posted 03-16-2003 07:34 PM            

SEVERE ACUTE RESPIRATORY SYNDROME - WORLDWIDE (02): ALERT
***************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases

[1] Taiwan
[2] USA response/briefing
[3] Worldwide summary alert
[4] Hong Kong
[5] East Asia

[1]

Date: Sun, 16 Mar 2003 11:24:28 +0800 (CST)
From: "Peter Chang, MD, MPH, ScD"

Official report by the CDC of Taiwan: Another Suspected Atypical Pneumonia
Case in Taiwan - follow up report on 15 Mar 2003
---------------------------
Here in Taiwan, we have one more reported case of atypical pneumonia, this
64-year-old woman developed fever on 8 Mar 2003 about one week after
traveling to Guandong (China) and Hong Kong. She was hospitalized on 13 Mar
2003 due to subsequent respiratory symptoms. Chest radiogram revealed an
atypical pneumonia in the right lower lung. CDC Taiwan has reviewed the
regular surveillance system for Acute respiratory distress syndrome (ARDS)
and complicated influenza cases. So far, there was no evidence of community
spread except for the couple reported on 14 Mar 2003 [see ProMED-mail Acute
respiratory syndrome - East Asia 20030314.0630]

We would appreciate any useful advice and assistance for pathogen
investigation.

Peter Chang, MD, MPH, ScD
Advisor and Coordinator for Health Affairs
for
Tzay-Jinn Chen, M.D., M.P.H.
Directer-General,
Center for Disease Control,
Department of Health,
Taiwan

******
[2]

Date: 15 Mar 2003
From: ProMED-mail
Source: CDC Press Release

Severe Acute Respiratory Syndrome
Center for Disease Control and Prevention CDC [USA] Issues Health Alert
About Atypical Pneumonia
----------------------------
Atlanta: In response to reports of increasing numbers of cases of an
atypical pneumonia that the World Health Organization (WHO) has called
Severe Acute Respiratory Syndrome (SARS), the CDC today announced several
steps to alert US health authorities at local and state levels.

CDC activated its emergency operations center on Fri, 14 Mar 2003, upon
learning of several cases reported in Canada among travelers recently
returned from Southeast Asia and their family members. The federal public
health agency:

Issued a health alert to hospitals and clinicians on Sat 15 Mar 2003
Briefed state health officials on Sat 15 mar 2003
Is investigating illness among travelers who may have passed through the
United States after having potential exposure to the virus.

Is preparing health alert cards to give to travelers returning from
Southeast Asia.

Is preparing guidance to assist public health departments, health care
facilities and clinicians in monitoring and identifying potential cases.

Deployed 8 CDC scientists to assist the WHO in the global investigation.

Is analyzing specimens to identify a cause for the illness.

CDC has been working with the World Health Organization (WHO) since late
February [2003] to investigate and confirm outbreaks of this severe form of
pneumonia in Viet Nam, Hong Kong, and parts of China. No cases have been
identified to date in the United States.

"The emergence of 2 clusters of this illness on the North American
continent indicates the potential for travelers who have been in the
affected areas of Southeast Asia to have been exposed to this serious
syndrome," said Dr. Julie L. Gerberding, CDC Director. "The World Health
Organization has been leading a global effort, in which CDC is
participating, to understand the cause of this illness and how to prevent
its spread. We do know that it may progress rapidly and can be fatal.
Therefore, we are instituting measures aimed at identifying potential cases
among travelers returning to the United States and protecting the people
with whom they may come into contact."

The WHO issued a global alert about the outbreak on 12 Mar 2003, cautioning
that the severe respiratory illness may spread to hospital staff. No link
has been made between this illness and any known influenza, including the
"bird flu" (A[H5N1]) outbreak reported in Hong Kong on 19 Feb 2003.

******
[3]

Date: 15 Mar 2003
From: ProMED-mail
Source: New York Times 16 Mar 2003 (from website)

As a mysterious respiratory illness spread to more countries, the World
Health Organization (WHO) yesterday issued a rare health alert, declaring
the ailment "a worldwide health threat" and urging all countries to help in
seeking its cause and control.

The agency said that in the last week it had received reports of more than
150 new suspected cases of the illness, now known as Severe Acute
Respiratory Syndrome, or SARS. The syndrome has caused at least 9 deaths,
the last one a nurse in Hanoi. It apparently does not respond to antiviral
and antibiotic drugs. [according to a Center for Disease Control and
Prevention (CDC) telebriefing held today, 15 Mar 2003 (available at:
) Dr. Gerberding's
response about efficacy of antimicrobials was: "...there is no consistent
utilization of antibiotics or antiviral therapy in the areas that have had
the most cases, and so we have no real information to help tell us whether
or not anything is having a clinical impact. At best we could just provide
anecdotal suggestions and no data or advice.", hence a conclusion that
there is no response to antiviral and antibiotics maybe premature. - Mod. MPP]

Reported cases have come from Canada and 6 countries in Asia — Hong Kong
and elsewhere in China, Indonesia, the Philippines, Singapore, Thailand and
Vietnam, the health organization said. There have been no reports of the
illness in the United States. But yesterday [today - 15 Mar 2003], an ill
passenger and 2 companions who traveled from New York City were removed
from a flight after it arrived in Frankfurt and put in isolation in a
German hospital.

The ill passenger is a doctor from Singapore who treated one of the
earliest cases there, and who flew to a medical meeting in New York City,
said Dick Thompson, a WHO spokesman. The doctor may have gone to a hospital
in New York — the agency is not certain which one — before flying back to
Singapore via Frankfurt with his wife and another doctor. Before boarding
the flight, the doctor called a colleague in Singapore to describe his
symptoms, and the colleague notified WHO.

The cause has not been identified, and scientists do not know whether it is
a virus or even an infectious agent. Although health officials have
suspected avian influenza, which has infected a small number of people
sporadically in Hong Kong since 1997, laboratory tests have not detected
that rare strain, known as influenza A(H5N1). As a result, laboratory
scientists are focusing on the possibility of a previously unknown
infectious agent.

Dr. Julie L. Gerberding, director of CDC, said in a news conference
yesterday [today - 15 Mar 2003] that it appeared to take direct and
sustained contact to transmit the illness from an affected individual to
other people. "There is no evidence to suggest that this can be spread
through brief contact or assemblages of large numbers of people," she said.

Asked whether this might be an instance of bioterrorism, she replied, "We
are keeping an open mind."

In an emergency advisory issued yesterday, WHO said that "there is
presently no indication to restrict travel to any destination."

But Dr. Gerberding said, "We are advising persons planning nonessential or
elective travel to affected areas that they may wish to postpone their trip
until further notice."

Updated information will be posted on the centers' Web site,
.

WHO and American officials urged all travelers to be aware of the main
signs. In addition to the breathing problems, the illness can cause a dry
cough and other flulike symptoms that are thought to develop 2 to 7 days
after exposure. They usually start with a sudden onset of high fever and go
on to include muscle aches, headache, sore throat and shortness of breath.

Standard lab tests often show low numbers of white blood cells and
platelets, which help blood to clot.

The health agency said any passenger or airline crew member who developed
such symptoms should immediately seek medical attention and ensure that
information about their recent travel was passed on to the health care
staff. "Any traveler who develops these symptoms is advised not to
undertake further travel until they have recovered," it said.

If a passenger became ill on a flight, the agency asked airlines to alert
the airport of destination and to refer any ill passengers to airport
health officials.

"There are currently no indications to restrict the onward travel of well
passengers, but all passengers and crew should be advised to seek medical
attention if they develop" symptoms, the agency said.

In another rare step, the CDC activated its emergency operations center in
Atlanta, including sophisticated communications technology, to enhance its
ability to coordinate information from other countries and to investigate
any suspect cases in this country.

