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CDC raises alarm over new form of pneumonia

Health organizations work to stop spread of 'worldwide threat'

A woman puts a mask on a boy in the emergency ward of a hospital in Hong Kong, where a new, deadly strain of pneumonia has been diagnosed.

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The World Health Organization alerts travelers to be aware of the symptoms, which include:
People presenting after February 1 with a history of fever greater than 38 C (100.4 F) AND one or more respiratory symptoms including cough, shortness of breath, difficulty breathing AND
One or more of the following:
Close contact with a person who has been diagnosed with SARS. Close contact means having cared for, having lived with, or having had direct contact with respiratory secretions and body fluids of a person with SARS.
Recent history of travel to areas reporting cases of SARS.
Probable cases are defined as:
A person with chest x-ray findings of pneumonia or Respiratory Distress Syndrome OR
A person with an unexplained respiratory illness resulting in death, with an autopsy examination demonstrating the pathology of Respiratory Distress Syndrome without an identifiable cause.

ATLANTA, Georgia (CNN) -- The U.S. Centers for Disease Control and Prevention recommended Saturday that Americans consider delaying nonessential travel to countries affected by an outbreak of a rapidly spreading, severe form of pneumonia that does not appear to respond to treatment.

The CDC "is advising persons traveling on nonessential or elective travel to affected areas that they may wish to postpone their trips until further notice," Dr. Julie Gerberding, the agency's director, said in a rare Saturday news conference.

Cases of the form of pneumonia, dubbed severe acute respiratory syndrome (SARS), have been reported in Canada, China, Hong Kong, Indonesia, the Philippines, Singapore, Thailand and Vietnam.

No cases have been confirmed in the United States. But early Saturday, a doctor from Singapore on a flight home from New York was taken off a plane during a stopover in Frankfurt, Germany, after showing signs of SARS, German and New York City health officials said.

The doctor, who was in New York for a conference, had recently treated two patients in Singapore with SARS, the New York City Department of Health said. He attended the conference for only "a few hours," the department said, and had "minimal contact with others" during his two days in the city.

The physician has been hospitalized with a respiratory illness, the health department said.

Also, another person who traveled from the state of Georgia to Canada appears to have been stricken with the illness, Gerberding said.

Health authorities in New York and Georgia are attempting to trace the travelers' contacts while they were in the United States, she said.

Asked whether the outbreak could have been caused by terrorism, Gerberding said, "We have to keep an open mind." However, a spokesman for the Transportation Security Administration, which oversees security on airlines, said, "All information at present indicates this is a public health issue unrelated to any act of terrorism."

The CDC news conference was held a few hours after the World Health Organization issued a worldwide emergency advisory containing guidance for travelers and airlines, and calling the disease "a worldwide threat." However, the WHO is not recommending people restrict travel.

During the past week, more than 150 new or suspected cases of the pneumonia have been reported, the WHO said. Nine of those people have died.

"This syndrome, SARS, is now a worldwide health threat," said Dr. Gro Harlem Brundtland, director general of the WHO. "The world needs to work together to find its cause, cure the sick and stop its spread."

The illness is characterized by fever higher than 101 degrees Fahrenheit [39.3 degrees Celsius] and respiratory symptoms such as shortness of breath, coughing or difficulty breathing.

Doctors are being urged to look for the illness in people who have either been in close contact with someone diagnosed with the disease or who have recently traveled to areas reporting cases of the illness.

Little benefit from medication

Neither antibiotics nor antiviral medications -- the standard weapons against pneumonia -- have proven effective, WHO spokesman Dick Thompson said.

The average incubation period between exposure to a sick person and onset of symptoms is about three days, the WHO spokesman said. The CDC put the incubation period at between two and seven days.

The cause of the disease remains a mystery. "We've run almost every flu test we can run and we don't get consistent results," Thompson said. "We get hints here and there, but right now I couldn't tell you if it's a virus or a bacteria. I just don't have any idea."

U.S. Health and Human Services Secretary Tommy Thompson said his agency "is applying a full-court press to learn more about this outbreak and how it might impact on the United States."

It is unclear how long it takes for the symptoms to go away or whether they go away at all, WHO's Thompson said. "Right now, nobody gets better. Some decline and stabilize for a while. Some people rapidly decline and need mechanical-assist devices to breathe."

But Gerberding of the CDC said some patients have improved.

The disease was identified in November in China's Guangdong province, where an outbreak killed five of 350 people afflicted before ending in mid-February, the WHO's Thompson said.

Hospital workers -- doctors, nurses, housekeeping staff, laboratory technicians and medical students -- appear at highest risk, he said.

The CDC has activated its emergency operations center to assist WHO in the investigation and will post recommendations on identifying and treating the illness on its Web site, Gerberding said.

The CDC also advises passengers returning from areas where SARS has been diagnosed to consult a doctor if they become sick with fever during the week after their return, she said.

Disease seems to spread like flu

Spread of whatever causes the illness appears to be person-to-person, with a number of cases in Asia being reported among health care and other hospital workers, as well as household contacts of the patients, Gerberding said.

That pattern of transmission is typical of any flu-like illness, she said, adding that health officials have no evidence that it can be spread through brief contact or among large groups of people.

In addition to the respiratory symptoms, signs of the illness can include initial rapid onset of high fever followed by muscle aches, headache and sore throat. Muscle stiffness, loss of appetite, malaise, confusion, rash and diarrhea are also common symptoms.

Early laboratory findings include low platelet and white blood cell counts.

In some cases, those symptoms are followed by pneumonia in both lungs, sometimes requiring use of a respirator.

-- CNN correspondent Patty Davis contributed to this article.

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