Traveler's dilemma: Mystery virus forces decision on long-planned China trip

I left Seattle two weeks ago today, flying on a bankrupt airline three days before war began.

By the time I reached Honolulu, the first stop on what was to be a two-week fellowship program to mainland China and Hong Kong, I had a hunch I'd be returning sooner than expected.

By Wednesday, I was on a plane back to Seattle. As I watched "Harry Potter" and ate chicken teriyaki, the United States began bombing Iraq, though that wasn't the primary reason my plans were canceled.

Rather it was SARS — severe acute respiratory syndrome, a flu-like virus spreading throughout Asia.

With little known about the virus and developments changing by the hour, the World Health Organization, the United Nations' health body, issued its first global health alert in a decade.

The Centers for Disease Control and Prevention in the United States went further, recommending that people consider postponing nonessential travel to Hong Kong, the Guangdong Province in China and Hanoi. And this week, the U.S. State Department weighed in, urging people, especially those with young children, not to travel to Vietnam.

Staying informed

Talk about the war has mostly drowned out news about SARS and the kinds of last-minute decisions epidemics like this pose for travelers. The virus has been linked to a pneumonia outbreak in China that started last November, bringing the number of combined reported cases to 1,300 in 13 countries as of last Wednesday.

The global death toll from the outbreaks climbed to 52 as of midweek, and concerns have been heightened by quarantines and school closures in Singapore and Hong Kong, refusals by commercial air carriers to transport patients and reduced hospital capacity in Vietnam.

To me, these are far more serious reasons to think twice about travel than the perceived risks of being a victim of a terrorist attack or running into anti-American sentiment in Paris.

But I didn't have to make the decision whether or not to go ahead with my trip. The coordinators of my program at the East-West Center in Honolulu made that decision for me — and it was just as well because I'm not sure what I would have done.

I'm not one to follow government warnings without question. My heart said "go," but my head said "find out more." But how? I was away from home without my usual access to sources of information. Changing plans would mean hassles and disappointment.

As I waited to hear back from my hosts, I decided to investigate.

I remembered some information I had received when I contacted the nurse at Group Health Cooperative's travel clinic several weeks before I left. She had sent me a report on the areas where I would be going — mainly the Guangdong Province of China and Hong Kong.

The report mentioned a respiratory illness and listed the symptoms — high fever, dry cough, shortness of breath or breathing difficulties. It wasn't considered serious at the time, but now that information was helping me put things in perspective.

The Honolulu newspapers reported the SARS story, but details were scarce, and I wasn't ready to buy into the "Killer Pneumonia" headlines I saw in some other papers.

I trust The New York Times, especially when it comes to medical reporting, but it doesn't arrive in Hawaii until late in the afternoon, so I went out to find an Internet cafe where I searched the Web, read the Times online and printed out the latest reports from the CDC and World Health Organization.

Developments were moving fast. Health-care experts could not identify the virus. The disease, although not believed to spread through casual contact, wasn't responding to any known treatments.

Hong Kong officials maintained that the virus was under control. But I got a different impression when I checked some airline Web sites. Singapore Airlines was offering anyone worried about SARS the opportunity to rebook, one clue that the outbreak was being taken seriously in Asia.

Another clue to the potential problems for travelers: The airline reminded passengers that it has a policy of not carrying anyone with any known infectious disease. "Boarding may be denied to customers in such circumstances," it said.

Talking to locals

I left the Internet cafe, and took a walk through Chinatown. There I met Chuck Wu, who sold me a honeydew melon pearl drink at Penny's Ice Dessert stand in the Oahu Market. He tried to convince me that continuing with the trip was not a good idea.

"You've got your health. Stay in Hawaii," he said. Wu was born in Thailand but lives on Oahu. His sister was planning a trip home the next day with her two children. "She'll go, but she'll leave the children here," he told me. "This is serious." While Americans tend to exaggerate things, Asians tend to keep things quiet, Wu said. "So when Asian people start talking about this, you know it's a big deal."

It also occurred to me that getting in touch with someone who lives in Hong Kong might be a good idea, so I called my husband. He had already talked with a co-worker who has family there. She confirmed that people were worried.

That afternoon I went back to my hotel and listened as President Bush gave Saddam Hussein a 48-hour ultimatum. The Department of Homeland Security raised the national terrorist alert level to orange. Although most of our group suspected we'd be traveling during wartime when we signed on for the fellowship, the reality of the problems that might pose combined with the SARS advisory was enough to cause our hosts to reconsider.

"Three strikes and we're out," the director at the East-West Center in Honolulu said when he called me that evening to tell me the trip would be postponed.

"What did the Chinese health officials know and when did they know it?" the Wall Street Journal asked in a story published the next day. The story suggested that the world may have been intentionally left in the dark about the November outbreak of what's now believed to be the same disease, and quoted journalists in Shenzhen and Shanghai as saying they were ordered not to report on the illness, even as their employers passed out herbal medicines to staffers.

I still can't say for sure what I would have decided on my own two weeks ago.

If we had gone ahead with our trip, we'd be in Hong Kong today where the streets are filled with people wearing face masks, and the city's hospital chief fell ill last week with SARS symptoms.

Yet I'm a healthy person and with 6.8 million people in Hong Kong, chances are slim I would be among the 300 in that city so far affected by SARS. My chances of being hit by a car while crossing the street would be far greater.

What I do know is that I have a much better idea of how to stay informed while traveling, and a renewed sense of how important that is in the face of headlines that scream "Killer Pneumonia" and bulletins from governments with self interests to protect.

Resources

Keeping yourself abreast of health risks while traveling begins at home.

"The key message is that traveling anywhere has its risks, and you need to realize what the risks are for you as an individual," says Dr. Ted Eytan, a family doctor at Group Health Cooperative in Seattle.

Before you leave, check with your doctor or health maintenance organization on the latest information available about the countries where you'll be going. Make sure your immunizations are current and that you have emergency contact information.

Group Health publishes a handy booklet with travelers health tips and emergency phone numbers. Members also can sign up for e-mail access to their doctor.

Updated medical information can be found on the CDC's Web site at www.cdc.gov and the World Health Organization's site at www.who.int/en.

Information on general travel and health information also is available from the King County Health Department at www.metrokc.gov/health and the University of Washington Travel Medicine clinic at healthlinks.washington.edu/clinical/travelmed.html.

Carol Pucci's Travel Wise column runs the last Sunday of the month in Travel. Comments are welcome. Contact her at 206-464-3701 or cpucci@seattletimes.com