The CDC has used the operations center only twice before, for the
mosquito-borne West Nile fever epidemic last year and the anthrax attacks
in 2001. The last time it issued a global health alert was in 1993, to
enhance measures to control tuberculosis. WHO officials said they could not
recall the last time an emergency global travel advisory was issued.

The CDC and New York City health officials are now investigating the travel
histories of the passengers now in a German hospital as well as one of the
8 cases suspected to be the new syndrome in Toronto and Vancouver, British
Columbia [Canada].

Two hours before the plane landed, the WHO notified German health
officials, who had the plane moved to a separate runway where the doctor,
his wife and a colleague disembarked and were taken to a nearby hospital.
German health officials advised the other passengers to monitor their
health and gave them a telephone number to call if they developed any
symptoms. Officials did not release any information on his condition.

Mr. Thompson, the spokesman for the WHO, said the cases in Toronto involved
a family who returned home after flying to Hong Kong. A woman, died shortly
after her return. Five other family members who had not been to Hong Kong
have since become ill; 4 are still in the hospital while the fifth, [the
fatal case's] son, died on 13 Mar 2003, according to Toronto Public Health
officials.

Toronto health officials said they were aware of 2 other cases in
Vancouver, both people who had recently traveled to Hong Kong. CDC
officials are aiding in the investigation because [the fatal case's]
daughter, who is being treated in Toronto, had flown to Atlanta recently,
Mr. Thompson said.

So far, laboratory scientists have not been able to identify a known or
novel infectious agent, said Dr. David L. Heymann, a WHO official.

Japanese officials said their tests showed that the influenza virus was not
the cause of the illness. But Dr. Heymann said samples from more victims
needed to be tested, because it can take weeks for the immune system to
produce influenza antibodies, the proteins that are formed to fight
invading microbes.

"We have not ruled out influenza definitively," Dr. Heymann said.

Tests of victims' samples have found no evidence of mycoplasma or similar
microbes that are the usual causes of atypical pneumonia. Additional tests
have shown no evidence of Ebola or any of the other viruses that cause
hemorrhagic fevers, hantavirus and bacteria.

In Hong Kong, an American businessman died on Thursday after passing
through Hong Kong and falling ill in Hanoi, where 30 doctors and other
medical personnel have fallen ill at the hospital where the businessman was
initially treated.

[by: Lawrence K. Altman and Keith Bradsher]

--
ProMED-mail

*****
[4]

Date: Sat 15 Mar 2003
From: "Pablo Nart"
Source: Reuters News online, Sat 15 Mar 2003 [edited]

Hong Kong: Total of Affected Medical Personnel Increases to 47
--------------------------------------------------------------
HONG KONG: Four Hong Kong medical workers were admitted to hospital on
Saturday with symptoms of a flu-like virus that has already killed one
person and infected dozens, sparking a rash of travel cancellations to the
territory. The 4 admitted on Sat 15 Mar 2003 brought the total of Hong Kong
medical workers suffering the same symptoms to 47. Thirty-seven have since
developed signs of severe pneumonia, up from 29 on Friday [14 Mar 2003].

Forty-one people in Hanoi are being treated for the illness, 2 of them in
critical condition. [according to another newswire report, one of these
cases died during the course of today - Mod.MPP] An outbreak of severe
pneumonia in China's southern Guangdong province in February infected 305
people, killing 5, but it is not known if there is any link. Singapore and
Taiwan issued travel warnings when a few of their residents contracted
pneumonia after trips to Hong Kong or mainland China. Vietnamese
immigration officials are now monitoring visitors for signs of infection.

[By Tan Ee Lyn and Vicki Kwong]

--
ProMED-mail

*****
[5]

Date: Sat 15 Mar 2003
From: H.L. Penning
Source: Straits Times Interactive, Agence France-Presse, Sat 15 Mar 2003
[edited]

East Asia: Pneumonia Outbreak Worsens
-------------------------------------
In Taiwan a 64-year-old woman and a married couple were confirmed to have
contracted the disease and were in hospital, said Mr Chen Tsai Chin, head
of the Taiwan Health Department's Centre for Disease Control (CDC). In
Hong Kong, 47 people are now under observation in 6 different Hong Kong
hospitals with 37 of them showing symptoms of pneumonia.

In Vietnam's capital Hanoi 6 more people were struck down with the illness,
a hospital spokesman said. The new cases brought the number of infections
in the capital to 40. Thirty employees of the Hanoi French Hospital
remained under treatment, with 2 people, including a French doctor, in a
critical condition, a hospital official said.

Singapore's Ministry of Health said on Fri 14 Mar 2003 that it had been
notified of 6 persons admitted to hospital for pneumonia, in addition to
who had earlier been confined after visiting Hong Kong. [more recent
newswires put the number of cases reported from Singapore at 16 - Mod.MPP]

--
H.L. Penning

[As the newswires have been flooded with multiple versions of the various
press releases during the course of today, this posting is an attempt to
synthesize the information available at this point. If the articles seem
to be less than concise, it reflects the less than concise understanding of
what is going on. At present the etiology of this outbreak remains
unknown, and the investigations are somewhat preliminary in terms of an
understanding of the precise epidemiology of this syndrome. Subscribers
are recommended to follow the URL links provided below for more details,
especially to the official websites such as the World Health Organization
(WHO) , the Centers for Disease Control and
Prevention (CDC) of the USA , the
Department of Health Hong Kong SAR
, and the Singapore Ministry of
Health . - Mod.MPP]

[see also:
Severe Acute Respiratory Syndrome - Worldwide 20030315.0637
Acute respiratory syndrome - Canada (Ontario) 20030314.0631
Acute respiratory syndrome - East Asia 20030314.0630
Acute respiratory syndrome - China (HK), VietNam (03) 20030313.0624
Acute respiratory syndrome - China (HK), VietNam (02)20030313.0623
Acute respiratory syndrome - China (HK), VietNam 20030312.0602,
Undiagnosed illness - Vietnam (Hanoi): RFI 20030311.0595
Influenza, H5N1 human case - China (Hong Kong) (05) 20030228.0500
Pneumonia - China (Guangdong) (07) 20030221.0452
Pneumonia - China (Guangdong) (02) 20030211.0369
Pneumonia - China (Guangdong) (03) 20030214.0390
Pneumonia - China (Guangdong) (04) 20030219.0427
Pneumonia - China (Guangdong) (05) 20030220.0446
Pneumonia - China (Guangdong) (06) 20030220.0447
Pneumonia - China (Guangdong): RFI 20030210.0357]
......................mpp/cp/mpp

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posted 03-17-2003 09:59 AM            

March 17, 2003

Airline passengers spread mystery killer bug
By Dominic Kennedy
British doctors have been told to look out for the flu-like symptoms and guidance is being prepared for hospitals to treat patients in isolation



A MYSTERIOUS deadly type of pneumonia is travelling the world by airliner and there is no known cure.
Bioterrorism is being considered as a possible cause of the outbreak, which has killed nine people and infected more than 150 others on three continents. British doctors have been told to look out for the flu-like symptoms and guidance is being prepared for hospitals to treat patients in isolation.

The illness, known as Severe Acute Respiratory Syndrome (SARS), has infected scores of doctors, nurses and medical staff who have been treating the victims.

The World Health Organisation has taken the exceptional step of issuing an “emergency travel advisory”, urging travellers to see their doctor if they develop symptoms.

There was concern yesterday as travellers flying into Hong Kong, where there has been a severe outbreak, arrived at the airport wearing face masks to avoid infection.

There was confusion, too, in Germany when a passenger became ill before his plane landed in Frankfurt. German officials kept 220 passengers in quarantine for several hours until it was agreed that they could be released.

Scientists have yet to prove that the outbreaks in various countries are definitely related and they do not even know whether the illness is caused by a virus or bacteria. The first clues appeared in Guangdong province, southern China, where five people died and 302 were infected with an “atypical pneumonia” in January and February.

