Toronto hospitals prepare for more SARS cases

TORONTO -- Hospital workers in Toronto once again strapped on stuffy masks and gowns Saturday to confront a new possible SARS outbreak that officials said involved 33 suspected cases, weeks after Canada proclaimed itself free of the deadly virus.

The new cluster of possible cases of severe acute respiratory syndrome prompted U.S. health officials to issue a new travel alert for Canada's largest city.

The World Health Organization confirmed one new positive case but said more confirmation of an outbreak was needed before considering such a travel warning.

In Toronto, health officials ordered restricted access and use of protective masks and gowns for all area hospital emergency rooms, repeating steps taken earlier this year against the largest SARS outbreak outside of Asia.

At least 500 people possibly exposed were told to quarantine themselves at home for 10 days as a precaution, they said.

Dr. Colin D'Cunha, the Ontario commissioner of public health, said 33 people with respiratory illness were being tested for SARS. All were believed to have contracted the illness in hospitals over the past month, he said.

Two of the suspected cases involved elderly patients who died in recent weeks. If confirmed, they would raise the SARS death toll in the Toronto area to 26.

A formal definition of a probable SARS case requires a link to a known SARS case, and that has yet to be established, D'Cunha said. But the officials were proceeding as if all the possible new cases were SARS.

"Clinically, we think they have it," said Dr. Donald Low, a microbiologist at the forefront of Toronto's anti-SARS efforts.

Despite the inability to trace the new suspected cases to known cases, officials said there was no danger of an uncontrolled outbreak.

"This is not a disease out there in the general community," D'Cunha said.

A WHO spokesman in Geneva said one new case in Toronto tested positive, and results on other cases were expected shortly. Dick Thompson said Canadian officials reported 31 cases of respiratory illness they were checking for possible SARS. The figure he was given excluded the two dead patients.

The reports of a possible new outbreak in Toronto came on a day of rare good news out of Asia, where severe acute respiratory syndrome originated.

For the first time since late March, no new cases were reported in Hong Kong on Saturday. Taiwan had no new deaths for a second day in a row and Chinese officials said they saw a "notable downward trend."

But Canada received the latest bad news in a dismal week after the discovery of mad cow disease in the cattle heartland of Alberta prompted the United States and other countries to ban imports of Canadian beef products. Health officials also recently warned that Canada can expect an increase of West Nile virus in the summer mosquito season.

On Saturday, innvestigators placed three more Alberta farms under quarantine in search of North America's first case of mad cow disease in a decade.

Alberta Agriculture Minister Shirley McClellan said 16 farms were now under quarantine -- 11 in Alberta, where the recent case of bovine spongiform encephalopathy, or BSE, was found; two in Saskatchewan to the east; and three in British Columbia to the west.

An editorial cartoon in Saturday's National Post newspaper showed a family walking outdoors exclaiming, "Aaah ... the weekend," all dressed in protective suits and helmets -- even the dog.

SARS has spread to more than 8,000 people around the globe and killed nearly 700, the vast majority of them in Asia. Canada earlier saw about 150 cases and 24 deaths.

Ontario and Toronto health officials said Friday an apparently undiagnosed SARS case at North York General Hospital may have infected health care workers, other patients and their family members in 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. It was not known where the new cases may have come from.

A third hospital, St. Michael's, closed its neurosurgery units until June 2 after learning a potential new SARS patient was treated there recently without respiratory precautions, D'Cunha confirmed Saturday. More than 50 staff members were put into 10-day quarantine.

Toronto was removed from the WHO list of locations with SARS earlier this month when more than 20 days -- the length of two SARS incubation periods -- had passed since the last known case on April 19.

WHO also had issued a travel advisory for Toronto on April 23, but lifted it a week later. Canada agreed to WHO demands to increase airport screening of international travelers and said it started using fever-detecting scanners at airports in Toronto and Vancouver, British Columbia.

The SARS outbreak that first appeared in March hit Toronto's vital tourism and convention industry hard as travelers canceled plans to visit the city. Ontario and city officials launched aggressive marketing campaigns to lure back business and visitors.