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Posted on 04/08/2003 7:05:27 PM PDT by Lessismore

Doctors still haven't pinned down exactly how a deadly flu-like virus is spreading and more cases are pointing to possible new ways it is using to pass from one victim to another.

A top Hong Kong health official said on Tuesday cockroaches might have spread the virus that causes severe acute respiratory syndrome (SARS) in an apartment complex in the city, leading to nearly 300 infections in a matter of days.

If proved true, it would represent an alarming development in the swiftly spreading epidemic in Hong Kong, a city of nearly seven million people filled with densely populated apartment buildings.

Health officials are also looking at the possibility that SARS can be spread by a latter-day version of Typhoid Mary, a cook in early 20th century America who spread typhoid fever without showing symptoms herself.

SARS has killed more than 100 people and infected 2,750 worldwide since it surfaced in southern China late last year.

The World Health Organization's infectious diseases chief said at the weekend he feared the SARS virus could be carried by people without symptoms.

"If there are people who have the virus and don't show symptoms, we are lost, because that would mean it had spread throughout the world, as it is easily contracted," David Heymann said in an interview with Spain's El Pais daily.

"That was how AIDS was transmitted before it was discovered. We still don't know if this is the case, that's why we need a test," he added.

The WHO said in an April 7 update published on their Web site that SARS diagnostic tests developed so far were problematic.

It said a test available for detection of SARS virus genetic material was useful in the early stages of infection. But it produced "many false-negatives, meaning that many persons who actually carry the virus may not be detected - creating a dangerous sense of false security."

This was the case for Fung Hong, the chief executive of a group of Hong Kong hospitals, who was confirmed with SARS early this week after originally testing negative for the virus.

This leaves open the possibility of more such cases and possible wrong diagnoses of patients showing some but not all the common symptoms, such as chills, high fever, body aches and breathing difficulties.

While the WHO has said the virus, new to science, has been isolated, little is known about it and there is no known cure.

"We don't know all the details of how the virus spreads. There's a limit to how much a country can prepare," said Dr. David Bell on Tuesday. Bell is a Manila-based member of the WHO team dealing with SARS in East Asia.

SARS is highly contagious and doctors say it can easily be spread to others in close contact with ill patients through breathing in droplets from sneezing or coughing.

Touching door handles, lift buttons or water taps that have been contaminated by droplets from an infected persons' coughs or sneezes is another way to pass on the virus.

Bell said it was possible - but not yet proven - that the occasional person could be a carrier of SARS without suffering severe symptoms.

"It's quite likely it occurs but it's probably very unusual. There's no evidence. If that were common, it would be spreading right through the community like influenza or something like that - and the fact is it isn't," he added.

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