The movements of a 49- year-old Chinese-American businessman will be studied by health experts as they try to trace the spread of the illness. On February 26 he flew to Hanoi, Vietnam, after spending time in Shanghai and Hong Kong. Two days later he fell ill. On March 6 his condition deteriorated and he was taken to hospital in Hong Kong, where he died last Thursday.

In his wake he left an outbreak of pneumonia in Vietnam, infecting 37 workers at the Hanoi French Hospital. Among them was a nurse who died on Saturday. Eleven others are being treated at another hospital in Hanoi.

The disease spread to Singapore, where three people who had visited Hong Kong were reported to have developed the symptoms last Thursday.

By yesterday ten of their relatives and friends and seven health staff who cared for them were admitted to hospital with the illness.

In Toronto Sui-chu Kwan, an elderly woman, died on March 5 and her son, Chi Kwai Tse, 44, died on Thursday after the family had visited Hong Kong. Four relatives and a close family contact also have the illness. Two people in British Columbia have also become infected.

In Taipei three people became ill, including a 64-year-old woman who arrived home via Hong Kong after visiting the Chinese mainland.

Hong Kong is sensitive about being seen as the source of the disease because of the potential devastation to its tourist industry.

Shoppers in the former British colony have stripped shelves of surgical masks and traditional Chinese flu remedies as 42 people, many of them medical staff, have been taken into hospital.

Three hospital wards have been cleared, a specialist heart clinic has had to reduce its services and non-urgent operations are being cancelled to keep intensive-care beds free.

Yeoh Eng-kiong, the Secretary for Health, Welfare and Food, tried to calm visitors yesterday, saying: “You are not more likely to get pneumonia coming to Hong Kong than any other cities.”

Reports in Hong Kong have pointed out that some local people developed pneumonia after visiting Hangzhou in eastern China and Zhuhai in southern China. The disease reached Europe at the weekend when a Singaporean doctor flying home from a medical conference in New York became ill before his plane made a planned stop at Frankfurt. He had treated some of the victims in Singapore.

The 32-year-old man’s condition was deteriorating yesterday, although it is not yet certain that he and his mother-in-law, who has a fever, have SARS. His pregnant wife is healthy but in quarantine.

German officials took the unprecedented measure of keeping passengers in quarantine for much of Saturday before releasing them to continue their journeys. The authorities finally conceded that their risk of infection was “extremely low”.

Other passengers were allowed to continue their journey to Singapore on a different aircraft and given medical advice when they arrived. The original aircraft will be disinfected and the material around the sick man’s seat destroyed.

The risk of bioterrorism is being taken seriously on both sides of the Atlantic. The Department of Health said: “The pattern of infection certainly looks like a naturally occurring illness but obviously we are keeping an open mind. It would be ridiculous for us to rule anything out at this stage.”

posted 03-19-2003 04:09 PM            

quote:

---

HK doctors 'identify killer disease'

Patients are being treated in at least three continents

Scientists in Hong Kong have claimed a key breakthrough against a virulent form of pneumonia which is claiming more victims around the world.
The researchers have identified the mystery respiratory illness at the heart of a global health scare as a virus from the paramyxoviridae family, which are responsible for conditions such as mumps and measles.

More work is needed to establish whether the virus is a new strain and whether it is curable, according to the doctors from the Chinese University of Hong Kong and Prince of Wales Hospital.

But a university spokeswoman told BBC News Online that the discovery indicated that the treatment being given to patients suffering from the atypical pneumonia in Hong Kong - the hardest-hit area - was the right kind.

---

posted 03-19-2003 06:00 PM            

http://www.foxnews.com/story/0,2933,81511,00.html

ATLANTA — Health officials said Wednesday that 11 suspected cases of a mysterious flu-like illness have emerged in the United States, while on the other side of the world, medical investigators continue to puzzle over how the illness spread in a Hong Kong hotel.

Centers for Disease Control and Prevention chief Dr. Julie Gerberding said the suspected U.S. cases are people who recently traveled to Asia and later developed fever and respiratory problems, matching definitions for the mystery illness, called "severe acute respiratory syndrome" or SARS.

The illness, for which there is no treatment, has caused 14 deaths, including five who died months earlier in an outbreak in China.

The worldwide number of cases, including the 11 suspect U.S. cases, now totals 264, according to the World Health Organization. Most of those cases are in Hong King, Vietnam and Singapore. The WHO said Wednesday that they continue to receive reports about some patients recovering from the illness, which causes high fever and severe breathing problems.

"There's a lot we still don't know about this problem," said Gerberding, who added that the CDC is still examining new samples that recently arrived from overseas.

"It's very preliminary to say any individual is a case of SARS," she said. "It is going to take some days to know for sure."

She declined to say where the U.S. cases are, but one of them involves a patient from Albuquerque, N.M., who recently returned from Hong Kong. The patient is in a hospital's respiratory isolation unit, New Mexico health officials said Wednesday.

Although more cases could be identified in the United States, people who haven't recently traveled to affected areas in Asia shouldn't worry, Gerberding said.

"We don't want people who haven't traveled to this region to be concerned about this problem, at least at this point in time," she said.

Health and Human Services Secretary Tommy Thompson cited the mysterious bug in announcing the government's plan to spend $100 million toward vaccines that would fight off new strains of flu.

He said the new disease reminds everyone of "the potential danger posed by emerging infectious diseases."

So far, the mystery bug has not been identified as a new flu strain. Instead, health investigators are focusing on a family of viruses called paramyxovirus. First German, then Hong Kong doctors reported finding it in case specimens there. WHO said its labs will study other samples to see if the same virus is present.

"There is now a clue about what might be causing this," said Dr. David Heymann, WHO communicable diseases chief. "This clue will make it easier to diagnose patients."

But Gerberding and other experts cautioned that it's still too soon to be sure this is the culprit behind the mystery illness.

"The laboratories that have identified this virus are very good laboratories," Gerberding said. "But we don't at this point know what it means."

The virus was found in patients' nasal passages, she said, and "it hasn't yet been identified from any tissues or lung material or other specimens that would directly implicate it as the cause of the infection."

Paramyxovirus is from a virus group that includes common childhood illnesses, such as mumps and measles.

"My suspicion is it may be a new virus within that family," said Dr. Larry Anderson, a CDC virus expert.

Investigators said Wednesday that seven of the people infected, including one who died, all stayed on or visited the same floor of Hong Kong's Metropole Hotel before the outbreak prompted a global alert. The discovery may be significant, because until now officials have said close personal contact is necessary to catch the illness.

"It would suggest that it spread through the air-conditioning system, but you can't rule out person-to-person contact, since you don't know if they were even in the same room together," said Ronald Atlas, president of the American Society of Microbiology. "But everything says it is airborne."

Gerberding noted that none of the hotel staff became ill. She said that investigating how the guests interacted will offer additional clues to the degree of contagion and how it's spread.

posted 03-27-2003 06:12 AM            

Nine tourists come down with SARS after flight to Beijing

WHO scientists theorize two viruses may be combining

DIRK BEVERIDGE
ASSOCIATED PRESS

HONG KONG—Adding to fears a deadly flu-like illness is being spread by air travellers, Hong Kong officials said yesterday nine tourists apparently came down with the deadly disease after another passenger infected them on a flight to Beijing.

The World Health Organization insisted air travel is safe but said its scientists are investigating each case to make sure the disease is not spread through ventilation.

In recent weeks Severe Acute Respiratory Syndrome (SARS) has spread beyond hospitals, where dozens of health-care workers became infected, to schools, with at least four closed for several days.

Hong Kong officials said the nine tourists became sick after a mainland Chinese man with SARS infected them on a March 15 Air China flight.

If SARS can be more easily spread through the air — rather than by close contact with infected people who cough or sneeze — it could force restrictions on travel to contain the disease.

