Killer Respiratory Virus Still A Mystery To Experts As Death Toll Mounts

Sydney Morning Herald

Tuesday March 18, 2003

Richard Macey

Just 20 days have passed since a man complaining of a high fever, dry cough and a mild sore throat checked into a Hanoi hospital.

Since then he and another eight people have died and hundreds more have fallen sick, with cases reported in Hong Kong, China, Canada, Singapore, Thailand, Indonesia, the Philippines and Germany.

In each case the patient has either been in South-East Asia, or has been in close contact with someone who has been there recently.

However, the cause remains a mystery, leading a Westmead Hospital virologist, Dominic Dwyer, to speculate yesterday that the pathogen may be either a new virus or bacteria, or a mutated version of a known one.

``Usually with respiratory disease it doesn't take too long for it to be detected in standard laboratory tests, but so far the organism hasn't been identified.

``It is probably a variant or something new because an obvious cause would have been picked up by now."

Dr Dwyer warned it may be just a matter of time before the first case of Severe Acute Respiratory Syndrome, or SARS, turns up in Australia. ``I think a case could appear in Australia, considering our connections with South-East Asia," he said.

By Saturday, 42 more cases had appeared in Vietnam almost all involving people who had been in direct contact with the Hanoi hospital. The one exception was the son of a health care worker.

More than 100 people have become ill in Hong Kong and seven have fallen sick in Canada, including two who died.

China's health authorities have reported a similar illness hitting more than 300 people, killing five, in Guangdong, north of Hong Kong.

Dr Dwyer said world health authorities watched closely for any sign of severe respiratory illnesses coming out of areas in or near southern China, a known source of influenza.

However, all influenza tests conducted so far had proved negative.

Medical researchers would now conduct a long series of tests for ``20, 30, 40 or more" known causes of disease to see if any provided a possible match.

``It's quite an investigative job, a bit of a shopping list of organisms," he said. ``It is most likely a virus, but we don't know, and that's the reason for concern."

Dr Dwyer said Australia had protocols in place to deal with such outbreaks. The first stage identified medical authorities who should be alerted when outbreaks happened overseas.

Protocols covered everything from advice to general practitioners, through travel warnings to upgraded nursing rules for hospitals.

``Everyone is taking this very seriously," Dr Dwyer said. ``I am sure we will get an answer."

DEADLY SPREAD

VIETNAM

Feb 26 Man travelling from Shanghai and Hong Kong admitted to Hanoi hospital. Later transferred to Hong Kong, where he dies.

March 5 7 Hanoi hospital workers become sick.

March 15 43 sick, 2 dead (including first patient).

THAILAND

March 11 A health worker who travelled from Hanoi to Thailand on March 11.

CHINA

Mid-February Similar symptoms appeared in 305 sick in Guangdong province, killing 5.

HONG KONG

March 12 20 health workers sick.

March 15 More than 100 sick in hospital.

PHILIPPINES

1 unconfirmed case

SINGAPORE

March 13 3 cases reported. All had been to Hong Kong.

March 15 13 more sick. All had been in close contact with 3 previous cases.

INDONESIA

March 15 1 unconfirmed case.

GERMANY

March 15 a sick health care worker from

Singapore arrives in Frankfurt on a flight from New York.

CANADA

March 15 7 cases, two died. The cases involve two different extended families,

both of which had at least one member return from Hong Kong in the previous week.

© 2003 Sydney Morning Herald

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