Asia's mysterious illness

GENEVA

Doctors focused their search for the cause of a mysterious flu-like illness Wednesday on a family of common respiratory viruses and raised the possibility that some early victims caught the disease in a Hong Kong hotel.

Meanwhile, officials said more people had died from the disease, bringing the total to 14 and for the first time listed 11 suspected cases in the United States.

The worldwide number of cases now totals 264, most of them in Hong Kong, Vietnam and Singapore. The 14 deaths from what is being called "severe acute respiratory syndrome," or SARS, include five who died months earlier in an outbreak on mainland China.

Investigators said Wednesday that seven of those infected, including one who died, had all stayed on or visited the same floor of Hong Kong's Metropole Hotel before the outbreak prompted a global alert. The discovery may be significant, because until now officials have said close personal contact is necessary to catch the illness.

Dr. Margaret Chan, director of the Hong Kong Health Department, said all had been on the ninth floor between Feb. 12 and March 2. They were three from Singapore, two Canadians, a man from mainland Cnina who later died, and a Hong Kong resident whose illness spread to dozens of workers at Hong Kong's Prince of Wales Hospital.

No hotel workers have become ill, and Chan did not say whether there was any other connection among the guests who got sick.

"The hygiene condition in the hotel is fine," she said. "We believe that the virus has already disappeared."

Around the world, labs searched victims' nasal secretions, blood and tissue for signs of paramyxovirus, the family of viruses including such ubiquitous bugs as the respiratory syncytial virus and the parainfluenza viruses, as well as those that cause such common childhood illnesses as mumps and measles.

"My suspicion is it may be a new virus within that family," said Dr. Larry Anderson, a virus expert at the U.S. Centers for Disease Control and Prevention in Atlanta.

Specialists in Germany and in Hong Kong report finding signs of paramyxovirus in victims there.

"We've identified the virus," Dr. John Tam, a microbiologist at the Chinese University of Hong Kong, said late Tuesday. "We used electronic microscope and found the virus in patient samples."

Some experts caution, however, that it still is too soon to be sure this is the culprit. Members of this family of microbes are extremely common, and they could be present by chance without causing the mysterious disease.

Nevertheless, the finding is the first potential clue to emerge in the three weeks since the illness came to the attention of health experts.

Dr. Yeoh Eng-kiong, Hong Kong's secretary for health, welfare and food, said experts believe they have found "a variant of a respiratory virus that causes infection in children," rather than a new virus type.

Yeoh called it "very, very peculiar" that all the current infections are in adults.

"The behavior of the virus is quite strange," he said.

Dr. Joseph Sung of Chinese University's Department of Medicine told The Associated Press that researchers are "quite certain" paramyxovirus is the cause, after they found more patients with the virus.

Yeoh said a combination of drugs, including steroids, seems to have helped alleviate symptoms in some patients.

The disease, first described as a new form of pneumonia, has sickened 219 people worldwide in about the past three weeks. Five of the deaths were in China during an earlier outbreak that officials suspect had the same cause.

Most of the illnesses have been health workers in Singapore, Hong Kong and Vietnam. Japan confirmed three cases Wednesday. Romania said it had one, a woman who recently traveled to China.

The doctor who died Wednesday had treated an American businessman for the illness at the Hanoi French Hospital in Vietnam, hospital director Yves Nicolai said. The businessman later died after being transferred to Hong Kong.

A nurse at the same hospital, who also treated the American, died Saturday.

Unconfirmed cases were being investigated in many other places, including the United States.

Four people suspected of having the illness are hospitalized in France. A few probable cases also have turned up in England, Taiwan and Slovenia.

WHO said its laboratories now will study other samples to see if the same virus is present.

"There is now a clue about what might be causing this," said Dr. David Heymann, communicable diseases chief at the Geneva-based U.N. agency. "This clue will make it easier to diagnose patients."

The incubation period for SARS appears to be three to seven days. It often begins with a fever above 100 degrees and other flu-like symptoms, such as headache and sore throat. Victims typically develop coughs, pneumonia, shortness of breath and other breathing difficulties. Death results from respiratory failure.

Heymann said WHO continues to get reports that some patients seem to be getting better.

News of the latest death prompted a run on vitamins and surgical masks at Vietnamese pharmacies. Thai Airways said it would provide free surgical masks to passengers, and Vietnam's airline said it was using anti-bacterial sprays on its planes.

Many airlines were turning away passengers with flu-like symptoms.