SARS quarantine ordered for hundreds in Hong Kong

U.N. health organization issues travel warning to stop spread of illness


HONG KONG - As the World Health Organization issued a travel warning yesterday, top officials in Hong Kong ordered the quarantine of more than 1,000 people and the closing of all primary and secondary schools for nine days.

Hong Kong's Health Department announced that 51 more patients had been hospitalized with pneumonia and other symptoms of severe acute respiratory syndrome, or SARS. It was the biggest single-day jump in the number of cases, raising the total to 367.

WHO said passengers with flu-like symptoms or those who may have been exposed to severe acute respiratory syndrome, or SARS, should not be allowed to fly.

"If the passengers are sick, health workers will be recommending to the airline that they not board the plane," said Dr. David L. Heymann, WHO's infectious diseases chief.

The advice - WHO can only make recommendations to governments - is directed at flights leaving areas where the disease is spreading locally: Toronto; Singapore; Hanoi, Vietnam; Hong Kong; Taiwan; Beijing, Shanghai and the Chinese province of Guangdong, where the earliest cases of SARS occurred.

WHO says that 1,408 people have fallen ill with SARS worldwide and that 53 people have died - not including a death yesterday that Hong Kong officials were reporting.

During a news conference yesterday, Hong Kong Chief Executive Tung Chee-hwa appealed for sick people to come forward. Although no cure has been found, progress has been made in treating the symptoms, especially when the disease is caught early, he said.

"For our health and for the health of our community, we have to win this battle," Tung said.

There has been growing criticism here of mainland China for having told Hong Kong officials almost nothing about the disease after doctors encountered the first few cases in adjacent Guangdong Province. China admitted Wednesday that 792 cases of the disease had been recorded by the end of February and that 31 people had died.

Tung, an ally of Beijing, did not directly address the subject when asked about it yesterday evening. He said only that the mainland had agreed to establish a process of close cooperation with Hong Kong on health issues. Britain handed over Hong Kong to China in 1997, but Hong Kong has retained separate legal, economic and health systems.

Dr. Yeoh Eng-kiong, Hong Kong's secretary of health, welfare and food, said at the same news conference yesterday that there had been some encouraging signs. Many of the earliest patients have begun to recover, although in some cases after nearly a month in the hospital.

Yeoh warned residents to expect more new cases. "How much virus there is in the community, we don't know," he said.

On Monday, Singapore decided to close all schools and quarantine in their homes the more than 800 people who have been in contact with the city-state's 69 victims. Hong Kong has had more than four times as many infected people, and Singapore's first three victims are believed to have been infected here.

When Singapore announced its quarantine, Hong Kong health officials said that they did not have comparable legal powers. But Yeoh said last night that an old colonial ordinance, unused for decades, gave his department what he described as "very draconian powers."

The Hong Kong government will order 1,080 family members of SARS victims to stay home except for daily visits to government clinics to check for the disease. Those who violate the quarantine face fines of up to $640 and up to six months in jail.

Nearly a thousand more people who have had limited contact with patients will be asked to keep the Health Department informed of their health.

Malik Peiris, the chief of virology at Hong Kong University, said at a news conference yesterday afternoon that a new diagnostic test had been developed that determines the presence of the virus that apparently causes SARS.

Arthur Li, Hong Kong's secretary of education and manpower, said 1 million primary and secondary students will not be allowed to attend school from tomorrow through April 6.

Tung also announced last night that Hong Kong would begin requiring all visitors to fill out a health declaration upon arrival. Health Department employees will be posted at border crossings and the airport to observe travelers and assess their health.

World health officials knew the disease had spread beyond Asia by international air travel March 15, when cases turned up in Canada. At the time, though, it was not clear whether those people were sick while on the plane or whether they got sick after getting home.

"Now we know that there are people who are traveling when they are sick," Heymann said. "There have been more and more cases who have traveled on airplanes and we aren't yet 100 percent sure of how this disease is spreading."

He said experts remain convinced that the infection is spread only by very close contact through coughing and sneezing.

But there may be people with a less severe bout of the illness, or some who are infected but showing no symptoms, who are transmitting it, Heymann said.

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