"We would want to be sure that it was people sitting next to that person and not the ventilation system in the airplane which was spreading the disease," said Dr. David Heymann, head of communicable diseases at WHO. "We have no evidence of the latter right now."

For one thing, he said, health investigators have followed thousands of passengers who flew with SARS-infected travellers and did not become sick.

However, he said that if cases are found that did not involve close contact with someone sick or at high risk, "we will then be very concerned that this might have become airborne."

The airplane cases seem similar to the way the disease got its start here — from one hotel guest, who spread it to six strangers staying on the same floor. One expert theorized it might have spread through the air-conditioning system.

SARS has spread most rapidly through Asian hospitals, some of which initially lacked the surgical masks and goggles needed to keep health-care workers from catching the disease.

Hong Kong reported 26 new cases yesterday, bringing its total to 286 — more than half the world total of 487.

In the United States, 39 cases have been diagnosed, 32 of whom had travelled to Asia.

Singapore's government has ordered 740 people who may have been exposed to stay home for 10 days or risk stiff fines.

Officials of WHO and the U.S. Centers for Disease Control said Monday SARS may be caused by a new form of the coronavirus, one of a few viruses that can cause the common cold.

But WHO virologist Dr. Klaus Stohrsaid researchers continue to find signs of another germ family, the paramyxovirus.

"What we are seeing actually are three hypotheses," he said. SARS might be caused by one of those two viruses, or "these two pathogens have to come together to cause this very severe outbreak."

Mar. 26, 2003. 07:02 PM

Thousands ordered quarantined

Everyone who visited infected east-end hospital at risk, official says

CASSANDRA SZKLARSKI
CANADIAN PRESS

Thousands of people have been told to "quarantine themselves," wear masks and in some cases stay home in an effort to stop the spread of a deadly SARS outbreak in Toronto that health officials are calling "an incident of unprecedented scope and magnitude."
Toronto's medical officer of health said everyone who visited the Scarborough Grace Hospital since March 16 should remain in their homes for 10 days following their visit. Two people died of severe acute respiratory syndrome after being treated at the east-end facility.

People who share a household with someone in quarantine may go to work or school, but must wear a mask when at home and in contact with those who are at risk of infection. Should anyone in the household show signs of becoming ill, the entire household must be quarantined.

"We realize this is a substantial amount of people," said Dr. Sheela Basrur. "This number will be in the thousands."

"This is an incident of unprecedented scope and magnitude."

The comments came as protective face masks flew off supply store shelves today as anxious Torontonians sought to shield themselves against a deadly outbreak that prompted Ontario to declare a "health emergency."

Basrur said international supplies of face masks were dwindling and that she has asked the province to make obtaining adequate supplies a priority.

The number of probable cases has nearly tripled in the past three days, with the number reaching 27 in Ontario and one in Vancouver. Three people have died. Five people are suspected of being infected.

Police wearing surgical face masks descended on Scarborough Grace this afternoon, stretching yellow police tape around the perimeter and blocking the entrances with their cruisers.

Ontario's public security commissioner said police were providing protection for a helicopter about to land at the hospital carrying an infectious disease expert. The hospital has no landing pad, forcing the helicopter to land on hospital grounds.

"The police presence is simply to allow that to happen and ensure public safety by cordoning off the area," said Dr. James Young.

News of the extended quarantine came hours after Health Minister Tony Clement announced he had declared a "health emergency" in Ontario. Under the province's emergency powers legislation, Clement said he will set up a command centre that will be staffed 24 hours a day to co-ordinate all information from hospitals and health workers.

"By characterizing it as a health emergency, we are giving ourselves the powers that we need and the information that we need at the most appropriate time to ensure that we can contain this disease as soon as possible," Clement said.

Dozens of households have already been quarantined and Scarborough Grace stopped taking new patients earlier this week. A second Toronto hospital, Mount Sinai, stopped accepting new critical care patients today after it was discovered that a patient transferred from Scarborough later displayed symptoms.

The government has already designated the illness a reportable, communicable and virulent disease under the Health Protection and Promotion Act, which lets officials quarantine people against their will.

In Ottawa, Federal Health Minister Anne McLellan was asked whether it's time to invoke federal quarantine legislation.

"We are working very effectively with local health authorities," McLellan said in the Commons. "At this point we do not think it is necessary to invoke the Quarantine Act."

About 30 Toronto residents showing symptoms of SARS, many of them health-care workers, have been quarantined, some in hospital isolation rooms. Their family members have been told to stay home for at least 10 days. They must wear face masks while interacting with other family members, sleep in separate rooms and are forbidden to leave their homes.

Basrur said those who don't comply can be forced to do so by court order.

"I expect that by the end of this (outbreak) that will have to be exercised," she said.

The outbreak has dominated the front pages of local newspapers, sending some Torontonians straight to a surgical supply store first thing this morning.

"Before we even opened there were three people at the door and I think they cleaned us out at that point," said Jim Garde, general manager of Starkman's Home Healthcare.

"It's gone crazy, we're trying to keep up with it right now. . . . It seems that about every second person that's coming in is buying a box of these masks."

Garde's store provides masks wholesale to several pharmacies, as well as to Toronto's ambulance service, public health office and police force. But many of the customers he's seen in recent days have been regular citizens, fearful they are at risk of infection.

It's made for huge sales for a business that generally sells one case of masks per month.

"We've picked up 30 cases this morning, we've got another 125 cases tomorrow," said Garde.

Health officials urged the public not to panic, pointing out that only people who have been in close contact - within about one metre, over a period of some time - with a person sick with SARS have so far become infected.

However, a Toronto elementary school near Scarborough Grace sent children home Tuesday after three kindergarten students fell ill with undiagnosed fever. The school was to remain closed until Monday.

Basrur said the closure had been unnecessary, because none of the children had come in contact with people suspected of infection.

Other schools sent notes home urging parents to watch for symptoms such as dry coughs and soaring temperatures and to keep sick children home.

Premier Ernie Eves said the province was doing what it could to address the mysterious disease that originated in China.

"The more we can do to contain cases of SARS, the better, and make sure it doesn't spread any further than it already has," said Eves.

Public health officials were trying to find a way to deliver food and other essentials to those in quarantine. Some of the volunteer organizations approached for help have expressed reluctance, fearing that would put helpers at risk, Basrur admitted.

"So far that has been a concern for some community organizations. We feel the potential for exposure can be brought to zero by reasonable precautions."

The SARS outbreak was carried to Toronto by Sui-chu Kwan who was returning from Hong Kong. Kwan died of the disease March 5.

Health Canada has urged Canadians planning trips to the most affected parts of Southeast Asia to defer travel for the time being. Those areas are Hanoi, Vietnam, Hong Kong, Guangdong province in China and Singapore.

Grover Hayashi of Elite Orient Tours said about 20 people have postponed flights with his company in recent days.

posted 03-27-2003 10:17 AM            

KEN FAUGHT/TORONTO STAR
Scarborough Grace Hospital's emergency department was closed March 24 to all new patients as part of an effort to contain symptoms of Severe Acute Respiratory Syndrome.

Mar. 26, 2003. 07:02 PM


Thousands ordered quarantined
Everyone who visited infected east-end hospital at risk, official says

CASSANDRA SZKLARSKI
CANADIAN PRESS

Thousands of people have been told to "quarantine themselves," wear masks and in some cases stay home in an effort to stop the spread of a deadly SARS outbreak in Toronto that health officials are calling "an incident of unprecedented scope and magnitude."
Toronto's medical officer of health said everyone who visited the Scarborough Grace Hospital since March 16 should remain in their homes for 10 days following their visit. Two people died of severe acute respiratory syndrome after being treated at the east-end facility.

