http://www.newscientist.com/news/news.jsp?id=ns99993984

Hong Kong fears possible SARS comeback

14:29 25 July 03

NewScientist.com news service

Eighteen people linked to a Hong Kong psychiatric institution have been hospitalised with respiratory symptoms and are being tested for the deadly SARS virus.

All have tested positive for influenza A, but this has not calmed fears that SARS - Severe Acute Respiratory Syndrome - could be making a comeback. Hong Kong medical experts are saying extensive tests are needed for accurate diagnoses.

"It will take another two to three days at least for the results of comprehensive tests to be out," a Hong Kong health department spokeswoman told Reuters on Friday. "Influenza peaks in July and August here. These cases could be influenza."

Preliminary SARS tests on the patients, admitted to hospital between Sunday and Thursday, were negative. But Hong Kong microbiologists say these are not entirely reliable.

The 18 patients were taken ill with coughs and fever at a psychiatric institution. Sixteen were patients, one was a staff member and one a relative.

Bad luck

Experts in the UK contacted by New Scientist say that although it is possible the patients might have both flu and SARS, it is unlikely.

"It's theoretically possible, but it would be hopelessly bad luck to have caught both influenza and SARS at the same time," says John Oxford, a virologist at Queen Mary, University of London. "I would be surprised if they had both."

Robert Booy, an infectious diseases expert also at Queen Mary, agrees that "co-infection is possible". But he says doctors will approach the cases with the idea that the simplest explanation - flu - is the most likely. But, as a general rule he says, five to 10 per cent of people who become unwell do have a co-infection.

SARS emerged in China's Guangdong province in November 2002, before rampaging across the world. It infected more than 8400 people and caused over 800 deaths in about 30 different countries.

Hong Kong - with over 1750 cases and 298 deaths - was the second worst hit country after China. It was removed from the World Health Organization list of affected areas in June.

Shaoni Bhattacharya