SARS back in Canada; 33 cases suspected

TORONTO — Weeks after Canada proclaimed itself free of SARS, hospital workers in Toronto once again donned masks and gowns yesterday to confront a new possible outbreak that officials said involved 33 suspected cases.

In Toronto, health officials ordered restricted access for all area hospital emergency rooms, repeating steps taken earlier this year against the largest SARS outbreak outside of Asia.

At least 500 people possibly exposed were told to quarantine themselves at home for 10 days as a precaution, they said.

Dr. Colin D'Cunha, the Ontario commissioner of public health, said 33 people were being tested for severe acute respiratory syndrome or SARS. All were believed to have contracted the illness in hospitals this month, he said.

Two of the suspected cases involved elderly patients who died in recent weeks. If confirmed, they would raise the SARS death toll in the Toronto area to 26.

A formal definition of a probable SARS case requires a link to a known SARS case, and that has yet to be established, D'Cunha said. But officials were proceeding as if all the possible new cases were SARS.

Despite the inability to trace the new cases to known cases, officials said there was no danger of an uncontrolled outbreak.

"This is not a disease out there in the general community," D'Cunha said.

The United States on Friday issued a travel advisory for Toronto, but the World Health Organization said more confirmation of an outbreak was needed before it announced such a similar warning.

WHO also had issued a travel advisory for Toronto on April 23, but lifted it a week later. Canada agreed to WHO demands to increase airport screening of international travelers and said it started using fever-detecting scanners at airports in Toronto and Vancouver.

For the first time since late March, no new cases were reported in Hong Kong yesterday. Taiwan had no new deaths for a second day in a row and Chinese officials said they saw a "notable downward trend."

SARS has spread to more than 8,000 people around the globe and killed nearly 700, the vast majority of them in Asia.