COMBINED WIRE SERVICES March 30, 2003 The World Health Organization doctor who first identified the outbreak of a global mystery illness died of the disease yesterday. Italian Dr. Carlo Urbani, 46, a WHO expert on communicable diseases, died in Thailand, where he was being treated after becoming infected with what has been termed severe acute respiratory syndrome, or SARS, while working in Vietnam, the United Nations agency said. Urbani - who worked in public health programs in Cambodia, Laos and Vietnam - identified the ailment in an American businessman admitted to a Hanoi hospital. The businessman later died. So far, at least 55 people have died from SARS. More than 1,500 cases have been reported, the vast majority in China and Southeast Asia. Federal health officials hoping to insulate the United States yesterday added all of China and Singapore to a growing list of destinations that should be avoided by tourists and business travelers. The national Centers for Disease Control and Prevention had previously recommended that travelers postpone nonessential travel to Hong Kong, Hanoi and China's southern Guangdong province. "We may be in the very early stages of something that could be a much larger problem with time," Dr. Julie Gerberding, director of the CDC, told reporters in a conference call. Prolonged face-to-face exposure seems to be the way that the illness is spread, although briefer contacts might also transmit it, she said. "The bottom line is that we don't know," she said. "If you were in an elevator and an infected person literally coughed on you, it's conceivable that you could acquire a respiratory infection," including the one causing this outbreak. Gerberding noted that there were no signs that the epidemic was spreading in the United States beyond a relatively small number of people who had traveled recently to Asia or the handful of health care workers and relatives who had steady contact with this group. The CDC has identified 62 cases. But fears that the virus, which is marked by high fever, coughing and, in severe cases, pneumonia, may be poised to escalate into a full-blown global epidemic are growing in Asia and other parts of the world. Hong Kong remained gripped by fear as 45 new cases were reported yesterday, for a total of 470; 12 deaths have been reported. Thousands of people donned surgical masks but many more refused to venture outside and activity in the usually bustling city ground to a halt. Taxi stands where people normally line up during rush hour had few customers in sight. Anti-war protesters in Hong Kong canceled a peace rally. For about two years, WHO has been building a new system to tackle the emergence of new global diseases. Just more than two weeks ago came the chance to try it out, when health authorities in Singapore reported that a doctor from their country might be sick with the mysterious Asian bug - and he could be carrying the new disease around the world on a flight home from New York. "We had the name, but not the flight number or even the airline," said Dr. Mike Ryan, whose name was at the top of a 24-hour contact list given to governments dealing with the illness. Ryan heads WHO's Global Outbreak Alert and Response Network. It took a few more calls to determine that the man was headed for Frankfurt. By the time the plane landed there on the morning of March 15, German quarantine services were waiting for him. "We've had killer outbreaks of new diseases before, like Ebola, but they have never spread internationally," said the WHO's infectious diseases chief, Dr. David Heymann. Heymann was part of the scientific team dispatched to what was Zaire in 1976 to investigate the first Ebola outbreak. The case of the Singapore doctor, together with a report the night before from Canada of a suspicious outbreak there, prompted the agency to ratchet up the response. Later that afternoon, WHO issued an unprecedented worldwide emergency travel advisory, declaring SARS a global health threat and alerting the world to the symptoms: fever, cough, breathlessness and breathing problems.

March 31, 2003, 4:27PM Reuters News Service

A family leaves the Amoy Gardens apartment complex today in Hong Kong. The complex was badly hit by a mystery illness that is spreading across Asia.

HONG KONG - More than 100 people in one Hong Kong apartment block were suspected to have been infected by a deadly pneumonia virus, officials said today, triggering fears that the killer disease was being spread through air or water.

At least two more people died from the Severe Acute Respiratoy Syndrome, known as SARS, in Hong Kong during the day, taking the death toll in the city to 15 and to 61 worldwide.

A total of 213 people living in the Amoy Gardens housing estate were confirmed or suspected to be infected with SARS, of whom 107 are from Block E of the complex, Health Secretary Yeoh Eng-kiong told a news conference.

Authorities have quarantined more than 200 other residents in Block E in an effort to contain the virus, which has infected almost 1,700 people across the world, mostly in Asia.

Dozens of health workers in full surgical gear stood guard at the entrance of the apartment block to stop any residents from leaving as policemen in masks cordoned off the area.

But residents said many families had already fled.

The number of those infected in Amoy Gardens, in the heart of the teeming Kowloon district, is almost one-third of the total number in Hong Kong, a city of seven million people.

Two elderly men died of the disease today, bringing the death toll in the city to 15.

Amoy Gardens is in a maze of crowded housing estates and smoke-spewing industrial buildings in one of the most densely-populated areas in the world.

Proliferation of the virus in such an environment is certain to create havoc and put immense pressure on public hospitals, which are already stretched and barely able to cope.

"We are now examining all possible angles, to see if it is airborne or in the (building's) water mains," a government spokeswoman said of the virus.

Health Minister Yeoh said: "We are now detecting the virus in the faecal material (from Amoy Gardens patients). So that would be one possible potential cause of spread to large populations under unusual circumstances."

"There was a suggestion that the sewage system was leaking...we are investigating."

Experts have previously said the virus was carried by droplets from sneezing or coughing, but the high number of cases at Amoy Gardens has raised fears the virus could be water or airborne.

"Up till today, it is spread through droplets. But no one can rule out that it could be airborne, because viruses change all the time," Yeoh said.

Fearful of the disease, some companies have ordered staff to work from homes while others have begun to organise backup, skeletal teams in case their workers get infected.