--------------------------------------------------------------------------------
'This is an incident of unprecedented scope and magnitude.' Dr. Sheela Basrur
Toronto Medical Officer of Health

posted 03-29-2003 03:59 AM            

Cold virus linked to mystery disease

Tuesday, March 25, 2003 12:40 AM EST (0540 GMT)

ATLANTA, Georgia (Reuters) -- A new strain of a virus that causes the common cold may be responsible for the emergence of a mysterious respiratory disease that has killed 17 people and sickened hundreds around the world, U.S. health experts said Monday.

The U.S. Centers for Disease Control and Prevention said tissue samples taken from two patients infected in a recent global outbreak of severe acute respiratory syndrome (SARS) had tested positive for a new form of coronavirus.

The same strain of the virus has also been found in lung secretions and other genetic material taken from seven other patients, the CDC said.

Coronaviruses, so-named because they have a crown-like appearance when seen under a microscope, are the second leading cause of colds in humans and are often responsible for upper respiratory infections in premature infants.

"We're culturing it and finding it in actual tissue samples," Dr. Julie Gerberding, director of the CDC, told reporters during a news conference in Atlanta. "In scientific terms, this is very strong evidence."

But she said a lot more research needed to be done.

More than 400 people have contracted an illness that resembles pneumonia in the past two months, according to the World Health Organization, which sent out a global health alert about the outbreak two weeks ago.

The WHO figure excludes 39 suspected cases in the United States.

The outbreak, which may be linked to a wave of similar illnesses that began in southern China in November 2002, has spread through Hong Kong, Vietnam and other parts of Asia.

A handful of cases, including three deaths, have been reported in Canada.

The illness begins with a high fever and dry cough that can lead to breathing difficulties and force the use of a respirator. The CDC said most of the U.S. cases were among people who had recently traveled to Asia.

Other cases have occurred among health care workers or relatives with close contact to those who have taken ill.

posted 03-29-2003 12:46 PM            

March 28, 2003, 9:00 AM EST

The Illness

What is Severe Acute Respiratory Syndrome (SARS)?
SARS is a respiratory illness of unknown cause that has recently been reported in Asia, North America and Europe. For additional information, check the World Health Organization’s (WHO) SARS web site or visit CDC’s SARS web site.

What are the symptoms and signs of Severe Acute Respiratory Syndrome (SARS)?
The illness begins generally with a fever greater than 100.4°F [>38.0°C]. The fever is sometimes associated with chills or other symptoms, including headache, malaise, and body aches. Some persons also experience mild respiratory symptoms at the outset.

After 3 to 7 days, the person may develop a dry, nonproductive cough that might be accompanied by or progress to the point where insufficient oxygen is getting to the blood. In 10%--20% of cases, patients will require mechanical ventilation. For more information, see the MMWR dispatch.

If I were exposed to Severe Acute Respiratory Syndrome (SARS), how long would it take for me to become sick?
The incubation period for SARS is typically 2--7 days; however, isolated reports have suggested an incubation period as long as 10 days. The illness begins generally with a fever (>100.4°F [>38.0°C]) (see signs and symptoms, above).

How does the disease (SARS) spread?
It is difficult this early in the investigation to say exactly how SARS spreads. Close contacts of cases, including health care workers and family members, have developed similar illnesses. Examples of close contact include having cared for, lived with, or had direct contact with respiratory secretions and body fluids of people with SARS.

What is the cause of SARS?
On the basis of available information, the cause of SARS cannot be definitively identified. On March 25, CDC announced that its scientists had detected a previously unrecognized coronavirus in 2 patients with SARS. These findings are preliminary and do not provide conclusive evidence that coronavirus is the cause of SARS.

Is there a test for SARS?
Although coronavirus has not been proven to be the cause of SARS, CDC and its partners are working to develop a new test to look for evidence of coronavirus infection in patients with SARS.

How many cases of Severe Acute Respiratory Syndrome (SARS) have been reported so far?
Visit WHO's SARS page for daily updates on case reports.

Are there any reports of people having contracted SARS in the US?
Visit WHO's SARS page for daily updates on case reports.

How many people have died from SARS?
Visit WHO's SARS page for a daily update of SARS cases and deaths.

Is SARS an outbreak of the Avian flu?
There is no evidence at this time that the current cases of SARS are related to Avian flu.

Who is most at risk of contracting SARS?
At this time, cases appear to primarily involve health care workers caring for patients with SARS and close family contacts.

What is known about the 7 cases of SARS that stayed in the same hotel in Hong Kong?
On March 19, 2003, the Hong Kong Health Department reported that at least 7 of the initial patients stayed or visited a hotel in Kowloon during the month of February. The significance of this finding is being explored.

Coronavirus

What are coronaviruses?
Coronaviruses are a group of viruses that have a halo or crown-like (corona) appearance when viewed under a microscope. These viruses are a common cause of mild to moderate upper-respiratory illness in humans and are associated with respiratory, gastrointestinal, liver and neurologic disease in animals.

What evidence is there to suggest that coronaviruses may be linked with SARS?
CDC scientists were able to isolate a virus from the tissues of two patients who had SARS and then used several laboratory methods to characterize the agent. Examination by electron microscopy revealed that the virus had the distinctive shape and appearance of coronaviruses. Tests of serum specimens from patients with SARS showed that the patients appeared to have recently been infected with this coronavirus. Other tests demonstrated that coronavirus was present in a variety of clinical specimens from patients, including nose and throat swabs. In addition, genetic analysis suggests that this new virus belongs to the family of coronaviruses, but differs from previously identified coronaviruses.

These laboratory results do not provide conclusive evidence that the new coronavirus is the cause of SARS. Additional specimens are being tested to learn more about this coronavirus and its link with SARS.

If coronaviruses usually cause mild illness in humans, how could this new coronavirus be responsible for a potentially life-threatening disease such as SARS?
There is not enough information about the new virus to determine the full range of illness that it might cause. Coronaviruses have occasionally been linked to pneumonia in humans, especially people with weakened immune systems. The viruses can also cause severe disease in animals, including cats, dogs, pigs, mice, and birds.

Have other laboratories found evidence of coronavirus in SARS patients?
CDC has been working with the World Health Organization (WHO), international partners at laboratory centers, and ministries of health in this investigation. Some of the laboratories participating in this WHO network have also reported positive results for the presence of coronavirus in specimens from SARS patients. Additional testing is under way at the WHO network laboratories.

What about reports from other laboratories suggesting that the cause of SARS may be a paramyxovirus?
Researchers from several laboratories participating in the World Health Organization (WHO) network have reported the identification of a paramyxovirus in clinical specimens from SARS patients. Laboratories in the WHO network are still investigating the possibility that a paramyxovirus is a cause of SARS. CDC has found no evidence to date of paramyxovirus in clinical specimens, but additional testing is under way.

CDC Activities

What is CDC doing to combat this health threat?
CDC has activated its Emergency Operations Center (EOC); is distributing health alert notices to travelers who may have been exposed to cases of SARS; is assisting state and local health departments in investigating possible cases of SARS in the United States; is providing safe specimen-handling guidelines to laboratories; is analyzing laboratory specimens to identify a cause for SARS; and has deployed more than a dozen CDC medical officers, epidemiologists, infection control specialists, and pathologists to support the World Health Organization in the global investigation. As always, CDC is committed to communicating regularly and effectively with public health professionals, elected leaders, clinicians and the general public.

