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CBS Apr 5, 2003 8:35 am US/Eastern

(CBS) (GUANGZHOU, China) An international team is turning up possible clues to the spread of severe acute respiratory syndrome as it tries to follow the disease's tracks across the bustling landscape of southern China.

Chinese experts in hard-hit Guangdong province told the scientists they have found a rare form of airborne chlamydia in some of their SARS patients, raising the possibility that more than one germ may be involved. Other Chinese cases suggest the disease might be passed by touching something tainted by a sick person's mucous or saliva.

SARS continued to spread Saturday even as health officials stepped up their efforts to contain the disease. New cases were reported in Indonesia and Sri Lanka, while Hong Kong reported three more deaths and Malaysia announced its first.

In the U.S., President Bush Friday added SARS to a list of communicable diseases that people can be involuntarily quarantined for. The president signed an executive order adding SARS to the list that includes cholera, diphtheria, smallpox and other diseases.

It's the first time a new disease has been added to the list in two decades.

"If spread in the population," the order says, SARS "would have severe public health consequences."

In Hong Kong, workers covered head to toe in protective gear captured rats and roaches at an apartment complex where at least 250 people were infected. They also rounded up pets — eight dogs, 14 cats, two hamsters and two turtles — after a cat was found to carry a coronavirus.

Coronaviruses are commonly found in animals, but microbiologists believe SARS is caused by a new form of coronavirus. Scientists are trying to determine if animals somehow carried the virus through the complex.

China responded Saturday to criticism of its handling of the outbreak by promising to create a disease warning system and keep its public better informed.

Vice Premier Wu Yi called for establishment of such a system "with emphasis placed on a public health information system," the official Xinhua News Agency and official newspapers said.

Wu's comments were the highest-level response yet to demands that the reflexively secretive communist government change how it handles such outbreaks. It followed an extraordinary apology Friday by the country's top disease-prevention official amid complaints that China released information too slowly.

On Saturday, the World Health Organization team met experts at Zhongshan University who collected hundreds of specimens of blood, lung fluid and other materials from people who died of SARS and those who recovered, said Dr. Robert Breiman, the team leader.

The team wants to map the spread of the disease in Guangdong. WHO suggested comparing samples to find out whether those who died fell victim to a combination of viruses or bacteria, not just one strain, Breiman said.

Chinese authorities say they found a rare, airborne form of chlamydia — a virus usually transmitted through sexual contact — in many who died.

"It raises the question of, if you have one pathogen and you get hit with, say, coronavirus (do) you get a particularly bad disease?" Breiman said. "Or are you more likely to transmit? Do you become what we call a `super spreader'?"

The WHO specialists say a key part of their search will be to draw on knowledge of Chinese experts who know the region and physicians with experience treating SARS patients.

SARS has killed at least 82 people in Asia and Canada and sickened at least 2,200 in more than a dozen nations. Mainland China accounts for more than half the fatalities.

No cure has been found, though health officials say most sufferers recover with timely hospital care. Symptoms include high fever, aches, dry cough and shortness of breath.

On Friday, the WHO team visited Foshan, an industrial city in Guangdong where provincial officials say the world's first known SARS case occurred in November. Guangdong accounts for 40 of the 46 deaths reported by China.

The WHO team said a key to the disease's speedy — yet seemingly erratic — transmission could lie in how the apparent first case, an unidentified businessman, passed it to four people without infecting his children. He survived and was released from the hospital in January.

Many of the world's flu strains are traced to Guangdong and farms where people are believed to contract diseases from pigs and ducks.

But the WHO team says most Chinese SARS cases are city dwellers, and Breiman said no link to animals has been established.

"Contact with animals is still being looked into, but nothing convincing one way or the other has come out," he said.

Another important clue that WHO unearthed from data provided by Foshan health authorities: The illness, originally thought to be transmitted primarily through such direct contacts as coughing and sneezing, appears also to be passed indirectly.

Five of the 24 cases in Foshan show no actual "trace of transmission" to others, suggesting that infection can be spread by touching something tainted by a sick person's mucous or saliva, the experts said.

