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WHO defends Toronto travel advisory

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ONTARIO, Canada (CNN) -- The World Health Organization on Thursday defended its recommendation that all non-essential travel to Toronto be delayed, and said it won't consider lifting the advisory for at least three weeks.

"For the risk group to drop, we have to say that no new cases or no new exports have occurred three weeks after the reported cases," said Dr. Julie Hall, head of the international health agency's global outbreak and alert response unit.

Only at that point would the travel advisory be downgraded, she told reporters in a conference call from Geneva.

Three weeks represents roughly twice the 10-day incubation period -- the time from exposure to onset of symptoms. "There's a lot of uncertainty, and we need to make sure that the double incubation period has fully passed," she said.

The decision to issue Wednesday's advisory was based on three factors: the number of new cases coupled with the size of the outbreak in the country, the number of cases exported from the country and how the disease is transmitted, she said.

Wednesday's announcement sparked furor among Canadian health and political officials, who declared it an overreaction based on incomplete information. (Full story)

Ontario Medical Commissioner Colin D'Cunha and other officials said there is no evidence of casual transmission of the disease. Authorities believe they know how each case has been transmitted, with the disease being confined to hospitals, a few households and some isolated areas of the community.

Canada has reported 140 probable cases of SARS, including 16 deaths.

"We have not seen and continue not to see casual transmission in our cases," said James Young, Ontario's commissioner of public safety. "It is perfectly safe to walk down the street in Toronto."

CDC official: 'I didn't bring any masks'

A member of the U.S. Centers for Disease Control and Prevention agreed.

"The Canadian situation differs in nature from the community spread that has occurred in other parts of the world," said Clifford McDonald, who was in Ontario.

McDonald said the CDC has issued a "travel alert" to inform those traveling to Toronto of the SARS situation, but he said that is far from a "travel advisory," which recommends postponing all but essential travel to the region. The situation in Canada has not met the CDC's criteria for a travel advisory, he said.

"I didn't bring any masks to wear on the street," McDonald said.

But cases of SARS have already been exported from Ontario to the United States, Australia and the Philippines, WHO's Hall said. And WHO is investigating a possible case that may have been spread to Bulgaria, she said.

The three cases exported to Australia and the one case to the United States were identified quickly and isolated with no further spread, she said.

But the traveler to the Philippines appears to have infected at least one other person there, she said. Another 60 contacts who are showing no symptoms of the disease have been isolated and are under observation, she said.

"It does show how one person, one case, can potentially spread the disease to a considerable number of people," Hall said.

Officials have been unable to explain why the mortality rate has crept up to 5.9 percent, up from less than 4 percent just three weeks ago.

One suggestion is that the coronavirus that causes the disease could have mutated into a more virulent form, but Hall said there is no evidence it has mutated "in any way at all."

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