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Pneumonia strain a 'global threat'

A traveler arrives in Taipei from Hong Kong. Taiwan has warned against nonessential visits to China.
A traveler arrives in Taipei from Hong Kong. Taiwan has warned against nonessential visits to China.

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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.

HONG KONG, China (CNN) -- Health officials around the world are on alert for a powerful strain of pneumonia that has killed at least nine people and sparked a World Health Organization warning.

The disease, called severe acute respiratory syndrome (SARS), has infected people from China to Canada, with more than 150 new or suspected cases reported in the last week.

The severe form of pneumonia does not appear to respond to treatment, prompting the WHO to say the illness is a "global threat."

So far the outbreak has been reported in Canada, China, Hong Kong, Indonesia, the Philippines, Singapore, Thailand, and Vietnam.

The spread of the disease has prompted the WHO to take the rare step of issuing an emergency travel advisory, and put airlines on alert for cases of suspected pneumonia among passengers.

WHO has not yet recommended travel restrictions but has advised all travelers and airlines to be aware of SARS and its symptoms.

Cathay Pacific Airways on Monday ordered its staff not to check in any passengers who show any signs of the illness, a move repeated in airports around Asia.

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

The Centers for Disease Control and Prevention based in the U.S. has urged people to consider alternatives if they have plans to travel to the affected areas.

The outbreak is believed to be centered in Hong Kong where 49 medical staff are hospitalized, two of them in critical condition.

An American-Chinese man who flew to Hong Kong from Hanoi with pneumonia died Friday morning and a Vietnamese nurse who treated him in Hanoi's French Hospital died Saturday.

Two members of an American-Canadian family died in Canada last week after returning to North America from a holiday in Hong Kong.

U.S. warning

The CDC "is advising persons traveling on non-essential 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.

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 after showing signs of SARS, German and New York City health officials said.

A woman helps put a mask on a boy in the emergency ward of a hospital in Hong Kong.

The doctor, who was in New York for a conference, had 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.

Asked whether the outbreak could have been caused by terrorism, Gerberding said, "We have to keep an open mind."

Transport authorities, however, are not convinced the matter is anything other than a health issue.

"All information at present indicates this is a public health issue unrelated to any act of terrorism," a spokesman for the Transportation Security Administration, which oversees security on airlines, said

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.

High fever

Taiwanese health workers put on protective clothing.
Taiwanese health workers put on protective clothing.

The illness appears to be spread person-to-person, through coughing and sneezing, which is typical of any flu-like illness, CDC's Gerberding said, adding that health officials have no evidence that it can 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 report

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