Reuters Health Last Updated: 2003-04-07 17:00:33 -0400 (Reuters Health)

TORONTO (Reuters) - The mysterious pneumonia-like SARS virus has claimed its 10th Canadian victim, health officials said on Monday, adding that another case is being investigated as a possible SARS death.

Health officials in Ontario said the number of people with severe acute respiratory syndrome (SARS) had risen to 188, with 88 probable and 100 suspect cases.

As of Sunday, there were reports of 217 probable or suspect SARS cases across Canada.

The illness has killed about 100 people worldwide and infected more than 2,600 since it emerged in southern China in November. Canada has the third-highest number of cases in the world after China and Hong Kong, and the bulk of them are around Toronto, which has a large Chinese immigrant population.

Thousands of people have been quarantined in Ontario to prevent the spread of the virus.

Outside Ontario, cases have been reported in British Columbia, New Brunswick, Saskatchewan, Alberta and Prince Edward Island.

SARS symptoms include high fever, chills and breathing difficulties, and the disease has a mortality rate of about 4 percent, roughly the same as measles. By comparison, hundreds of thousands can die in a year from various strains of influenza, and malaria kills about 1 million a year, mostly children.

Reuters health Last Updated: 2003-04-07 16:08:56 -0400 (Reuters Health) By Maggie Fox

WASHINGTON (Reuters) - Airlines suspend flights. A medical conference is canceled in Canada. Thailand forces tourists to wear masks. Such responses to a new but so far limited epidemic may seem extreme but are part of human nature, experts say.

Severe acute respiratory syndrome, or SARS, which has killed 100 people worldwide and infected more than 2,600, came to the world's attention just last month and has led to some unprecedented measures.

The World Health Organization issued its first travel warning based on a disease, advising people to avoid worst-hit areas like Hong Kong and southern China.

Hong Kong-based airline Cathay Pacific cut flights to Hong Kong by 14 percent, while Continental Airlines suspended non-stop flights between Newark and Hong Kong on Monday.

Yet SARS is hardly the deadliest disease. It is less infectious than influenza and, with a 4 percent mortality rate, not nearly as deadly as HIV/AIDS, which kills all its victims. Malaria kills up to a million people every year, mostly children.

But SARS is new and that scares people, said David Ropeik of the Harvard Center for Risk Analysis.

"Whether it is an over-reaction depends on whether it is a real threat, and we don't know yet," Ropeik said in a telephone interview. "The characteristic at work here is if it is new, it is always scarier."

POTENTIAL FOR DEVASTATION

Virus expert C.J. Peters, who helped discover the Ebola virus in Africa, said he would take extreme care with SARS.

"I have been involved with a lot of emerging diseases, viral diseases, and this is unlike any other because it is transmitted from person to person more efficiently than any of the others," Peters, now at the University of Texas Medical Branch at Galveston, said in a telephone interview.

"People got lathered up over Ebola because it can be 90 percent fatal, but a huge Ebola epidemic is 200 to 300 cases. It is not transmitted very efficiently."

SARS, in contrast, has spread to 19 countries and is carried by travelers.

Ropeik said tourists who abandoned plans to visit China and residents who fled affected apartment blocks are acting on primordial instincts, not logic.

"It is steeped more in emotion than in fact," he said. "When a threat is new to you, the safest thing is to get out of the way and then you'll live. The more you don't know, the more you treat it as a threat and the better you survive."

Also, he said, the enormous media attention given to SARS has made people more aware of it. "The more you are aware of a risk, the more you worry about it, he said.

That is why no one panics when an especially bad influenza epidemic kills 500,000 people around the world in one year. "The reason we are not afraid of flu is we are not thinking about it," he said.

But people may over-react, Ropeik said. "The danger is, sometimes it can lead us into more risk."

ILLOGICAL REACTIONS

For instance, during the anthrax attacks in the United States in October 2001, thousands of people who were not near an anthrax-laced letter took antibiotics just in case.

