Singapore Orders Quarantines Over SARS

March 24, 2003
By D'ARCY DORAN

Singapore on Monday ordered about 740 people who may have been exposed to a mysterious flu-like illness to stay home for 10 days in efforts to contain the disease, which has sickened hundreds of people worldwide.

Health Minister Lim Hng Kiang said he was invoking the Infectious Diseases Act for what could be the first time since Singapore gained independence in 1965.

The city state of 4 million people has recorded 65 cases of severe acute respiratory syndrome, or SARS, including 14 new cases reported on Monday, Lim said. Twelve patients are in serious condition, he added.

"The number in (intensive care units) will increase, unfortunately, and there may be fatalities," Lim told reporters. "A stronger wall is now created to break the chain of infection."

Quarantined people caught outside their homes could face fines of up to $2,825 for a first infraction and $10,000 for a second offense, officials said.

Also Monday, Hong Kong officials reported 18 new cases of the disease, bringing the total to 260, and said two more patients had died - a man in his 60s who was infected with a blood disease as well as SARS and a man in his 40s who had hepatitis as well as SARS.

Many Hong Kong residents wore surgical masks as they went around town, hoping to avoid infection. A high fever, combined with coughing, shortness of breath or difficulty breathing, are some of the symptoms.

Dr. William Ho, chief executive of Hong Kong's Hospital Authority, became sick Sunday night, but it was not clear whether he had caught SARS, the authority's chairman, Dr. Leong Che-hung, said. Ho was hospitalized in stable condition Monday, Leong said.

Those on the quarantine list in Singapore included people who may have had exposure to infected people, including children at a school and a daycare, which will be closed for the duration of the quarantine.

Entire households will be quarantined and the government plans to arrange to deliver groceries to them and compensate people who could suffer financial difficulties due to lost income, Lim said.

National Environment Agency officers will monitor the quarantined people daily, checking for symptoms of the disease, the health ministry said in a statement.

SARS has made 386 people around the world ill and killed 11 people in the past three weeks, according to the latest World Health Organization figures.

The United States has reported 22 suspected cases, the WHO said. The State Department on Saturday warned Americans not to travel to Vietnam, one of the first countries affected.

Officials suspect SARS is linked with an earlier atypical pneumonia outbreak in mainland China's Guangdong province that killed five people and sickened 305. A World Health Organization team that arrived over the weekend in Beijing said Monday it was analyzing the Chinese cases in the scramble to unravel the disease.

Scientists hunting down the cause of the illness said they have a second suspect, a coronavirus, a family of viruses that includes the second most common cause of colds.

Until now, the leading candidate has been a paramyxovirus, a family which includes viruses ranging from mumps and measles to canine distemper.

"We have images emerging from the laboratory network that look like a coronavirus," said Dr. Klaus Stohr, a WHO virologist who is coordinating the laboratory work. "However, we know that some of the paramyxoviruses look, in the electron microscope, like coronaviruses, so we are getting more pieces of quite a complex puzzle."

"We now have two major groups and it's up to the laboratories to see where the virus is going to end up. I think it's going to be far more likely that it's going to be a paramyxovirus, but more data has to be collected."

Electron microscope images are not definitive because they only show the size and shape of the virus. Other tests, such as genetic profiling, are needed to confirm such findings.

Hong Kong officials also said about 100 health care workers and relatives were being treated with a combination of the anti-viral drug ribavirin and steroids and 85 percent were showing signs of improvement.

Some of the sickest Hong Kong patients were receiving injections of antibodies obtained from victims who have recovered and their initial responses appeared good, the territory's health secretary Dr. Yeoh Eng-kiong said.

© 2003 The Associated Press
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