World Health Alert Issued After Pneumonia Deaths


By Cindy A. Roberts
Associated Press Writer

Mar 16, 2003

The World Health Organization warned Saturday that a highly contagious and deadly pneumonia-like illness of unknown cause is fast becoming a worldwide health threat. The illness also claimed another victim - a nurse who died in Vietnam.

In a rare "emergency travel advisory," the health agency said it has received more than 150 reports of what it called "Severe Acute Respiratory Syndrome" in the past week, mostly in southeast Asia.

At least four people have died this month - an American businessman, a Vietnamese nurse who treated him and two people who arrived in Canada recently from Hong Kong.

In southern China's Guangdong province between November and mid-February, an outbreak of pneumonia with similar symptoms killed five people and sickened more than 300.

It was not immediately known if the previous Chinese outbreak was caused by the same strain as the most recent cases.

"Health officials around the world are taking this situation very seriously," U.S. Health and Human Services Secretary Tommy Thompson said Saturday.

The department was "applying a full-court press to learn more about this outbreak and how it might impact on the United States," Thompson said.

While no formal travel restrictions are in place, U.S. health officials said travelers may wish to postpone nonessential trips to countries at risk. Health officials are preparing to issue an alert for passengers returning from countries where SARS has been reported.

WHO officials could not remember issuing such a travel advisory before.

The growing list of countries reporting cases of the illness include China, Hong Kong, Indonesia, Philippines, Singapore, Thailand and Vietnam. Most cases involve medical workers.

The most recent death occurred Saturday. The victim was a Vietnamese nurse who treated the American businessman who also died of the disease, the French Embassy in Hanoi said.

No cases have been identified in the United States, health officials said. But a doctor believed to be infected was taken off a New York-to-Singapore flight in Germany on Saturday and quarantined.

Two people traveling with him - his wife and another doctor - also were being held for observation at the Wolfgang Goethe University Clinic in Frankfurt, Germany.

In New York, health authorities put hospitals on alert.

Also, a man traveling from Atlanta to Canada is "reported to have developed some respiratory symptoms," said Dr. Julie Gerberding, director of the federal Centers for Disease Control and Prevention in Atlanta.

Doctors do not know what causes the illness - even whether it is a bacteria or virus. Gerberding said doctors are unsure whether antibiotics or antiviral drugs have an effect on the disease since they have not been consistently used in the areas with the most cases.

The potentially fatal illness is believed to spread "person to person" and have an incubation period of two to seven days, Gerberding said.

"There is no evidence to suggest that this can be spread through brief contact or assemblages of large people," Gerberding said.

When asked whether the illness could be caused by bioterrorism, Gerberding said, "We have an open mind and will be keeping an open mind as we go forward."

WHO spokesman Dick Thompson said in Geneva, "Until we can get a grip on it, I don't see how it will slow down. People are not responding to antibiotics or antivirals. It's a highly contagious disease and it's moving around by jet. It's bad."

One of the most severe outbreaks has been in Hanoi. A CDC team of epidemiologists flew to the Vietnamese capital Saturday and gathered samples from people who may be infected. The samples were immediately flown to Atlanta for laboratory testing.

"SARS is now a worldwide health threat," Dr. Gro Harlem Brundtland, the WHO's director general, said in a statement issued in Geneva. "The world needs to work together to find its cause, cure the sick, and stop its spread."

The Singapore doctor began suffering symptoms while in New York, said Dr. Angela Wirtz, a health official in the German state of Hessen, where the patient is being treated.

The man recently attended a New York conference, but it was not immediately known exactly when he was in the city, the nature of the meeting or which airline he used.

There was concern the doctor may have infected others on board.

Another 155 passengers who deplaned in Frankfurt were quarantined at the airport. German nationals were released while passengers in transit to other cities in Europe were awaiting travel permission from those countries, German health officials said. They did not give a breakdown of number of travelers or destinations.

Eighty-five people bound for Singapore and the plane's 20-member crew continued their journey but were to be quarantined upon arrival, health officials said.

The WHO advisory urged travelers who may have come in contact with someone infected to watch for symptoms such as high fever, coughing and shortness of breath.

SARS also may be associated with headache, muscular stiffness, loss of appetite, confusion, rash and diarrhea.

The advisory did not call for restrictions on travel to any destination but said people who suspect they may have the illness should seek medical attention and not travel until they recover.

In Atlanta, the CDC emergency operations center has been activated and its staff is working around the clock. U.S. health officials are in contact with health officials in China, where cases have been reported for at least several weeks.

Travelers leaving China's Guangdong province, near Hong Kong, were being asked Sunday to fill out questionnaires about their health, said a duty officer with the Exit and Entry Quarantine Department at Guangzhou Baiyun International Airport.

Travelers must submit to a physical if they report symptoms of atypical pneumonia, said the officer, who refused to give his name. He said there had been no cases of the illness reported at the airport.

"We are doing everything humanly possible to learn what is causing this outbreak," Tommy Thompson said from O'Hare International Airport in Chicago, before flying to Washington.

The Hanoi outbreak started after an American businessman traveling from Shanghai via Hong Kong apparently infected about 30 hospital workers, four of whom - including a French doctor - now are in critical condition. The unidentified U.S. citizen was evacuated and died in Hong Kong.

In Canada, Toronto Public Health officials said a woman died on March 5 and her adult son died on March 13 after arriving recently from Hong Kong. Four of their relatives were hospitalized.

The illness also might have emerged in British Columbia, Canada, where one person was in intensive care at a Vancouver hospital and another person has recovered, Toronto health officials said.

Toronto has established a hot line for people who fear they have the illness.

AP-ES-03-16-03 0118EST

This story can be found at: http://ap.tbo.com/ap/breaking/MGAQD6FMCDD.html

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Mar 16, 2003
Mysterious Illness Prompts Activation of Emergency Center at CDC
The Associated Press

ATLANTA (AP) - The federal Centers for Disease Control and Prevention activated its emergency operations center for only the third time ever in response to reports of mysterious pneumonia-like illness that has caused at least four deaths.

No cases of the illness have been identified in the United States, health officials said. But a doctor believed to be infected was taken off a New York-to-Singapore flight in Germany on Saturday and quarantined.

CDC officials tried to reassure Americans on Saturday that - although the illness has sickened more than 150 people in seven countries - it appears to be contagious only in close contact, such as among family members and hospital workers.

"There is no evidence to suggest that this can be spread through brief contact of assemblages of large numbers of people," CDC Director Dr. Julie Gerberding said.

The growing list of countries reporting cases of the illness include China, Hong Kong, Indonesia, Philippines, Singapore, Thailand and Vietnam.

Dr. James Hughes, director of the National Center for Infectious Diseases, said the CDC has dispatched four staff members to Hanoi and its chief of influenza epidemiology to Hong Kong. Another staff member is en route to Hong Kong, with one more en route to Taiwan, he said.

Doctors do not know what causes the illness - even whether it is a bacteria or virus.

The CDC's emergency operations center has extensive computer and mapping capabilities and is used to coordinate information from other countries and international health organizations. It was used last year during the outbreak of the mosquito-borne West Nile virus and during the anthrax attacks of 2001.

AP-ES-03-16-03 0005EST

This story can be found at: http://ap.tbo.com/ap/breaking/MGAFNLSJCDD.html

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In accordance with Title 17 U.S.C. Section 107, any copyrighted work in this message is distributed under fair use without profit or payment for non-profit research and educational purposes only. [Ref. http://www.law.cornell.edu/uscode/17/107.shtml]

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