Fri Apr 11, 4:23 AM ET
By Jason Szep
SINGAPORE (Reuters) - Singapore's largest hospital struggled to contain the SARS virus on Friday after tracing the origin of a mysterious batch of infections -- a man in his 60s whose multiple ailments masked the illness while he unwittingly passed it on to 19 people.
Over the border in Malaysia, officials said 13 crew of a cruise ship which had sailed to Singapore and Thailand had been quarantined after one was identified as a "probable" SARS sufferer.
Singapore General Hospital, where 19 people, including staff, patients and visitors, have caught Severe Acute Respiratory Syndrome (SARS) in a week, fears the virus could have spread to other wards.
Nine people have died of 133 confirmed cases in the tiny city state -- a rate of 6.7 percent, above the global average of about four percent. It has the world's fourth-highest number of cases.
"We are facing an unprecedented situation. We are dealing with a serious, unseen threat," Singapore's minister of manpower, Lee Boon Yang, said on Thursday.
He was speaking as governments around the world tightened their defenses against SARS. Singapore has deployed surveillance cameras and the United States has broadened its definition of who is at risk.
Singapore General Hospital Medical Board chairman Tay Boon Keng listed the elderly Chinese man as a SARS "super spreader," and said he "fell through a crack" after being transferred from a hospital that handles SARS victims exclusively.
"There is concern that the virus could have spread to other wards," said a spokeswoman.
Of the 133 cases so far recorded in tropical Singapore, nine people have died in less than a month and 77 have recovered.
As authorities rang former hospital patients trying to trace anyone exposed to the super spreader, authorities were taking drastic steps.
Security officers fanned out across town to enforce quarantine orders that affect 490 residents, mounting Internet-linked "webcams" in homes and threatening to slap electronic wrist tags on offenders.
The disease has already delivered a heavy economic blow across Asia, hitting hotels, airlines, bars and restaurants, taxi companies, cruise tours and other tourist services.
The 26-year-old cruise ship crew member, an Indian national, was only the fourth person Malaysia has discovered to be suffering from SARS although 27 people are in hospital awaiting test results. She was taken to hospital on Monday and was in "stable condition and recovering," Ismail Merican, Deputy Director-General of Health, told a news conference.
"Thirteen crew members of the ship have been quarantined on the ship at Port Klang," he said.
He did not say how many passengers had been on board or why none had been quarantined.
The ship began its cruise in Singapore, stopped in Port Klang, Malaysia, and visited the Thai island of Phuket. The official withheld the name of the cruise operator or the ship.
In the former British colony of Hong Kong, hospital workers said the epidemic had pushed the health care system to the brink of collapse.
Worldwide, more than 110 people have died and nearly 3,000 have been infected.
A quarter of Hong Kong's 1,000 cases of SARS, marked by fever, cough and severe pneumonia, are health workers, including 12 diagnosed with the illness on Thursday.
"I am afraid that if more hospital staff get infected, the entire health care system would collapse," Peter Wong, a spokesman for three major nurses' unions, said on Thursday.
He said Hong Kong government hospitals were not providing staff with adequate protective gear. FLEEING THEIR HOMES
Hong Kong said three more people had died of SARS, bringing the toll to 30 and officials feared the illness could spread through the city's crowded apartment blocks.
Health workers at one block with confirmed cases sprayed down sidewalks and scrubbed entrances. They also distributed bleach to some residents, including one older woman who had wrapped herself in plastic and put a plastic bucket on her head.
World Health Organization teams were in Beijing and in China's Guangdong province, the source of the infection, but WHO infectious disease chief Dr. David Heymann said they would like permission to look further.
"China is a worrisome area because (we) don't know what is going on outside Beijing," he said in an interview.
The United States widened its definition of people at risk of SARS, saying anyone who passed through an airport in an affected country should watch for symptoms of respiratory illness and contact a doctor immediately if they developed fever or cough.
The U.S. Centers for Disease Control and Prevention believes its strict measures and broad definition of who is a suspected SARS patient has helped keep the disease from spreading in the United States where there are 166 suspected cases in 30 states.
CDC and European researchers both said they had come closer to proving that a new virus from the coronavirus family causes SARS. They found the virus, which may have jumped from animals to humans, in most patients with SARS.
The CDC has developed three tests for the virus and is working to get a licensed version that can be used widely, although this could take at least a week and probably longer.
Back in Asia, hot meals are off the menu for passengers on Taiwanese flights between Hong Kong and Taiwan as airlines step up efforts to stop the spread of SARS.
The commander of the 37,000 U.S. troops based in South Korea banned military and associated civilian staff from traveling to China and Hong Kong because of SARS, the U.S. military said.
In green and clean Singapore meanwhile, ministers are following Prime Minister Goh Chok Tong's lead and abandoning handshakes in public crowds or when holding meetings.
Instead they are adopting a traditional Thai bow with both hands clasped. (Additional reporting by Maggie Fox in Washington, Syed Azman in Kuala Lumpur, Martin Nesirky in Seoul and Tiffany Wu in Taipei))