CDC Recommendations

What should I do if I think I have SARS?
If you are ill with a fever of over 100.4 °F [>38.0°C] that is accompanied by a cough or difficulty breathing, or that progresses to a cough and/or difficulty breathing, you should consult a health care provider. To help your health care provider make a diagnosis, tell them about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

What should I do if I have recently traveled to a country where cases of SARS have been reported?
You should monitor your own health for 7 to 10 days following your return. If you become ill with a fever of over 100.4 °F [>38.0°C] that is accompanied by a cough or difficulty breathing, or that progresses to a cough and/or difficulty breathing, you should consult a health care provider. To help your health care provider make a diagnosis, tell them about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

What medical treatment is recommended for patients with SARS? Has new information about coronavirus changed that recommendation?
CDC currently recommends that patients with SARS receive the same treatment that would be used for any patient with serious community acquired atypical pneumonia of unknown cause. Reported treatment regimens have included antibiotics to presumptively treat known bacterial agents of atypical pneumonia. Therapy also has included antiviral agents such as oseltamivir or ribavirin. Steroids have also been administered orally or intravenously to patients in combination with ribavirin and other antimicrobials. For more information on SARS visit CDC's SARS web site and see "Interim Information and Recommendations for Health Care Providers."

The possibility that coronavirus is the cause of SARS has not changed treatment recommendations. The new coronavirus is being tested against various antiviral drugs to see if an effective treatment can be found.

What has CDC recommended to prevent transmission of SARS?
CDC has developed interim infection control recommendations for patients with suspected SARS in the health care and community setting. Visit CDC's SARS web site and review CDC Interim Information and Recommendation for Health Care Providers and CDC Interim Guidance for State and Local Health Departments.

Are there any travel restrictions related to SARS?
At this time there are no travel restrictions in place that are directly related to SARS. However, a CDC travel advisory recommends individuals who are planning nonessential or elective travel to parts of China (Hong Kong, SAR, and Guangdong Province) and Hanoi, Vietnam may wish to postpone their trip until further notice. For additional information about travel advisories, check CDC's Travelers' Health site, which will be updated as necessary.

Should potential SARS patients be isolated?
CDC has developed guidelines that address infection control precautions in the health care and community setting. These can be found at CDC's SARS web site and will be updated as new information about SARS becomes available.

How should a suspected SARS patient be transported to ensure infection control?
To minimize the potential of transmission outside the hospital, case patients should limit interactions outside the home until more is known about transmission of SARS. Placing a surgical mask on case patients in ambulatory health care settings, during transport, and during contact with others at home is recommended.

What precautions should health care facilities follow in regards to permitting visits by close contacts (e.g., family members) of SARS patients?
Close contacts (e.g., family members or other members of the household) of SARS patients are at risk for infection. Health care facilities should implement a system to screen for fever or respiratory symptoms in SARS close contacts who visit the facility. Close contacts with either fever or respiratory symptoms should not be allowed to enter the health care facility as visitors and should be educated about this policy. Health care facilities should educate all visitors about use of infection control precautions ( http://www.cdc.gov/ncidod/sars/infectioncontrol.htm ) when visiting SARS patients and should emphasize the importance of following these precautions.

What precautions should health care workers exposed to SARS patients follow?
Health care facilities should be vigilant in conducting active surveillance for fever or respiratory symptoms among care givers with unprotected exposure to SARS patients. Health care workers who develop fever or respiratory symptoms during the 10 days following an unprotected exposure to a SARS patient should not report for duty, but should stay home and report symptoms to the appropriate facility point of contact immediately. Exclusion from duty should be continued for 10 days after the resolution of fever and respiratory symptoms. During this period, infected workers should avoid contact with persons both in the facility and in the community.

Exclusion from duty is not recommended for an exposed health care worker if they do not have either fever or respiratory symptoms; however, the worker should report any unprotected exposure to SARS patients to the appropriate facility point of contact (e.g., infection control or occupational health) immediately.

Interim guidance for the management of exposures to SARS in a health care facility is at http://www.cdc.gov/ncidod/sars/exposureguidance.htm.

Travel and Quarantine

What are CDC's quarantine officials doing to prevent and control the spread of SARS?
During the ongoing investigation into SARS, CDC's quarantine inspectors play an important role. Inspectors or their designees provide information to returning air travelers arriving-directly or indirectly-from Hong Kong, Guangdong Province, People's Republic of China, and Hanoi, Vietnam. This same information is being provided via the major shipping associations and the International Council of Cruise Lines (ICCL) to persons traveling on cargo ships and cruise ships.

Inspectors are handing out health alert notices to arriving air travelers alerting them of their possible exposure to SARS. The notices ask travelers to monitor their health for 7 days and see a doctor if they get a fever with a cough or have difficulty breathing. Inspectors are also boarding airplanes to check travelers for any symptoms matching the case definition of SARS.

Which travelers are being given health alerts?
Travelers returning from Hong Kong, Guangdong Province, People's Republic of China and Hanoi, Vietnam are being given printed information (health alert notices) that they may have been exposed to cases of severe acute respiratory syndrome (SARS). Travelers are advised to monitor their health for at least seven days, to contact their physicians if they become ill with a fever accompanied by a cough or difficulty in breathing, and to inform their physician of their recent travel.

What does a quarantine inspector do?
Quarantine inspectors serve as important guardians of health at borders and ports of entry into the United States. They routinely respond to illness in arriving passengers and ensure that the appropriate medical action is taken.

What is considered routine health inspections of airplanes or ships versus what is happening now?
Routine health inspections consist of working with airlines, cargo ships, and cruise ships to protect passengers and crew from certain infectious diseases. Quarantine inspectors meet arriving aircraft and ships reporting ill passengers and/or crew (as defined in the foreign quarantine regulations [pdf]) and assist them in getting appropriate medical treatment.

What is the risk to individuals who may have shared a plane or boat trip with a suspected SARS patient?
Available data indicate that transmission seems to require direct or close contact. Cases have occurred among health care workers caring for ill patients and close family contacts. CDC is taking locating information from travelers who are on flights with people suspected of having SARS. CDC, with the help of state and local health authorities, is attempting to follow up on these travelers for 7 days to make sure no one develops symptoms consistent with SARS. So far, no cases of SARS have been reported in these travelers.

Who actually notifies quarantine officials of potential SARS cases? Is it the crew of the airplane or ship? The passengers?
Under foreign quarantine regulations [pdf], the master of a ship or captain of an airplane coming into the United States from a foreign port is required by law to report certain illnesses among passengers. The illness must be reported to the nearest quarantine official. If possible, the crew of the airplane or ship will try to relocate the ill passenger or crew member away from others. Quarantine officials arrange for appropriate medical assistance to be available when the airplane lands or the ship docks. If the passenger is only passing through a port of entry on his/her way to another destination, port health authorities may refer the passenger to a local health authority for assessment and care.

If I’m on board an airplane or ship with someone suspected of having SARS, will I be allowed to continue to my destination?
CDC does not currently recommend that the onward travel of healthy passengers be restricted in the event that a passenger or crew member suspected of having SARS is removed from the ship or airplane by port health authorities. All passengers and crew members may be advised by port health authorities to seek medical attention if they develop these symptoms.

What does a quarantine official do if a passenger is identified as meeting the case definition for suspected SARS?
Quarantine officials arrange for appropriate medical assistance to be available when the airplane lands or the ship docks, including medical isolation. Isolation is important not only for the sick passenger’s comfort and care, but also for the protection of members of the public. Isolation is recommended for travelers with suspected cases of SARS until appropriate medical treatment can be provided or until they are no longer infectious.

What does a quarantine official do if a passenger identified as meeting the case definition for suspected SARS refuses to be isolated?
Many levels of government (Federal, State, and local) have basic authority to compel isolation of sick persons to protect the public. In the event that it is necessary to compel isolation of a sick passenger, CDC will work with appropriate State and local officials to ensure that the passenger does not infect others.

Other

Is there any reason to think SARS is or is not related to terrorism?
Information currently available about SARS indicates that people who appear to be most at risk are either health care workers taking care of sick people or family members or household contacts of those who are infected with SARS. That pattern of transmission is what would typically be expected in a contagious respiratory or flu-like illness.