Sound scientific evidence shows such actions can lead to the mutation of bacteria in a person's body, making antibiotics less likely to work the next time that person needs them.

People want to have a sense of control over their destinies, Ropeik said. That is why people rushed to buy duct tape and plastic sheeting when the U.S. Homeland Security Department warned of risks of a chemical attack.

People can also under-react. The U.S. Centers for Disease Control and Prevention complains that one-third of Americans who should get flu shots every year do not, even though influenza kills 36,000 Americans a year.

CDC infectious disease chief Dr. James Hughes said the CDC was trying to find out just what the risk of SARS is. He said it was too early to know because it is not yet clear how many people have been exposed to the virus.

Hughes said the CDC had tracked down several Americans who had been staying in the Metropole Hotel in Hong Kong's Kowloon district where a single patient infected seven others. The CDC is also working on surveys of people who flew on the same aircraft with known SARS patients.

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As SARS, the mystery illness that has killed at least 87 people, continues to spread globally, Barry Petersen reports on the safety measures being taken in Asia, where the virus first appeared. Apr 4, 2003 10:53 pm US/Eastern (CBS) (WASHINGTON) People in the U.S. can now be quarantined if they have the mystery illness. President Bush has added severe acute respiratory illness 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." SARS, whose symptoms include fever, aches, cough and shortness of breath, has killed at least 85 people in Asia and Canada and sickened at least 2,300 in more than a dozen nations as infected travelers spread the disease. In the United States, 100 cases in 27 states have been reported. About 4 percent of the victims have died from the disease, though none of them in this country. There's no cure yet, but most sufferers are recovering with timely hospital care. As CBS News Correspondent Barry Petersen reports, the worst outbreak of SARS has been in Asia, where it started. Hong Kong is a city of masked faces and frightened eyes. People are so afraid of infection they no longer even shake hands with friends. Schools are shut down, restaurants empty, flights cancelled daily and tours are down 90 percent. "Don't get to close to people. Keep yourself three to six feet distance," advises Wendy Qwok, a public relations exec. One of the scariest things for people here is how long it took China to admit there was an outbreak, reports Petersen. China apologized Friday for not doing a better job of informing people about SARS. Meanwhile, an international medical team went to the city where it believed the mystery illness may have first broken out. The admission, extraordinary for a government that rarely acknowledges fault, came after escalating criticism abroad — and one day after the health minister explicitly said China had followed its own rules in dealing with the problem. "Today, we apologize to everyone," said Li Liming, director of the Chinese Center for Disease Control. "Our medical departments and our mass media suffered poor coordination. 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." Earlier, Doctor Anthony Fauci of the National Institutes of Health said scientists may be closing in on a cause for the flu-like illness. He said experts are pretty sure SARS could be caused by a previously unknown form of the coronavirus, which is known to cause some common colds. The president's action came on a day that saw health authorities across the United States report a total of eight suspected new cases of a deadly flu-like illness which first appeared in Asia. In Washington, the three suspected new cases of severe acute respiratory syndrome, or SARS, involved people who fell ill last month after returning from Asia, Dr. Maxine Hayes, a state health officer, said Thursday. The three were no longer sick and were not infectious. California reported four suspected new cases, bringing the total number of people in the state possibly suffering from SARS to 35. The new cases in California, which is home to the United States' largest Asian population, included a 7-year-old Hong Kong resident visiting the United States and two people who recently traveled to mainland China. At Los Angeles International Airport on Thursday, a Southwest Airlines jetliner was isolated on the tarmac at for more than an hour after a passenger informed a flight attendant he might be infected with SARS. The man's claim was later determined to be a hoax. In Florida, a 70-year-old woman was hospitalized after showing symptoms of SARS following a trip to Asia, Florida state epidemiologist Dr. Steven Wiersma said. The woman was not in intensive care and the sickness did not appear to be life threatening at this point, Wiersma said. Two other Florida residents, a 21-year-old woman and a 36-year-old man, were identified Wednesday as suspected SARS cases. They were not hospitalized but were asked to stay home to avoid spreading the illness, Wiersma said. In Foshan, a city in China's southern Guangdong province, World Health Organization investigators worked with local authorities to isolate data from a few people believed key to the emergence of SARS. At the top of their list: a Foshan man believed by investigators to be the first known person infected. The man, who was not identified, is suspected of having passed the virus to four people — but, mysteriously, not to his four children. He survived and was released from the hospital in January. "It's going to be a tricky task to find out what went on," said Powell, a spokesman for the WHO team, who said investigators had not met the man. "It's going to be a long job, a long epidemiological study to try to find out exactly how the infection was transmitted." Singapore's Health Ministry reported the island nation's sixth SARS death — a woman who died Friday. Health Minister Lim Hng Kiang said all visitors arriving in Singapore beginning Monday must sign a declaration saying they do not have SARS. Anyone caught lying will be fined $2,800. No cure for SARS has been found, although health officials say most sufferers recover with timely hospital care. Symptoms include high fever, aches, dry cough and shortness of breath.

