news.com.au April 07, 2003

A MAGISTRATE has insisted on marrying a couple outside amid fears about the deadly SARS virus. Eric Sax insisted on the precaution at the Belgian ceremony after learning the groom had just arrived from China, according to local media reports.

China has been identified as the point of origin for Severe Acute Respiratory Syndrome, which has sparked a global health scare.

Sax told the La Derniere-Heure newspaper in Brussels that moving the wedding outside "was a simple precaution".

He said he decided to marry the couple outside the local town hall in Uccle, a chic Brussels suburb, after learning the groom, a Chinese national, had arrived from China just days before.

Source Monday, April 7, 2003 Posted: 2:55 AM EDT (0655 GMT)

Experts say there was a major setback in the struggle to contain a potentially deadly virus spreading worldwide.

WHO experts search for clues in the place the first SARS cases were reported.

HONG KONG, China -- Hong Kong hospitals are bracing for a worst case-scenario of up to 3,000 cases of the SARS virus by the end of April, as one more person succumbed to the illness in Canada.

Hong Kong recorded two new deaths on Sunday, bringing to 22 the number of people who have fallen victim to the mysterious SARS, or severe acute respiratory syndrome, in the territory.

Authorities also said they had 42 new SARS cases, with 842 people so far infected in this former British colony of 6.9 million people. Over a hundred have recovered so far.

In Singapore, where infection numbers are the fourth highest in the world, its prime minister warned growth targets for the year would have to be revised downward because of the outbreak.

So far, SARS has killed 95 people around the globe.

The latest victim was from Canada, bringing to nine the death toll in the country. Infections have risen to 179 in the province of Ontario, which has the bulk of cases.

Canada has the world's third highest infection total. Globally, cases exceed 2,600.

Enormous strain

In Hong Kong, Hospital Authority chairman Leong Che-hung told a local television station there would be sufficient manpower and facilities to deal with up to 3,000 patients, although intensive care units would be under pressure.

A rising number of infections has placed enormous strain on hospitals, especially since most of those infected have been health workers.

"We hope that we can contain the disease so that we don't have to go to the worst-case scenario," Leong said during an interview with ATV.

The government is now trying to hire doctors and nurses from the private sector.

Dr. Lo Wing-lok, an infectious disease expert in Hong Kong, told The Associated Press he thought the illness could be contained in two to three weeks by more quarantines and mandatory checkups, but also issued a warning.

"If there's no change in the distribution of resources and no contingency plans, most of the regional hospitals would not be able to provide normal services to patients," said

Hong Kong is the second worst-hit area after southern China's Guangdong province, where the disease originated.

China has been slammed for being too slow to acknowledge the disease and warn its neighbors. It said on Monday its death toll had climbed to 53 with 1,268 infections as of April 6.

A Finnish man died in Beijing from the virus on Sunday, taking the number of deaths in China's capital to four, a health official said. (Full story)

As the death toll mounts, the World Health Organization (WHO) says the key to controlling the disease could lie in identifying highly infectious people, known as "super spreaders."

A WHO team is visiting hospitals and talking with experts in Guangdong, where the epidemic is thought to have originated, to hunt for clues.

Chinese health officials say the disease has been brought under "effective control."

Chinese Premier Wen Jiabao, whose administration is grappling with its first big crisis since taking office in March, said China was "safe to visit" and the country could curb the spread of the disease. (Full story)

Experts have linked SARS to a new form of coronavirus, other types of which usually are found in animals.

Other developments

• The biggest hospital in Singapore, which has 106 infections, started screening visitors after 20 of its nurses and a doctor were suspected of catching the virus.

• In Hong Kong, 22 percent of flights were cancelled on Sunday, similar to Saturday's level, as travelers cancelled their plans.

• Also in Hong Kong, a 45-year-old man locked himself in his apartment and refused treatment for the illness, holding police at bay for 14 hours before agreeing to go to a hospital.

• A vaccine is being developed by the United State's National Institutes of Health. The U.S. president adds SARS to the list of communicable diseases, the first new disease to be added in two decades.(Quarantine order)

• Indonesia has temporarily suspended sending its nationals to other Asia after it declared the disease a national epidemic last week. (Indonesian move)

• In Australia 14 people have been identified for medical assessment at airports since the introduction of the new quarantine arrangement on Friday.