Friday, March 28, 2003

PRRS AND PCV IN CHINA'S PIGS COULD
BE A MODEL OF THE TWO VIRUS
THEORY OF SARS IN PEOPLE
http://www.aidsgate.blogspot.com/

posted 03-31-2003 05:36 PM            

So SARS is just another war phase. This war is against you and I, a step that wil become more obvious in the next few years. They don';t need us anymore, we did the work of building up the world. Now they reap their harvests, much more than money.
Depopulation is actually an economic manouver that concentrates wealth for certain people on top of the food chain. All these plans are made to be carried out over generations, and now there is enough wealth that it is worthwhile again. The 1930's depression may have been created for similiar reasons.

posted 04-03-2003 12:19 AM            

Well, where do I start? first, hello to all.

I'm in Toronto, at the centre of SARS outbreak in Canada, maybe N. America?

I fell ill a few days ago with what i nervously joked about as being SARS. Feeling better but still have a few symptoms (which of course resmble any that accompany the flu or a bad cold).

The #'s are growing everyday. Some people can be seen walking the streets or driving in their cars wearing masks.

Every hospital in the province has restrictions on visitors. At least two hospitals are quarantined in Toronto.

Conferences are being cancelled. Travellers are being warned not to come here. My sister back in Alberta is under the assumptiion that the whole city is under quarantine.

Its funny how things can get blown out of prortion.

We probably won't see a full shut down until maybe the middle to end of the month.

i hope i'm kidding.

Am i endangering people as i travel the city?

Is this really the next BIG one? i suspect that with a death rate around 6% (so far reported) this really isn't that catastrophic - in comparison to the flu epidemic of 1918.

But what really worries me is the timing and the relatively high probability that this has come from the lab of some evil scientist(s), or maybe even a well meaning scientist working for evil people.

I almost fell out of my chair on Saturday night when the CBC was previewing their top TV news stories and accompanying SARS was the underlying text

GERM WARFARE

no kidding, i have it on tape.

The co-ordination room for this emergency is called the 'war room'.

and i hear reports (?) from asia of medical staff being issued full on military issue chem/bio protection suits.

Who wants to bet that the US military Cabal blames Saddam Hussein for this, or the Russians, or the Chinese?

I don't know what kind of coverage this is getting in the rest of the world but this has bumped the war to second billing for several days on the news - tv, print and radio.

Maybe mother nature has finally had enough of our shit and engineered a little something of her own to bring things into prspective.

or maybe this fever is just making me ridiculous.

cheerio

ps, if this virus can cross the electronic barrier, you're all screwed (cough, cough)

posted 04-03-2003 06:27 AM            

Deadly virus effortlessly hops species
Genetic engineering helps reveal origin of deadly 'flu

2 April 2003
HELEN PEARSON

A single genetic change could have created the deadly virus that has killed over 50 people and infected more than 1,600, a new study suggests.

A new type of coronavirus is thought to be behind the pneumonia-like disease dubbed severe acute respiratory syndrome (SARS). Now, in a simple overnight experiment, researchers transformed a coronavirus that is lethal to cats into one that infects mouse cells by replacing a single gene1.

The result strengthens the idea that the SARS coronavirus might have arisen when an animal and human virus met and swapped genes, says the study's lead scientist, Peter Rottier of Utrecht University in the Netherlands. "It's a very plausible explanation," he adds.

Rottier's team created the new coronavirus by injecting cat cells with feline infectious peritonitis virus (FIPV), a common pathogen that kills around 5% of cats. The researchers added a gene fragment from a mouse coronavirus; this makes a coat protein that recognizes and helps to penetrate mouse cells.

After several hours, some particles of the cat virus had exchanged their coat gene for the mouse one - and could then infect mouse cells. This is analogous to what might happen if the two viruses simultaneously infected the same cell.

Coronaviruses are unusual in their ability to reshuffle genes easily in this way, explains Michael Lai of the University of Southern California in Los Angeles, who works on them. The study shows that the viruses "can easily switch their host range by switching genes", he says.

The SARS virus might also have arisen when an existing animal or human coronavirus mutated into a more deadly form, says Lai. Which of these explanations is true will become clear when the full genetic sequence of the virus is pieced together, possibly this week.

Rottier's team is already producing live vaccines against coronaviruses, using the same technique. They screened the strains of FIPV that infect mice for those that had become innocuous in the genetic reshuffle. Vaccination with one of these strains protects cats from the original, lethal FIPV, they found.

In theory, bioterrorists could abuse this genetic transformation procedure to turn an animal coronavirus into a dangerous human pathogen such as that responsible for SARS. But this and other similar virus-altering techniques are not new, say experts. For example, in 2000, the team used the same method to engineer a mouse coronavirus that infects cats.

posted 04-04-2003 10:07 AM            

Following is an article expressing a point of view that I thought was of interest.

Apr. 3, 2003. 01:00 AM


Tiny virus makes world seem very, very small

JIM COYLE

A wise fellow I know once observed that the biggest points sometimes have the smallest focus, that such immensities as the meaning of life can be found in the fleeting moment of a child's wonder, a woman's laugh, a kindness freely given.

Recent events would seem to confirm that equation. For it's difficult to imagine a focus smaller than the microscopic organism that's been spreading rapidly around the world in recent weeks, killing scores, sickening thousands and terrifying multitudes. And it's just as difficult to imagine a point bigger than the one being made by the SARS outbreak.

It was perhaps best expressed by Dr. Donald Low, head of microbiology at Toronto's Mount Sinai Hospital. "We're in this together," he said this week, shortly before being forced into isolation himself as a result of possible exposure to SARS.

It could hardly have been better put. When the camera draws back for a wide-shot of the medical emergency hitting Greater Toronto and places beyond, it's clear that Dr. Low is exactly right, clear that the outbreak raises big-picture questions about how humanity lives, about costs and values, about how we share the planet, about how interconnected are the world's peoples.

Clearest of all is how flimsy a refuge is the bliss born of ignorance, how great a delusion the supposed immunity conferred by distance, how shortsighted decisions made solely in local or national self-interest.

There have been many recent euphemisms for the principle of connectedness Dr. Low expressed. The Butterfly Effect, in which a gentle flutter on one side of the world causes a tempest on the other. Six Degrees of Separation, in which any one of us is but a half-dozen relationships away from any other.

However you put it, the six billion or more souls on Earth are, as the good doctor says, increasingly in it together. The most virulent viruses may emerge from tropical hot zones, or rain forests, but they don't stay there. A world in which no one is more than a day away from anyone else creates a melting pot for pathogens and a superhighway for disease transmission.

The last half-century has created circumstances utterly new to mankind. There has been an unprecedented explosion in population. There has been unprecedented tampering with the environment. And there is now unprecedented mobility.

Demographers put it this way: it took 10,000 generations to reach the first two billion in population on Earth, only one lifetime to reach the next two, and two decades more to bring us to more than 6 billion. As a result, many in the world endure poverty, inadequate housing, sanitation and health care.

The issues raised by the spread of infectious diseases are many and complex. The disparity in wealth between regions of the world, poverty and overcrowding, environmental degradation and deforestation, water shortages and mismanagement, the agricultural practices in which efficiency is paramount, the extinction of animal species.

For all of these help to create incubators in which organisms thrive, in which the jump to human hosts is short, and from which epidemics begin.

--------------------------------------------------------------------------------
`In many respects, it seems as if life in the late 20th and early 21st centuries is tailor-made for viral emergence'

Barry and David Zimmerman, in Killer Germs

--------------------------------------------------------------------------------

In a sense, then, all policy is, sooner or later, health policy; and all policy anywhere eventually becomes local.

"Governments are learning the hard way that dam-building, deforestation and the like all create new opportunities for microbes and their natural hosts to interact with humans," said biologists Barry and David Zimmerman in their recent book Killer Germs.

According to their research, the emergence of new viruses is more often due to human activity than a viral mutation.

