Deadly Mystery Disease Worries Travelers

Scientists are scrambling to try to get a handle on a new killer illness that has been spreading around the world.

The flu-like ailment has caused at least nine deaths in seven countries, including two in North America.

More than 170 people have fallen ill over the past three weeks, most of them in Hong Kong and Vietnam, according to reports. And experts suspect that another 300 people in China's Guangdong province had the same disease beginning in mid-November.

But the World Health Organization told reporters today that it did not appear that the mysterious respiratory disease would evolve into a world pandemic.

After issuing a rare global alert about the disease on Saturday, the U.N. health body is now saying that the new illness does not appear to be a highly infectious type of flu since it is not spreading as easily as the flu would.

"Influenza is very easily transmitted. With the disease we are talking about now, it does not seem to be that easy. The likelihood of a pandemic is minimal," WHO head of communicable diseases David Heymann told Reuters.

But health officials are not able to rule out the idea that the disease that doctors have dubbed Severe Acute Respiratory Syndrome, or SARS, might turn out to be a form of the flu.

Cases Emerge Worldwide; New York on Alert

No cases have been identified in the United States, but health officials are checking out more than a dozen possible ones.

"It will not be a surprise to us if we identified cases in the United States," said Dr. Julie Gerberding, director of the Centers for Disease Control. The CDC is watching 14 suspect cases in the United States, but Gerberding said she doubted that any of them are connected to the outbreak.

New York health officials are already on the alert. A doctor who treated one of the Singapore victims had been in New York for a medical conference. On his way back Saturday he fell sick, was pulled off the plane in Frankfurt, Germany, and put into quarantine.

Britain today reported its first suspected case, according to Reuters. England's chief medical officer said the patient was admitted to a hospital on Sunday after returning from a trip to Hong Kong.

Meanwhile, French health authorities told The Associated Press they're worried about two people who hospitalized after they returned from Asia with flu-like symptoms. The pair has been hospitalized in Paris for tests.

The North American fatalities were a woman and her grown son who died in Toronto after visiting Hong Kong.

Following the case of the doctor who fell sick on the way home from New York, Mayor Michael Bloomberg said the city is taking no chances. "What we have done is interviewed every single person who came contact with him when he was here. We are observing all of them," Bloomberg said. "We have heightened our surveillance of all the hospitals just in case there is an outbreak of something."

Warning Cards Issued at Airports

The Centers for Disease Control and Prevention on Saturday began distributing cards at airports receiving flights returning directly from Hong Kong, warning travelers returning to the United States from Hong Kong and Guangdong Province, People's Republic of China and Hanoi, Vietnam that they may have been exposed to cases of SARS.

The cards are being handed out by quarantine officials at O'Hare International Airport in Chicago, LAX Airport in Los Angeles, JFK International Airport in New York, Newark International Airport in New Jersey and San Francisco International Airport, the only U.S. airports receiving direct flights from Hong Kong. No U.S. airports receive direct flights from Hanoi or the Guangdong Province.

CDC officials expect to expand the distribution of cards to Anchorage, Alaska and the territory of Guam later today.

The travel cards warn those returning from the three areas that they should monitor their health for at least seven days. They are also advised to contact their physicians if they become ill with a fever accompanied by a cough or if they have difficulty in breathing, and to tell their doctors about their trip and whether they had been exposed to anyone with SARS.

CDC Sets Up War Room

The CDC in Atlanta has set up a 24-hour war room to keep tabs on the mysterious disease.

Dr. Julie Gerberding, CDC director, says people who experience typical respiratory problems, often caused by the common cold, should not jump to conclusions.

"I think the clues to this particular diagnosis, again, are the traveler exposure history, but also the fact that it progresses so quickly to the full pneumonia," Gerberding said.

The incubation period for SARS appears to be three to seven days. It often begins with a high fever and other flu-like symptoms, such as headache and sore throat. Victims typically develop coughs, pneumonia, shortness of breath and other breathing difficulties. Death results from respiratory failure.

"Often, viruses, like the common winter cold, cause a lot of fever and symptoms but they don't typically cause this degree of pneumonia," Gerberding said. "So when we have a patient with this travel history and a severe pneumonia and we don't have an obvious cause, that will certainly cause us to be concerned that it is a case of SARS."

Not Believed to Be Terrorism

Experts discounted the possibility that terrorism is the source and believe it almost certainly is a contagious infection that spreads most easily from victims to their doctors, nurses and families through coughing, sneezing and other contact with nasal fluids.

"This does seem like a very contagious disease to healthcare workers and to family members of those who are sick, but this doesn't seem to be related to any kind of terrorist attack," Gerberding said.

Lab tests have ruled out some varieties of flu as well as some viruses that cause hemorrhagic fever. Doctors say they're looking at the possibilities of a new strain of influenza or an exotic disease.

To date, reports of SARS have been received from Canada, China, Hong Kong and Guangdong Province, Singapore, Thailand, and Hanoi, Vietnam.

U.S. health officials said travelers should consider postponing trips to countries at risk. Those who have traveled to Hong Kong or Guangdong province in China, or Hanoi, Vietnam, are being told to monitor their health for seven days. If a fever and shortness of breath develop, they are advised to see a doctor.

The CDC advises physicians and other clinicians to be alert for travelers who:

Have a fever of 100.4 degrees Fahrenheit or higher; One or more symptoms of respiratory illness including cough, shortness of breath, difficulty in breathing, hypoxia (deficiency in the amount of oxygen reaching tissues of the body), X-rays indicating the presence of pneumonia, or respiratory distress;

And, one or more of the following:

History of travel to Hong Kong or Guangdong Province, People's Republic of China, or Hanoi, Vietnam within seven days of symptom onset;

Close contact with persons with respiratory illness having the described travel history. Close contact includes having cared for, lived with, or had direct contact with respiratory secretions and body fluids of a person with SARS.

The CDC is asking airlines to alert the destination airport of any passengers meeting the case definition criteria and refer arriving passengers who have symptoms to health authorities for care and assessment.

The center also says that aircraft passengers and crew should be informed of the person's status as a suspect case of SARS and airline passengers and crew should provide all contact information for how passengers can be reached for the subsequent 14 days to airport health authorities.