The Associated Press & Reuters contributed to this report.

news.com.au By Dirk Beveridge April 04, 2003

AS scientists scramble to unravel the mystery of severe acute respiratory syndrome, a sense of crisis is spreading even faster than the illness itself.

Women wear designer masks in Hong Kong / AP

People in Hong Kong are buying surgical masks by the thousands. Hospitals have closed in Canada, a jetliner was briefly detained and inspected in California, and the Panama Canal dispatched inspectors to check ship crews for symptoms.

A hoax that Hong Kong had been declared an "infected city" prompted panicked people to rush out and stock up on food. In Thailand, authorities turned away a French warship en route from Singapore, which has reported cases.

Economists warn it could batter Asia's economy as manufacturers temporarily shut down, consumers avoid malls and restaurants and tourists to stay away.

Severe acute respiratory syndrome, or SARS, has now sickened more than 2,200 people worldwide and killed at least 80. Some of the alerts cropping up in infected countries are real, some aren't; but fears about the disease are gaining momentum.

In Hong Kong, authorities used barricades and tape to seal 240 people inside their infected apartment building. The next night, they were put in quarantine camps.

Hong Kong has become something of a masked city, with hundreds of thousands of people putting them on around town - some sporting creative designs such as cartoon characters or bright floral patterns. The World Health Organisation recommends masks only for those in contact with victims.

"If you put on a mask but don't fasten your seatbelt in your car, that's upside down," said Dr Guenael Rodier, WHO's head of surveillance and response.

Doctors and nurses in Singapore have donned germ-warfare suits to get closer to patients.

The Geneva-based WHO warned people yesterday to avoid travel to Hong Kong and China's Guangdong province, where most of the mainland's deaths occurred. But many places have already been screening travellers.

Thailand said yesterday that nobody who appears to have SARS symptoms can enter the country, and visitors from infected areas must wear masks. Air New Zealand said some cabin crew members were refusing to fly to Hong Kong.

Schools in Singapore and Hong Kong were closed, and producers of Singapore's version of Wheel of Fortune said it had eliminated live studio audiences to avoid spreading the disease. At the Singapore Zoo, officials were no longer letting people have their photos taken next to the orangutans to avoid infecting the animals.

The first alarm sounded in February when people in southern China began stocking up on medicine, surgical masks and vinegar, which they boiled as a disinfectant to stop a mysterious disease sweeping through Guangdong province.

Health experts are increasingly focusing on a type of coronavirus - a common cause of colds - as the probable cause of SARS, but a cure may be more elusive. The WHO and the US Centres for Disease Control and Prevention say no medications have been proven effective against SARS.

Hong Kong experts are more optimistic, after gaining enormous experience with SARS cases by virtue of having dealt with so many. Health secretary Yeoh Eng-Kiong said most SARS victims can expect to recover.

Yeoh said a treatment involving the antiviral drug ribavirin and steroids is probably able to cure 95 per cent of the patients, assuming they get early treatment and don't have other bad illnesses complicating their conditions.

People in weakened condition can in fact become good hosts for the virus, making them more contagious than victims who are otherwise in better health.

"In certain people, it seems to be very, very contagious," Yeoh said.

The experts believe that the most likely method of transmission is through droplets caused by coughing or sneezing.

China yesterday acknowledged 12 more SARS deaths, for a total of 46, but critics have said Beijing was too slow in admitting what it knew. A WHO team arrived in Guangdong province today after days of awaiting government permission.

When a mainland Chinese medical professor named Liu checked into Hong Kong's Metropole Hotel on February 21 for a two-day stay, there was no reason for anybody to be alarmed as he went to his room on the ninth floor.

The professor, who had treated disease victims in China, was in Hong Kong for a wedding but got sick and died on March 4 in a local hospital.

Medical sleuths soon came across a key finding: People who had carried the disease to Vietnam, Singapore and Canada had all been on the same floor at the same time, as had a man who spread the disease to Hong Kong's Prince of Wales Hospital.

Someone then spread SARS to the Amoy Gardens apartment complex. At least 240 people in Amoy Gardens got sick.

People living in apartments 7 and 8 of many floors in one building were sickened, raising speculation that the disease was carried vertically through a sewer or drainage leak. AAP

The Guardian Toronto dispatch Monday April 7, 2003

So far, more than six Canadians have died from Sars. And with so little known about the virus, it is hard to reassure the public, writes Anne McIlroy

The mystery virus known as Sars flew to Toronto late in February inside the lungs of a 78-year-old woman who had stayed at the same Hong Kong hotel as a sick doctor from Guangdong, China.