ABC Analysis By Dalia Sussman

April 5 — Three-quarters of Americans are following news of the SARS virus, but with fairly muted concern: Fewer than four in 10 are worried about catching the disease, lower than the levels of recent worry about the West Nile Virus or mad cow disease.

 Thirty-eight percent worry that they or an immediate family member will catch Severe Acute Respiratory Syndrome. By contrast, 53 percent in a Gallup poll last fall worried about exposure to the West Nile virus, and 45 percent in January 2001 worried about mad cow disease becoming a problem here.

High-intensity concern, moreover, is lower: Only one in 10 are worried "a great deal" about getting SARS.

The World Health Organization reports 2,270 reported cases and 79 deaths from SARS in 16 countries. The CDC reported today that as of April 3, there are 115 U.S. cases in 27 states.

Sampling, data collection and tabulation for this poll were done by TNS Intersearch.

Those Following Media More Worried

Reports of the disease are drawing broad attention. Seventy-four percent say they're following news about SARS — 26 percent "very" closely, 48 percent "somewhat" closely.

Level of attention is a big factor in fear of catching the virus. Fifty-eight percent of those following the news "very" closely express concern about being infected; among those who aren't tuned in, just 24 percent share that level of concern. An open question is whether they're worried because they're following the news closely; or following the news closely because they're worried.

Still, deep concern even among those very closely following the news is low: Twenty percent of these people say they're worried "a great deal" about getting SARS.

Concerned About Catching SARS Among those who watch the news "very closely" 58% Among those who watch the news "somewhat closely" 34% Among those not following the news closely 28%

Women are more likely to be following the news very closely—32 percent are, compared to 19 percent of men. Women are also nine points more likely to express concern that they or a family member will get the virus.

SARS vs. Terrorism

Fear of contracting the SARS virus is at about the same level as concern about being the victim of terrorism was in February — 34 percent were worried about being the victim of an attack, 10 percent worried "a great deal."

When the two are put head-to-head though, fear of terrorism has a slight edge. Forty-two percent are more concerned about being victims of terror than they are about catching SARS. Thirty-five percent fear SARS more. Fifteen percent of Americans say they're not worried about either.

Women are 12 points more likely to say they're more worried about terrorism; men divide about evenly.

People who are following news about SARS divide about evenly on whether their greater worry is the disease, or terrorism. But those not following the SARS news are 23 points more likely to be concerned about terrorism.

Methodology

This ABC News/Washington Post poll was conducted by telephone April 3, among a random national sample of 511 adults. The results have a 4.5-point error margin. Fieldwork was conducted by TNS Intersearch of Horsham, Pa.

Previous ABCNEWS polls can be found in our Poll Vault.