TORONTO, May 29 -- More than 5,000 people were ordered into
quarantine in Ontario today, and health officials reported 33 new
probable cases and 29 suspected cases of SARS, raising fears the
disease could spread rapidly once more.
Officials took measures to contain the new outbreak of the virus,
which lingered unnoticed in hospitals until it was detected again
last week. Authorities restricted hospital access and closed a
liquor store after they learned that an employee may have been
exposed to SARS during a hospital visit.
Medical officers issued warnings that those quarantined must obey
the isolation order or face being locked in hospitals. Among 2,000
people previously quarantined are about 1,700 students from Father
Michael McGivney Catholic Academy, which was closed after a student
suffering from SARS symptoms attended classes last week.
"Everyone is having to adjust again as we are dealing with this
whole new cluster of cases. We did the right things before. . . . We
will have success again," said James Young, Ontario's commissioner
of public security. He said the disease could be contained again if
people wash their hands and stay in isolation and if medical
investigators are successful in tracking SARS cases. "People have to
abide by isolation whether they are teenagers or someone else,"
Young said.
Health officials, still recovering from an outbreak in March and
April, said this second occurrence of SARS will worsen before the
situation is controlled. They expect the number of cases to increase
as the investigation continues and more people become critically
ill.
The source of the latest outbreak is unknown, but officials are
continuing to investigate how a 96-year-old man contracted SARS. The
man, who died on May 1, developed pneumonia after undergoing surgery
in the orthopedic unit of North York General Hospital. His case was
linked to the original spread of SARS from Scarborough Grace
Hospital, the epicenter of Toronto's outbreak in March.
The 96-year-old man, who did not show classical symptoms of the
disease, became a silent SARS case, transmitting the disease to
unsuspecting health care workers and other patients. As the disease
lurked stealthily, protection guidelines were lifted for health care
workers who were not working in SARS units and thus "became sitting
ducks for this infection," an official reported. The 96-year-old
man, however, was not a patient in a SARS unit, health officials
said. No one suspected him until other patients began showing
symptoms of atypical pneumonia that were not responding to
antibiotics.
Officials thought they had contained the spread of the disease
two weeks ago. Toronto was declared safe after the World Health
Organization removed the city from its list of SARS-affected areas
on May 14. Officials then focused on repairing the devastated
economy and trying to lure tourists back to the city.
But hospital workers said they never believed SARS had been
eradicated.
"The latest outbreak is a resurgence of the first outbreak," said
Richard Schabas, chief of staff at York Central Hospital. "The first
outbreak was not entirely extinguished. It was like an ember
smoldering in a fire. You think you put it out and the next thing
the wind comes up and you have a new fire."
Schabas said precautions for health care workers were lifted too
soon. "But the real issue isn't that," he said. "If you looked at
the data as it was known at the time, removing the precautions was a
good thing to do. The problem was the data wasn't good enough. We
didn't do intensive surveillance and case findings. We should have
been looking very hard at every hospital in Toronto to see if we
could identify not just SARS cases, but cases of pneumonia that
looked like SARS. We should have zeroed in on them."
Nurses said this week that they reported to their supervisors
recent cases of patients with unusual types of pneumonia. They
complained that the disease had time to spread because
investigations were not conducted until two days later.
A liquor store in Aurora, Ontario, was closed until further
notice, authorities said today. They were trying to find out how a
cashier at the liquor store contracted SARS when he visited a
hospital. The patient he was seeing did not have SARS. "He had
reason to visit the hospital May 23. He had a temperature before
that," said Colin D'Cunha, Ontario's commissioner of public health.
"He may have come in close personal contact with an infectious case
on that floor." Health officials say there was minimum risk to
customers in the store, but they have asked other employees to
isolate themselves.
Officials also said they were investigating several reports of
people in the United States who may be suffering from SARS-like
symptoms after visiting Toronto, but they said they think it is
unlikely the people have SARS. "There are a couple of situations in
Detroit and one in Pennsylvania and one in Arkansas," D'Cunha said.
Health officials in West Virginia said they were investigating
the case of a 68-year-old man who may have contracted SARS during a
recent visit to Toronto. The man, who was in critical condition in
Wheeling Hospital, has been classified as a probable SARS case
because his symptoms fit the disease and he was in Toronto last week
and a month earlier.
A WHO report from Geneva said Taiwan is close to bringing SARS
under control. WHO cited improvements in infection control in
hospitals, which have been the main source of outbreaks.
Taiwan posted 50 new probable SARS cases today. Taiwan has
reported 660 SARS cases and 81 deaths, with 177 cases coming since a
second wave of infections peaked seven days ago.
[On Friday, Taiwan reported seven new probable SARS cases, the
Reuters news agency reported.]
In the United States, the Centers for Disease Control and
Prevention reported that a U.S. doctor flown to Atlanta from Taiwan
last Friday may not have the disease. The doctor, Chesley Richards,
was thought to have contracted SARS in Taiwan, but authorities said
preliminary tests indicate he does not have the coronavirus that
causes SARS.
Richards remained in isolation and further tests will be
conducted, health officials said.
Staff writer Rob Stein in Washington and special correspondent
Tim Culpan in Taipei, Taiwan, contributed to this report.