She died of severe acute respiratory syndrome on March 5, but not before infecting four other members of her family. The five of them unknowingly spread the disease to more than 120 Canadians, many of them health care workers.

Toronto is now the North American epicentre of the outbreak that began last autumn in Guangdong and which Chinese authorities kept secret. Canada's largest city now has more cases of Sars than any place outside of Asia, and the number of suspected cases rises every day.

There have also been confirmed cases in British Columbia, Alberta, Saskatchewan, Prince Edward Island and New Brunswick.

So far, the disease has infected more than 2,200 people in 16 countries, killing more than 70, including more than half a dozen Canadians.

In Toronto, some hospitals and schools have been closed and thousands of people have been quarantined, including one of the key physicians heading the battle to contain the virus.

The public health system is feeling the pressure, especially with so many nurses in quarantine. Most surgeries have been put on hold. Stores have sold out of protective masks. Parents are yanking their kids out of school if they know another child in the playground has been to China.

One of the reasons Sars has frightened so many Canadians is because its early symptoms are common, especially during cold and flu season.

Symptoms include a dry cough, a feeling of malaise and a temperature over 38C (100.4F). It becomes deadly when it leads to pneumonia, which isn't contagious, but happens when the lungs are so damaged by the virus they fill with fluid.

The fatality rate is about 4%, almost twice that of the deadly flu pandemic that swept the world in 1918-1919, killing as many as 100 million people. There is no cure for Sars, although patients are being treated with anti-viral drugs.

The outbreak has also made Canada seem like a dangerous place to visit. A major international conference on cancer was cancelled last week at the last minute. Australia, Ireland and Spain have advised their citizens not to visit Canada because of the outbreak. One disturbing new development is that the disease seems to be infecting more and more children.

In Canada, public health officials are now urging people not to panic. They say there is no need for people to wear a face masks unless they have been in contact with someone who has been infected the disease. Healthy people are being urged to live their lives normally.

Politicians are going out of their way to show they aren't frightened. The federal health minister, Anne McLellan, who insists there is no reason for people to avoid travel to Canada, says she goes to Toronto every week. Paul Martin, the former finance minister widely expected to become prime minister next year when Jean Chretien steps down, made a much publicised trip late last week to visit the Chinese community in Toronto.

Many people have been avoiding Chinese restaurants for fear of picking up Sars, although there is no evidence it is more widespread in the Chinese community than in the general population.

But public concern about Sars will likely continue to rise until the virus has been contained, or until doctors can answer key questions about it. It is still not known for sure what causes the disease, although the leading suspect is a coronavirus that jumped from cows or birds into humans.

Coronaviruses belong to the family of pathogens that cause the common cold and intestinal disorders in humans. A particularly nasty version of a feline coronavirus kills every cat it infects.

Doctors aren't sure how Sars is spread. They suspect it is carried in small droplets, which means people need direct contact with a carrier to get infected. But it may be spread through the air. No one knows if people can be infectious before they are exhibiting any symptoms. With so little known about the virus, it is hard for public health officials to be reassuring.

Email amcilroy@globeandmail.ca Special report Sars Other articles More articles by Anne McIlroy Useful links Canadian government Canada.com CBC Newsworld Canadian Alliance The Globe and Mail Liberal party of Canada

news.com.au April 07, 2003

MORE deaths from SARS n Canada and Hong Kong at the weekend have provided a gloomy backdrop to efforts to find a cure for the mystery killer disease.

As the first suspected case of infection by the Severe Acute Respiratory Syndrome (SARS) virus was detected in Kuwait and a fifth in Britain, World Health Organisation (WHO) experts pursued the search for the cause of the illness in the epidemic's epicentre, southern China.

The illness also claimed another high profile victim with the death of Interntational Labour Organisation (ILO) official, Pekka Aro, announced at a Chinese health ministry press conference in Beijing. He was the highest profile casualty of the outbreak since WHO expert Carlo Urbani – who first identified the disease – died in Bangkok last month.

Aro, from Finland, was among 19 new cases announced in the capital, bringing the number of deaths in Beijing to four.

At least 51 deaths from SARS have been reported in China and 1,247 people have been infected, according to official figures released on Sunday.