In recent decades, plant and animal habitat have been significantly altered due to human activity. Dam construction creates huge bodies of standing water, delightful to mosquitoes. Rain forests have been cleared for arable land, sending animals scurrying in search of new homes and hosts. Agricultural practices such as monoculture (the production of a single crop) increase the chance of epidemics.

Though much of that specific activity takes place in poorer regions, global environmental damage generally remains far more the result of actions by over-consuming rich countries. And such damage has consequences of unknowable scope.

"Global warming, for example, is creating new hospitable habitats for virus-carrying mosquitoes and ticks. ... Floods and excessive rainfall present a similar problem, establishing new breeding grounds for insect visitors.

"In many respects, it seems as if life in the late 20th and early 21st centuries is tailor-made for viral emergence."

The Zimmermans concluded it would be an act of enlightened self-interest for richer nations to play a larger role in improving living conditions elsewhere in the world, in sharing the bounty, in treading more lightly on our environment themselves, and in establishing global information networks for dealing with disease outbreaks.

"The commitment in money and manpower would be enormous," they acknowledged.

posted 04-05-2003 12:27 AM            

WASHINGTON (AP) - President George W. Bush on Friday gave health officials authority to quarantine Americans sick with a deadly flu-like illness which has killed over 80 people throughout the world.

Health officials have no immediate plans to use the new powers in fighting severe acute respiratory syndrome, or SARS.

In an executive order signed Friday, Bush added SARS to the list of diseases for which health authorities have authority to involuntarily quarantine Americans.

posted 04-07-2003 08:47 PM            

ONE MORE TIME ON DISEASE INVENTION

April 7. Because even alternative news sites fall for this on a regular basis, I want to trace a pattern.

One, the government or some government health agency announces an outbreak of what looks like a new disease.

Two, the government says it has people on the scene looking for the germ that is causing the new disease.

At this point, all sorts of people accept One and Two and begin to surmise that the germ may have been designed in a lab.

Sure, people do that work in labs, all the time. They tinker with bacteria and viruses and more exotic micro-organisms.

BUT. Why accept, on the face of it, that the government has discovered an outbreak of some singular discrete new disease entity in the first place? Why assume that? Why buy that?

These government agencies are in the business of welding together people and their symptoms and coming up with authoritative disease names.

A cough and a fever in Hong Kong becomes linked to a headache and diarrhea in Miami. They say the folks in Hong Kong and Miami are all suffering from Zabeeweedee, the ONE new disease which is caused by some ONE germ they are presently looking for.

Hold it right there. THIS is the place to pause.

Are they lying? Did they really track those people on the plane? If so, why are they now saying, for example, in the SARS situation, that "the very first person with SARS in China (itself a fatuous idea)" did NOT give SARS to his immediate family?

Before asserting that some new disease was really a planted germ they cooked up in a lab, why not find out if it IS a disease, instead of something more subtle: a linking up of people and their symptoms that don't really fit together.

Come ON.

You know, people in Hong Kong and Singapore and China and Canada die all the time. Every day. And some of them display, among other things, cough and fever and fatigue and respiratory problems. They call it flu, they call it pneumonia, they call it lung complications. But now they call it SARS. And they have found no convincing virus. They have found no root cause. But that doesn't stop them. They are already working on a vaccine against a germ they don't have.

They have admitted, on top of it, that the people in China are dying of pneumonia, but in the US, pneumonia hasn't been seen so far. What's next? Will cervical cancer become the leading US symptom of SARS? Polio? Automobile accidents on lonely roads after midnight?

After 20 years of investigating medical scandals, I've learned to stop the merry-go-round just after it starts, and say PROVE IT. PROVE THAT YOU JUST FOUND A NEW DISEASE. PROVE THAT ALL THESE CASES ARE LINKED.

JON RAPPOPORT http://www.nomorefakenews.com

posted 04-08-2003 05:25 AM            

I use to frequent Jon Rapapport's site but it's been some time since I've stopped by over there. I always thought that the guy had a pretty sane perspective on things and here he is once again demonstrating it.

posted 04-10-2003 09:35 PM            

"I think we might find that SARS causes quite a massive immune response on the part of the human host­ that the virus is able to trick the sick human host and have it over react. ...Maybe the way this SARS disease hurts the host is almost like the host turning on itself (in an auto-immune way)."

- Donald Low, M. D., Chief of Microbiology, Mt. Sinai Hospital, Toronto, Canada
-------------------------------------

More FYI:
Interview by Linda Molten Howe

Death from SARS Might Be Caused by Body's
Own Massive Immune Response to New Virus

SO WHAT DO YOU THINK IS HAPPENING THAT IS MAKING THE SARS PATIENTS SO SICK AND KILLING THOSE THAT DIE?

I think we might find that SARS causes quite a massive immune response on the part of the human host ­ that the virus is able to trick the sick human host and have it over react. In fact, we might see that some of the lung damage is a result of host inflammatory products such as interferon in such high quantities which can cause damage. Maybe the way this SARS disease hurts the host is almost like the host turning on itself (in an auto-immune way). Our experience is more of a diffuse pneumonia which often involves both lung fields.

YOU ARE SEEING ALVEOLI DAMAGE?

Yes, in the few number of cases where we do have autopsy examinations, we've seen alveoli damage, but very little in the way of inflammatory cells. But they are clearly a picture of acute injury to the lung.

HOW MANY OF YOUR PATIENTS HAVE HAD TO GO ON VENTILATORS?

We must be up around 10, which would be fitting in with the findings in Hong Kong and we've had 7 people who have died.

OF THOSE WHO DIED, WAS THERE ANY COMMON DENOMINATOR ABOUT WHY THEY DIED?

With regards to risk factors, it's older age, typically patients who are older than 65 years or have underlying disease. But we recognize this can also occur in younger patients and it might be a result that those patients who are exposed to a sick person where they get exposed to a large number of virus particles that results in such an overwhelming infection in both lungs.

What Exactly Is the SARS Microbe?

Editorial Note: After this interview, China health officials reported on April 4, that the SARS microbe - at least in Hong Kong and Guandong Province - seems to have hooked up with the Chlamydia pneumonia virus, creating a brand new virus that has jumped from animal to human.

THE ORIGINAL ELECTRON MICROSCOPE INFORMATION FROM DR. JOHN TAM IN HONG KONG.

Yes, I know John.

IT SUGGESTED PARAMYXO VIRUS WHICH CAUSES MUMPS, MEASLES AND CHILDHOOD CROUP. THEN A WEEK ALTER, CDC WAS SAYING THAT OTHER WORK BEING DONE BY OTHER PEOPLE SUGGESTED IT MIGHT BE THE CORONA VIRUS THAT CAUSES THE COMMON COLD. DO YOU HAVE ANY INFORMATION NOW THAT IS REINFORCING EITHER ONE OF THOSE HYPOTHESES?

I think most of the information is pointing towards the corona virus and this is a new corona virus that did not come from humans, but came from animals. It's jumped species, but not only has been able to jump species and cause disease, but is able to transmit from person-to-person. That is the worst possible combination of events because that means we have a new virus that can cause significant disease in a totally non-immune population.

WHY IS IT THAT THIS ALWAYS SEEMS TO COME OUT OF CHINA AND HONG KONG - THAT PART OF THE WORLD?

If you go and visit there, what you'll find is that there are very few backyards that don't have chickens and pigs in them. I was just in Cambodia and a floating village on one of the lakes, and right next to the home in a little float was a pig and some chickens. There is a very close approximation of animals with humans and that's what happened with the avian influenza of 1997 the disease in chickens was able in close proximity to jump into humans. Fortunately there, we never saw any transmission from humans to humans.

THAT'S WHEN THEY KILLED THOSE HUNDREDS OF THOUSANDS OF CHICKENS TRYING TO CONTROL?

Exactly.

If New Animal-To-Human