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http://www.nytimes.com/2003/04/07/international/asia/07CND-HONG.html?ei=5070&en=f546ce446f20d280&ex=1050984000&pagewanted=print&position=top

W.H.O. Criticizes China Over Handling of Mystery Disease

By THOMAS CRAMPTON,

International Herald Tribune

HONG KONG, April 7 — As medical investigators puzzled over a possible new infection route for the mystery disease spreading round the world, the World Health Organization criticized China today as being uncooperative and secretive in handling the outbreak.

With the pace of new infections of the disease known as severe acute respiratory syndrome, or SARS, showing no sign of abating in Hong Kong, the authorities in Beijing revised disease data to include deaths in previously unreported regions. The number of victims of the disease worldwide grew today to more than 2,600 infected and 100 dead.

Specialists in Vietnam expressed concern that the little-understood disease may spread through those who suffer only minor symptoms. A small but telling outbreak in Vietnam came to light following a lapse in new cases longer than the disease's presumed incubation period of two to seven days.

"This is a very disappointing development in Vietnam," said Peter Cordingley, a spokesman for the World Health Organization. "We had hoped to hold the Hanoi model up as an example."

One theory now suggested by medical investigators is that infected people may carry the disease without suffering extreme symptoms. Healthy carriers of a disease are not unusual, the most famous of whom was Mary Mallon. Popularly known as Typhoid Mary, she spread typhoid fever in the United States without suffering symptoms herself.

The cluster causing concern in Vietnam included four members of the family of a 67-year-old man from Ninh Binh province, 60 miles south of Hanoi, who was hospitalized with SARS on Wednesday, the first reported case in 10 days.

Health authorities said they suspect that the man caught the disease from his son-in-law, who may have suffered a mild version after visiting his wife in a French hospital in Hanoi. Ten hospital workers and 8 patients have suspected infections and 14 family members must now undergo daily checkups.

Further highlighting how little is known about diagnosing the disease, the chief executive of a Hong Kong hospital was readmitted there today with a confirmed case of the disease after having been discharged on March 27.

Dr. Fung Hong of the Prince of Wales Hospital had been released after testing negative for coronavirus, which is thought to cause the disease. Today, however, a hospital spokeswoman said he had been readmitted and was listed in stable condition. The disease is thought to be caused by a previously unknown member of the coronavirus family.

Experts initially thought the disease could only be spread through close contact with droplets emitted by a cough or sneeze from a victim at the height of infection, but the Vietnam outbreak and the fast spread of the disease in the Amoy Gardens housing complex in Hong Kong have raised concern that alternative infection routes may exist.

Chinese specialists, who have been battling the disease since November, now say that many who died had a rare airborne form of the virus chlamydia, usually transmitted through sexual contact. The findings have raised questions as to whether SARS is caused by one virus or bacterium and made more lethal by another.

Medical authorities in Hong Kong have spent more than a week trying to understand how more than 250 residents of the housing complex became infected with the disease. The lack of a clear explanation for the outbreak was one reason cited by the World Health Organization when it warned travelers last week against traveling to Hong Kong and the neighboring Guangdong province of southern China.

Complaining that Beijing had not cooperated in fighting the disease, Gro Harlem Brundtland, director-general of the W.H.O., a U.N. agency, criticized China's silence over outbreak that began in southern China.

"It would have been definitely helpful if the international expertise and W.H.O. had been able to help at an earlier stage," Dr. Brundtland said. "I'm saying as the director-general of the World Health Organization: Next time something strange and new comes anywhere in the world, let us come in as quickly as possible."

Breaking with the previous policy of total silence about the disease, China's state television today reported that the country's death toll had risen by one, to 53. The report said this included 43 deaths in the Guangdong and one death each in the provinces of Shanxi in the north, Sichuan in the west and Hunan in central China, the first fatalities announced for those areas. The report gave no indication of when the deaths occurred.

Singapore's prime minister, Goh Chok Tong, became the latest in a long line of prominent individuals canceling trips to China. The Straits Times newspaper reported that Mr. Tong called off the official trip to Beijing on the advice of doctors.

In Beijing the International Labor Organization office was closed today for disinfecting. A Finnish official from the organization on Sunday became the first resident expatriate to die of the disease in China.

Health authorities in Hong Kong said today that one more person had died of the disease and 41 more had been infected, bringing the total deaths in the territory to 23 and the total infected to 883.

The outbreak continues to wreak havoc on Asian economies, with economists warning their growth predictions will be cut.

The virus has emptied Hong Kong hotels and prompted the territory's airline, Cathay Pacific, to cancel nearly a quarter of its weekly flights. Supporting stories by travelers that departing flights are filled with women and children, Hong Kong's immigration department reported that a net 133,400 people had left the city in the past 20 days.

In Singapore, Mr. Tong warned today that the nation's target of economic growth of 2 percent to 5 percent this year would be revised down due to the disease.

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