Hong Kong and Singapore have closed schools in a bid to contain the disease and quarantined those exposed. Besides these two cities, deaths have also been reported from Vietnam, Canada and from China, where the disease originated in November.

A doctor from the World Health Organization, who was infected in Vietnam after he had identified the virus, died in a Bangkok hospital at the weekend.

The disease has triggered tighter screenings at many airports and a growing number of countries have advised citizens against unnecessary travel to the worst-affected areas.

In Singapore, nurses have been deployed at the airport to check incoming passengers.

Apart from scaring away tourists, the epidemic has disrupted business in Hong Kong. A growing list of shops, banks and offices have shut after employees were found infected.

Some expatriates have departed quietly, taking their families with them on home leave.

The U.S. Centers for Disease Control and Prevention warned on Saturday that the virus may wreak more havoc.

"The potential for infecting larger numbers of people is great," said its director Julie Gerberding. "We may be in the early stages of what could be a larger problem."

Cases have also surfaced in the United States, Germany, Britain, France, Japan, Ireland, Italy and Taiwan.

Almost 1,700 people have been infected worldwide, but some have since recovered. About four percent of the people who catch it die from the disease.

Herald Sun By MANDI ZONNEVELDT, health reporter 01apr03

FRESH outbreaks of the deadly SARS virus have led to fears it may be airborne.

Almost 100 more cases of the killer flu were reported in Hong Kong yesterday, with authorities forced to isolate an entire housing block where 213 people had been infected.

Until now, experts have believed the deadly disease could only be spread by droplets expelled by a cough or sneeze.

But United States Centres for Disease Control and Prevention director Dr Julie Gerberding said the rapid spread of the virus suggested it could be airborne.

"We are concerned about the possibility of airborne transmission across broader areas and by objects handled by those who have been infected," she said.

"The potential for infecting large numbers of people is very great.

"So we may be in the very early stages of what could be a much larger problem."

Hong Kong Director of Health Margaret Chan also refused to rule out the possibility of the virus being airborne.

Australian travellers are cancelling trips to Asia as the SARS toll climbs, with at least 59 now dead -- including a fourth Canadian victim -- and more than 1600 infected.

Australians who heed the Health Department's warning to "reconsider" travel to Hong Kong, China, Singapore and Vietnam stand to lose their money.

Insurance Council of Australia spokeswoman Sandie Watson said

most travel insurers would refuse to cover people who cancelled trips to Asia in the absence of an official government travel warning.

"If you just cancel out of concern you may not be covered," she said.

"We always advise people to check with their travel insurer before cancelling any trip."

Taylor's Lakes man Ken Goodwill, who has paid for a trip to Singapore and Thailand in May, yesterday expressed his frustration at the situation.

"If you've pre-paid your flight and accommodation, you're in a lose-lose situation now," he said.

"You lose your money if you cancel and if you go there and get stuck in a situation where you can't travel you also lose.

"I won't be travelling unless things pick up and it's going to cost me thousands of dollars."

Health experts are yet to find a cure for SARS, now believed to be a previously unseen strain of the same virus that causes the common cold.

Queensland University's Dr John Mackenzie and Curtin University of Technology professor Aileen Plant are joining a World Health Organisation team investigating the source of the outbreak.

<A HREF=iol.co.za>SOURCE March 31 2003 at 10:49AM

Singapore - Authorities on Monday began screening incoming passengers at the Changi International Airport in an attempt to contain the spread of a killer pneumonia virus, the government said.

Passengers from countries listed by the World Health Organisation (WHO) as affected areas will be screened by nurses stationed at Changi, the Civil Aviation Authority of Singapore (CAAS) said.

The WHO has listed Singapore, Toronto, Hanoi, Hong Kong, Taiwan and the Chinese cities of Beijing, Shanxi and Guangdong as affected areas.

Singapore is one of the areas affected by the mysterious severe acute respiratory syndrome (SARS), with the number of reported cases now standing at 91 - with three dead.

Authorities have enforced tough measures to halt the spread of SARS"To minimise the import of SARS cases, Singapore is stepping up health screening procedures for passengers arriving at Changi Airport from affected countries," the CAAS said in a statement.

"This is in view of new index cases that are traced to people who have travelled overseas," it said.

The spread of SARS on the island nation of four million has been traced to three original "index cases" involving Singaporean women who had visited Hong Kong.

Last week a fourth index case, also a woman who was in Hong Kong, was tracked down. On Sunday, health authorities said there was a fifth case of SARS contracted outside of Singapore after a 17-year-old Indonesian male student visited Guangdong and Hong Kong with his brother and parents on March 15.

Authorities have enforced tough measures to halt the spread of SARS by closing schools up to the pre-university level until April 6 and serving quarantine orders on at least 800 households.

The mysterious illness has now infected more than 1 600 people in 15 countries and killed at least 59 people. It erupted in southern China, spread to Hong Kong and has been taken worldwide by airline passengers. - Sapa-AFP

News.com.au March 31, 2003

TWO more people have died of a mystery flu-like illness in Hong Kong, health officials said.

Hong Kong has now suffered 15 deaths from severe acute respiratory syndrome, or SARS, and the global total has topped 60.

The Hong Kong health secretary, Dr Yeoh Eng-kiong, told a news conference a 79-year-old man who also had heart disease and a man in his 60s who did not receive early treatment for SARS were the latest victims.

Yeoh said Hong Kong officials were considering the establishment of quarantine centres. He did not say where they would be or how many people they might end up holding.

Hong Kong has now reported 610 cases of the disease, including an alarming jump of 92 cases at a single apartment complex where 213 people have been hospitalised.