The spread of SARS has disrupted air travel and forced the closure of schools, hospitals and businesses in many countries. Hong Kong's airport authority said 116 flights, one-fifth of all flights to the territory, were canceled on Saturday.

Ananova: 

Everton have been forced to cancel their post-season tour of China due to concerns over the outbreak of severe acute respiratory syndrome in the region.

Goodison Park officials have spent the past two weeks monitoring the spread of the potentially fatal virus and today opted to pull the plug on the trip.

David Moyes' men were scheduled to spend time in Hong Kong and Shenzhen, but have followed Foreign Office advice and cancelled the tour.

Everton's head of corporate affairs and PR Ian Ross told the club's official website: "Sadly, we have to announce that the club's proposed trip to China has been cancelled.

"The simple truth is that we could not take the risk of exposing anyone - be they players, officials or supporters - to the possibility of infection by the SARS virus.

"We have taken expert advice on a daily basis over the past fortnight and we have now been advised not to travel to the Far East at this point in time.

"The club doctor has spoken at length with the relevant authorities both in the United Kingdom and in China.

"There is an understandable degree of disappointment inside the club because this particular trip had been long in the planning and was eagerly anticipated.

"As a consequence of our sponsorship deal with Kejian, our profile in China is exceedingly high. It would, I suspect, have been an illuminating and successful trip.

"However, our first responsibility is to our supporters and to our players - we just cannot compromise where safety is concerned. It is bitterly disappointing but the health of those who work for this club and who play football for this club must come first."

<a href=www.upi.com>UPI From the Science & Technology Desk Published 4/6/2003 9:27 AM View printer-friendly version

The death Sunday of a Finnish man from severe acute respiratory syndrome capped a series of regional developments on the mysterious disease.

Pekka Aro, 53, worked in the Beijing office of the International Labor Organization. He died from SARS at 1:25 a.m. Sunday, Dr. Guo Jiyong, deputy director general of the Beijing Municipal Health Department, said at a news conference.

Aro showed symptoms of the disease after arriving in Beijing from Bangkok, Thailand, on March 23, officials said. He was hospitalized April 2 in Beijing's Ditan Hospital, where he died Sunday.

Aro is the first foreigner to die from the flu-like illness in china. Officials in Beijing said he most likely was infected overseas.

His death brings the number of people who have died from the disease in mainland China to 52. On Saturday, China's Ministry of Health said there were 1,247 cases of the disease, of whom 51 had died.

The disease, which has mainly affected China's Guangdong province and adjacent Hong Kong, has spread to other parts of the world, which are struggling to cope with the outbreak that has killed at least 89 people thus far.

In Pakistan Sunday, the government directed all airports to screen incoming airline passengers for SARS.

In Japan, the government said it would ask local bodies to draw up plans to deal with a potential outbreak.

"Given so many patients in surrounding countries, we will have to prepare ourselves" for an outbreak of SARS, Health Minister Chikara Sakaguchi told a meeting of the Japanese Association of Medical Sciences.

Last Thursday, Japan designated SARS as an infectious disease, and tightened quarantine inspections at airports and issued travel warnings. It has reported three probable cases of the disease, and 19 suspected cases.

IHT Thomas Crampton/IHT IHT Monday, April 7, 2003   HONG KONG Pressure mounted Sunday on health systems in several Asian countries as the mysterious killer pneumonia infected more healthcare workers and sent more victims to hospitals.

Doctors and nurses in Singapore, Hong Kong and Vietnam were reported coming down with suspected cases of the disease, highlighting the dangers of infection even among those most highly trained to protect themselves. The disease. known as severe acute respiratory syndrome, or SARS, has continued to spread with suspected new cases reported in Indonesia, Sri Lanka and Kuwait. In addition, Malaysia announced its first death.

Australia and the United States enacted measures to allow quick quarantine of anyone suspected of infection, while officials in Canada, which has suffered the largest local spreading of the disease outside Asia, expressed cautious optimism this weekend that an outbreak may have come under control.

