Deadly illness has some canceling trips to Asia

By Robbie Dingeman
Advertiser Health Writer

Several local travel agencies said yesterday some clients are beginning to cancel travel to Hong Kong and China, and an East-West Center program postponed a study tour because of concerns about the mysterious, sometimes deadly respiratory infection that has triggered a global health alert.

Patients waited at a Hong Kong hospital emergency ward where those who contracted a mysterious form of pneumonia were hospitalized yesterday. Associated Press

Concerns about the disease, called severe acute respiratory syndrome (SARS), continued to mount yesterday. World health officials report between 167 to 219 new cases in China, Vietnam, Germany, Canada, Singapore, Hong Kong, Taiwan, Thailand, Slovenia and Britain in the past three weeks. At least four people have died.

More than 300 other cases and at least five deaths have been reported in the Guangdong province of China. Health officials in other countries, including the United States, Australia and Israel, were investigating other possible cases, officials said.

The national Centers for Disease Control and Prevention is advising the postponement of "elective or nonessential travel" to Hong Kong and Guangdong Province, China; and Hanoi, Vietnam.

Travelers coming to Hawai'i from parts of Asia are receiving "health alert" cards before they leave their airplanes, said Dr. Paul Kitsutani, CDC medical officer for the state Department of Health.

About 300 people who arrived in Honolulu Monday aboard two flights from Narita, Japan, and Taipei, Taiwan, were given health alert notice cards, Kitsutani said. Those cards advise them to monitor their health and report fever and respiratory ailments that develop within 10 days.

Kitsutani said yesterday that airline staff will hand out the alert cards to international travelers arriving in Honolulu or Kona on flights that have "at least 10 passengers that are coming from Hong Kong, Singapore and South China" until further notice. He said those are the only two airports with international arrivals from those areas.

Dennis Donahue, coordinator of the East-West Center media program, said seven American journalists were to leave this weekend for a professional study tour that would take them to Beijing, three cities in Guangdong Province and Hong Kong.

Most of the confirmed cases have been centered in Guangdong and Hong Kong.

Donahue said the decision was made Monday night to cancel the trip for the Hong Kong Journalism Fellowship program because of the illness and "the uncertainty over war with Iraq." He said the trip will be rescheduled after the scope of the respiratory illness and the world situation become clearer.

At Panda Travel, administrative manager Wesley Okamoto said agents received a couple of cancellations yesterday from people concerned about going to Hong Kong.

Agents at Regency Tours received at least a dozen cancellations from people scheduled to fly to Hong Kong and China and caused some people planning visits from Asia to Hawai'i to cancel their reservations.

Flight attendants nationally and locally are continuing to monitor government recommendations but have made no suggestions about changing procedures or practices because of the respiratory illness.

Ed Kalahiki, local council president of the Hawai'i-based United Air Lines chapter of the Association of Flight Attendants, said he and colleagues are alert to the danger of an illness and have been told by airline executives that they are reviewing the situation to see what precautions should be taken for those flying out of China and Hong Kong.

"I do believe there is cause for concern," Kalahiki said. As the closest state to Asia, it makes sense to be particularly cautious.

"If Hawai'i ever became infected with the virus, we would suffer in more ways than tourism," Kalahiki said, noting the high number of elderly residents more vulnerable to illness. In addition, "we could end up with restrictions on air travel until the disease is isolated and treated."

Dawn Deeks, spokeswoman for the Association of Flight Attendants in Washington, D.C., said her union has not issued any new regulations or guidelines. "I think the most important thing is to stay alert and to stay aware," Deeks said. She suggests that airline staff keep an eye on their passengers and monitor their own health for any of the suspect symptoms.

That was the advice echoed by Mary Stanik, spokeswoman for Northwest Airlines, one of Hawai'i's largest carriers and one that flies directly to Asia.

"We have not changed our procedures," Stanik said. "We are continuing to monitor the CDC recommendations and guidelines."

State Epidemiologist Dr. Paul Effler this week sent an advisory to all physicians and healthcare providers, putting them on alert for patients who became ill after Feb. 1 with fever and symptoms of a respiratory illness that includes coughing, difficulty breathing or other respiratory problems, and had traveled to Hong Kong, Guangdong province, Hanoi, Singapore or Toronto within 10 days or had close contact with people with respiratory illness who have traveled to those places.

Dr. Alan Tice, infectious diseases specialist at The Queen's Medical Center, said world health officials are now finding some benefits from the extensive bioterrorism preparation over the past year, which has resulted in improved communication and cooperation among officials and better-equipped laboratories that can do more analysis locally and quickly.

Dr. Francis Liu, chief of infectious disease medicine for Kaiser Permanente-Hawai'i, noted that there have been no reports of people contracting the disease from air travel. So far, the pool of people with the disease remains small, Liu said. "Therefore, the risk is probably very low," he said, because the disease does not seem to be spread through casual contact.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429. The Washington Post contributed to this report.