Canada quarantines 5,000 due to SARS

Toronto - Authorities seeking to control the spread of a new cluster of SARS cases have quarantined more than 5,000 people in Toronto and warned that the number of suspected cases will likely rise. 

The latest people to be isolated in Canada's largest city were 1,700 students and staff at a suburban Toronto high school, who were told to stay home for 10 days after a classmate showed symptoms of SARS, health officials said Wednesday. Father Michael McGivney Catholic Academy in Markham was also closed until June 3 as a precaution.

Two more elderly patients died, raising the overall SARS toll to 29 deaths in the Toronto area in the biggest outbreak of severe acute respiratory syndrome outside of Asia.

Dr. Colin D'Cunha, the Ontario commissioner of public health who announced the deaths and latest figures, said 50 more cases were under investigation and the number of probable or suspected cases will rise.

"Absolutely there will be more in the next few days," said Dr. James Young, the province's commissioner of public safety.

The spread of a new cluster of SARS cases is known to have infected 11 people and to be suspected in 23 others.

"This is a problem that is serious, but it is not dangerous at all to travel to Toronto," said Canadian Prime Minister Jean Chretien during a visit to Athens, Greece.

The first SARS outbreak in Toronto began when a woman who traveled to Hong Kong in February contracted the disease there.

The 78-year-old woman died on March 5 in Toronto and her son died of SARS a week later, but not before the disease had spread to several other people, including patients and health-care workers at the hospital where they were treated.

Thousands of people were subsequently quarantined as health officials scrambled to contain the outbreak and Toronto was removed from the WHO list of SARS-affected areas on May 14 after more than 20 days passed without a new case being reported.

But the WHO returned Toronto to the list of SARS-affected areas after the latest cases were made public last week. The new cluster is believed to come from an elderly patient whose case dates from April 19.

At least 5,000 people in Toronto are currently under quarantine, health officials say.

On Wednesday, the World Health Organization (news - web sites) advised Canada to broaden its definition of SARS cases after a health official expressed concern that the current one provided an incomplete account of the situation.

Dr. Donald Low, a microbiologist and key figure of the anti-SARS team dealing with the Toronto-area outbreak, said the number of new probable cases would be well over 20 if officials used the same definition applied during the initial outbreak in March and April.

On the Health Canada Web site Wednesday, a probable case was defined as someone showing a severe progressive respiratory ailment — a more serious condition than the WHO definition, a respiratory ailment visible on a chest x-ray.

Dr. Paul Gully, a federal health official, said revising the case definition was under consideration and conceded that such a change would cause some suspected SARS patients to be classified as probable.

Officials worry the WHO could issue another warning against travel to the city, like one on April 23 that was lifted a week later. A travel advisory is tougher than Toronto's current listing as a SARS-affected area.

D'Cunha, Ontario's health commissioner, said the criteria for such an advisory are 60 or more probable cases, five new probable cases a day and proof the illness was being exported to other countries.

The possible exposure at Father Michael McGivney Catholic Academy involved a student who attended school last week while feeling ill, officials said. The student is the son of a health care worker linked to a Toronto-area hospital with known SARS cases and also displaying SARS-like symptoms.

On Wednesday, the student was listed as a suspected case of SARS, but Dr. Murray McQuigge, a York Region Public Health official, said there was no doubt.

"We're saying this person does have SARS. This is deadly serious business," McQuigge told a news conference.

WHO spokesman Dr. David Heymann said Wednesday the U.N. agency always knew Toronto could face a renewed outbreak, and there were no plans to re-impose a warning against travel to the city.

In response to the new cases, health authorities re-imposed strict controls on Toronto-area hospitals — closing those where the new cases were found to new patients and limiting access to emergency rooms in all others. -- Associated Press

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