The newly emerged disease has a mortality rate of about 4 percent. It has killed at least 90 people and infected more than 2,400 in 18 countries. Spread through contact with the spittle of an infected victim and perhaps other means, the little-understood disease can reduce formerly healthy patients to reliance on a respirator within days.

In Hong Kong, where authorities are battling a persistently rising number of cases, many residents spurned tradition to stay at home over the normally heavily traveled Ching Ming holiday. Usually, thousands of Hong Kong families tend their ancestor's graves during the holiday in Guangdong, the Chinese province where the outbreak began last November.

Just 127,000 people traveled from Hong Kong to Guangdong on Friday, compared with 270,000 people on the same day last year. Millions, however, are due to travel throughout China soon for the Golden Week holiday starting May 1. China's government has promoted the holiday in recent years as a way to increase consumer spending.

Heavily criticized for its slow and incomplete disclosure of statistics, China on Sunday announced the first death of a resident expatriate and made an extraordinary apology for botched efforts at combating the disease.

Pekka Aro, a Finnish man working for the Beijing office of the International Labor Organization, died Sunday, bringing China's official death toll from the disease to 52. While China reported 1,247 people infected with the disease, the government's lack of cooperation with the World Health Organization has left many skeptical of its statistics.

Chinese government statements that the outbreak is under control have been contradicted by officials from the World Health Organization who say the disease is still spreading in China. Reports by foreign reporters citing unnamed hospital officials have put the number of infected patients under treatment in Beijing at 50, more than four times the official figure. Breaking from the Chinese government's practice of never acknowledging mistakes, a top health official apologized over the weekend for failing to inform the public about the disease.

"We apologize here to all of you that our health departments did not have enough close cooperation with the media," Li Liming, director of the Chinese Center for Disease Control, said at a news conference in Beijing. "We weren't able to muster our forces in helping to provide everyone with scientific publicity and allowing the masses to get hold of this sort of knowledge." Having waited 11 days before giving permission for a team of specialists dispatched by the World Health Organization to visit Guangdong, the Chinese government continues to restrict the scientists' work. The agenda for the scientists has been set and controlled by Chinese officials, and by Saturday they still had not received laboratory specimen samples from the SARS cases in China.

Specimens are crucial for identifying the virus and controlling its spread. Since China lacks the technology for proper testing, the samples must be taken overseas or the equipment must be imported.

Robert Breiman, head of the World Health Organization team, said, "We've proposed that both happen and we're assuming that's what will happen. Orally, they've agreed. We're waiting for it to actually happen."

A persistently rising number of cases in Hong Kong has leading doctors warning that the healthcare system is headed for crisis. In addition to health workers themselves succumbing to the disease, more patients are being admitted with the disease than discharged.

The Hong Kong government reported 81 new cases and five deaths over the weekend, bringing the total infected to 842 and the deaths to 22. By Sunday 108 patients required intensive care, compared with 52 a week earlier.

Already wearing surgical masks and shunning public places, residents stepped up precautionary measures. Roman Catholic churches removed basins of holy water and worshipers, many of whom wore masks, were urged not to hold hands during prayers. In Singapore, where SARS has sickened 103 people and killed six, a doctor, 20 nurses and a midwife from Singapore General Hospital have been isolated after showing symptoms of the disease. The suspected infections came despite Singapore's quick creation of some of the world's strictest immigration controls and quarantine measures against spreading of the disease.

<a href=www.upi.com>UPI From the International Desk Published 4/7/2003 8:26 AM

SINGAPORE, April 7 (UPI) -- Six new cases of that severe acute respiratory syndrome were reported in Singapore Monday.

All were new cases were nurses but some were from three hospitals where SARS patients are not treated, raising fears that isolation strategies have failed.

The ministry of health also reported the deaths of two SARS patients, bringing the total to eight out of 112 diagnosed cases. The latest fatalities include a doctor and the mother of Esther Mok, the former flight attendant who is linked to 91 confirmed SARS infections.

As of Monday, SARS patients remained hospitalized, including 12 in intensive care.

The number of people under home quarantine has fallen to 133.