More possible cases of disease reported

By Rob Stein
Washington Post

Health authorities in North America, Asia and Europe yesterday investigated possible new cases of a baffling, sometimes fatal respiratory disease that nations around the world are racing to contain.

Passengers wore masks at Hong Kong's Chek Lap Kok international airport yesterday as airports screened travelers for flu-like symptoms. Associated Press

In the United States, the federal Centers for Disease Control and Prevention in Atlanta was investigating 14 reports of people with similar symptoms, though officials said they are fairly certain that at least 10 of those cases are unrelated.

CDC withheld all other details about the possible U.S. cases.

In Hawai'i, state health officials reported no confirmed cases of the disease but received dozens of calls yesterday from people wanting to know more about it.

Federal officials began handing out health alert notice cards to people arriving in Hawai'i from international destinations where the disease has been reported, said Dr. Paul Effler, chief of the state Health Department's communicable disease division.

Effler said the CDC uses the cards to encourage travelers to monitor their health, watching especially for a fever that comes with a cough or breathing difficulties. He noted that people seem to be alert to the problem but not unnecessarily worried. "There are a lot of causes of respiratory illness," and people shouldn't panic, Effler said.

Health officials do, however, expect the illness to arrive in the United States.

"It will not be surprising to us if we see cases in the United States," CDC Director Julie Gerberding said. "The current emerging threat is a wake-up call: We really do live in a global village. An emerging problem in one part of the world will soon be a problem to all of us."

Tommy Thompson, Health and Human Services secretary, said he briefed the White House yesterday on the status of the outbreaks, while the CDC held a series of teleconferences with doctors' groups and state and local health officials to keep them abreast of developments and advise them on how to respond.

David Heymann, head of communicable diseases for the WHO, said he is optimistic that the epidemic is being kept in check. "I think we're containing it," he said. "I think we're finding the cases before they can cause serious outbreaks."

As officials worked to identify cases and prevent infections, scientists intensified testing to try to identify the virus or other infectious microbe that was causing the illness, dubbed SARS, for severe acute respiratory syndrome.

The WHO announced yesterday that it had established a "virtual laboratory" based in Geneva to coordinate the testing of blood and tissue samples at 11 laboratories in at least nine countries — the United States, France, China, Hong Kong, Britain, the Netherlands, Germany, Canada and Japan.

So far, all tests for known pathogens have been negative, raising concern that the disease may be caused by a new virus or bacterium. But Gerberding said the CDC is working "around the clock" to try to identify the cause.

The WHO had also obtained permission from China to send a team of scientists there to investigate a epidemic in the Guangdong Province that affected more than 300 people between November and last month, killing at least five before it apparently subsided.

Officials believe that outbreak may have been the beginning of the epidemic. It wasn't until Feb. 26, when an American businessman living in China arrived in Hanoi, Vietnam, severely ill with the disease, that the world became aware of the emerging problem. The man died March 6 in a Hong Kong hospital, but not before infecting dozens of hospital workers in Hanoi. Subsequent outbreaks were reported at several hospitals in Hong Kong.

A doctor from Singapore is being treated for the disease in Frankfurt, Germany, after his plane was intercepted during a stopover from New York to Singapore. The man had cared for two patients in Singapore before traveling to New York for a medical conference, where he became ill. His wife and mother are also being kept in isolation. New York officials have been tracing the doctor's movements and searching for any signs that he may have spread the illness.

Eight cases have been reported in Canada, including a cluster in Toronto that was started by an elderly woman who recently returned from a visit to Hong Kong. She and her middle-aged son died, and several other family members and their doctor fell ill. One of the victims recently spent several days in Atlanta, prompting health officials there to track down everyone she came into contact with.

The disease begins with flu-like symptoms, including a high fever, cough, difficulty breathing and aches, and often progresses to pneumonia. Some patients deteriorate to the point where they need a respirator. So far the disease hasn't seemed to respond to antibiotics. The disease seems to spread through tiny droplets from a sneeze or cough, though it appears unlikely to be transmitted by casual contact.

Advertiser Staff Writer Robbie Dingeman contributed to this report.