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Toronto back on WHO SARS list

St. Michael's Hospital,Toronto
Toronto is again confronting a cluster of SARS cases.

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TORONTO, Canada (CNN) -- Toronto has been returned to the World Health Organization's SARS-affected list, 10 days after being taken off.

It was added to the transmission list Monday after three more reported deaths from the disease. A further 26 suspected cases were reported as well as eight deemed probable. (Canada's new outbreak)

It is feared the number of cases could rise as four hospitals, believed to be at the center of the latest outbreak, are investigated. But the WHO is not recommending any travel restrictions at the moment it said in a statement on its Web site.

"Actions being taken include immediate isolation of all cases, heightened infection control, intensive contact tracing, and voluntary home quarantine of contacts," the site said.

"These measures have proved highly effective in quickly containing outbreaks."

About 800 people are in quarantine. The WHO reported Monday that a total of 148 probable and suspected SARS cases existed in total in Canada, including 27 fatalities, since the outbreak began.

Canada thought it had contained SARS and declared itself free of the disease a week ago, but has now found itself struggling with the largest outbreak outside Asia.

The virus is mainly infecting health workers and patients' families and has not spread to the community, officials say.

Dr. Paul Gully, of Health Canada, said the new cases were likely to be the result of hospital transmission from a single case.

He added: "For people coming to Toronto, there is not a risk. There is not a risk unless you are going to a hospital. Those hospitals where there was a risk would not be open to you anyway."

Screening at airports for SARS will resume. Last week, based on the new cluster of cases, the U.S.-based Centers for Disease Control and Prevention issued an alert for anyone traveling to Toronto. An alert does not advise against travel to the area, but informs travelers of a health concern and gives them advice to reduce their risk of exposure.

Canadian officials add that a link has been found between the new cluster of cases and the original outbreak, last seen in April.

On 23 April, WHO advised people planning to travel to Toronto to consider postponing all but essential trips. This recommendation was lifted on 30 April, following epidemiological evidence that the outbreak had been controlled to an extent that travellers were no longer at risk.

On 14 May, Toronto was removed from the list of areas with recent local transmission after it recorded a 20-day SARS free period.

In a separate move Taiwan officials said they are cautiously optimistic that SARS is "under control" among its population after reports that the number of new cases is falling.

The drop to 15 cases Monday was not enough to stop the disease claiming its third political resignation. Taipei's health bureau chief Chiou Shu-ti quit over a major outbreak in a city hospital.

So far 72 people have died on the island from SARS. More than 580 cases have been reported, with officials hoping the disease peaked on Thursday when 65 cases were reported.

But the WHO said on its Web site that Taiwan "continues to have the most rapidly growing outbreak."

"Taiwan now has more than twice the caseload of Singapore (206 probable cases), which was among the most severely affected initial outbreak sites," it added.

The global death toll from SARS pushed past 700 on Sunday.

China, which is the hardest-hit area in the world, reported its smallest one-day rise in new SARS cases since it began tallying figures. It counted two more deaths and another eight infections on Monday.

One of the deaths and five of the new cases were in hard-hit Beijing.

While noting the falling number of new cases, China's executive vice minister of health Gao Qiang told local officials the situation "remains grave" with prevention and treatment still "enormous and difficult," the state-run Xinhua news agency reported.

While the World Health Organization lifted an advisory against travel to Hong Kong and the southern province of Guangdong on Friday, the health body still advises against nonessential travel to Beijing and four other Chinese regions, as well as to Taiwan.

It is believed the epidemic originated in Guangdong province, and researchers said Friday that they might have traced the disease to civet cats, considered a delicacy by some Chinese. (Cat clues)

After marking its first day with no new cases on Saturday, Hong Kong on Monday said SARS had killed one person in the city and infected another.

Just days after the lifting of the WHO's travel warning, the airport authority in the SARS-scarred territory of 6.8 million people said it would halve its landing fees for airlines over the next six months.(HK cuts fees)

Hong Kong is one of the world's busiest airports but it has been rocked by SARS, with many airlines cutting flights to the territory.


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