Deadly pneumonia has spread globally

NewScientist.com news service

The threat from a highly contagious form of pneumonia is now global, with at least nine countries thought to be affected.

Eight cases in Canada, including two deaths, and two cases in Germany were announced over the weekend. In total, the illness is suspected to have killed nine people and infected more than 470.

Over 300 of the cases have been China, where the first deaths from severe "atypical" pneumonia were reported in mid-February. The remaining 170 have centred on outbreaks in Hanoi, Vietnam, and Hong Kong, or can be traced to people who recently visited the region. The two groups of cases may be linked via a US businessman, who died after visiting both areas.

The cause of the illness, dubbed Severe Acute Respiratory Syndrome (SARS), is still unknown. But some victims are responding to a combination of anti-viral drugs and steroids, Hong Kong's health minister said on Monday.

Emergency guidance

On Saturday, the WHO issued emergency guidance for airlines and passengers. It recommends that any individual with a high fever and a respiratory symptom, such as a cough, and who has had close contact with a person diagnosed with SARS or who has recently returned from an affected country, should seek medical advice.

"The syndrome is now a worldwide health threat," said WHO secretary general Gro Harlem Brundtland. "The world needs to work together to find its cause, cure the sick, and stop its spread."

The guidance follow a issued a rare WHO global alert to health authorities on 11 March, as reported by New Scientist. The WHO's concern reflects the ease with which deadly infections can now travel the globe, thanks to the frequency of international travel.

In-flight illness

The Canadian cluster of cases included six people from the same family. In Germany, a doctor who had treated a patient in Singapore and who developed symptoms on a flight from New York to Frankfurt was taken to an isolation ward immediately after landing. He was accompanied by his wife and mother-in-law, who is now suffering from a high fever.

Laboratories in the US, Hong Kong and Japan are trying to identify the agent responsible. "At the moment, nobody knows the cause," says Bill Rawlinson, a medical virologist at the Prince of Wales Hospital in Sydney, and a member of the advisory committee to the WHO influenza reference laboratory in Melbourne. "But at the moment it's considered unlikely to be influenza."

The highly contagious and virulent nature of the infection suggests the agent could be a mutated form of an existing human pathogen, rather than one that has jumped from infecting animals to humans, says Peter Collignon, director of microbiology and infectious disease at Canberra Hospital, Australia.

"The number one priority is to work out what the agent is. Then we can work out how to stop it spreading and whether vaccines can be used," he says.

While infectious disease researchers rush to find the cause, health officials around the world are racing to track down people who may have come into contact with victims, and bracing themselves for their first cases.