanoi victims, a nurse, died Sunday.

Elsewhere, there are these reports:

  • In Canada, a 10th case was reported Sunday. One of two suspected cases there is the doctor who treated infected family members of two people who died, according to the Canadian Press. Kwan Sui-chu died March 5 soon after returning from Hong Kong. Her son, Chi Kwai Tse, died on Thursday; four other family members are hospitalized, Canadian health officials reported.
  • In southeast Asia, Hanoi has reported at least 42 cases; Taipei reported three people hospitalized with flu-like symptoms; and Singapore's toll has jumped to 20, including three residents who infected 10 family members and seven hospital workers.
  • And in China, health officials released a rare report Sunday on a similar outbreak in the Guangdong province that had stricken 300 and killed five people by mid-February.

Health officials are encouraged that some recent victims seem to be recovering, although they don't know whether that is because of treatment or the illness running its course.

WHO officials, who earlier this week issued their first global health alert in 10 years on the outbreaks, have urged all countries to help.

The WHO emergency travel advisory issued over the weekend urged travelers who may have come in contact with an infected person to watch for such symptoms as high fever, coughing and shortness of breath. Health officials also urged people who suspect they may have the illness to seek medical attention and not travel until they recover.

More information

Updates on the respiratory illness and travel advisories can be found at the U.S. Centers for Disease Control and Prevention or the World Health Organization.

SOURCES: U.S. Centers for Disease Control and Prevention, teleconference, March 17, 2003; The New York Times; The Associated Press; Canadian Press; The Standard; BBC online; World Health Organization statistics
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