Posted 5/23/2003 9:15 PM Updated 5/23/2003 11:21 PM
Canada may return to WHO list of SARS-affected areas
TORONTO (AP) — U.S. health officials reinstated a travel alert for Toronto Friday as Canada announced a new cluster of about 20 possible SARS cases in Toronto.
The alert came as a harsh blow for Canada's largest city, which was removed from the World Health Organization's list of SARS-affected areas last week after apparently snuffing out the biggest outbreak of the illness outside of Asia.
The Centers for Disease Control and Prevention cited possible new cases of severe acute respiratory syndrome in renewing the alert, which warns Americans to take precautions when traveling to a particular area. It stops short of the next step of advising against the trip.
The SARS outbreak in Canada is the worst outside Asia, prompting emergency rooms throughout Toronto, the site of most cases, to operate under special restrictions that limit access. Hundreds of people have been advised to go into a 10-day quarantine in case they were exposed.
At a somber evening news conference, Ontario and Toronto health officials said an apparently undiagnosed SARS case at North York Hospital may have infected health care workers, other patients and their family members on one ward in late April.
A patient transferred from the ward to St. John's Rehabilitation Hospital was considered the likely source of four more cases under investigation, they said. The five possible cases at the second hospital were announced earlier Friday.
Dr. Donald Low, a microbiologist and major figure in the city's anti-SARS efforts, said the new cluster could involve two deaths of elderly patients. If confirmed, they would increase the SARS deaths in the Toronto area to 26.
"It's been a rough day," Low said. "We're assuming the worst, that there's a likely transmission to health care workers and family members."
Asked how many possible new cases were involved, Low said: "It's so fluid right now, it's unfair to put a number on it, but I think we're talking twenties."
Ontario Health Minister Tony Clement called the situation a setback, while Dr. Colin D'Cunha, the province's commissioner of public health, said it was uncertain if all the possible cases would be confirmed as severe acute respiratory syndrome.
Toronto last reported a new SARS case on April 19.
A WHO spokesman said Friday that determining the source of the latest cases would determine if Toronto gets put back on the U.N. agency's list of SARS-affected areas.
"Nothing has changed at this point," spokesman Iain Simpson said from WHO headquarters in Geneva.
Canadian officials had lobbied hard to get Toronto off the SARS pariah list, saying its continued inclusion sent the wrong message to the world about the state of the city's outbreak, believed to be all but over.
The SARS outbreak caused economic damage in Toronto, harming the vital tourism and convention industry as Americans and others canceled plans to visit the city.
News of the possible new cases came as Canada struggled with the first North American case of mad cow disease in a decade, involving a single cow in Alberta. The United States and other countries have banned imports of Canadian beef products, which economists say could reduce Canada's economic growth.
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(USA ONLine Edition)
http://www.usatoday.com/news/health/2003-05-23-sars-canada_x.htm