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Officials fighting to stop SARS in North America

U.S. travel restrictions to Canada considered

Patients pass a SARS warning posted on a door in a Toronto hospital Monday.
Patients pass a SARS warning posted on a door in a Toronto hospital Monday.

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ATLANTA, Georgia (CNN) -- Top North American infectious disease specialists said Monday that they face an uphill battle to stem the spread of SARS in their countries, and said they were considering tightening travel restrictions to countries where it has become entrenched.

The United States is in a better position than many other countries to stem the spread of severe acute respiratory syndrome, but it is still not possible to predict how broadly the illness will extend, the director of the Centers for Disease Control and Prevention said.

"One of the advantages we have is that of time," Dr. Julie Gerberding told CNN. "We have been able to see what's going on in Canada, and, more importantly, see what's going on in Asia and pre-emptively take the steps here to really do everything possible to contain this.

"We also have a public health system that's been gearing up for terrorism and other threats, and really stood pointed and ready to engage in this effort."

So far, Toronto, Ontario, has 132 probable cases of SARS, according to the World Health Organization. Worldwide, there have been 3,861 probable cases identified and 217 deaths -- 12 of which have occurred in Canada, the WHO said. (Full story)

Fewer than 40 U.S. cases

Gerberding said she could not predict whether the 39 suspected cases in the United States -- none of which has proved fatal -- will mushroom.

Some countries' containment efforts that have focused on isolating those who have come into contact with infected people appear to have paid off.

"Other countries, like Hong Kong, have just not been able to keep the epidemic under control, and I wish we knew why," Gerberding said.

Hong Kong has tallied 1,402 cases and 94 deaths from SARS.

Despite the lower numbers in the United States, Gerberding cautioned against complacence.

"I think it would be very dangerous for us to conclude that we're out of the woods on this one. We need to stay vigilant."

Although the CDC issued an advisory urging Americans not to travel to Hong Kong or mainland China "unless you absolutely have to," that is not the case with travel to Toronto.

"The disease is spread from face-to-face contact with known cases of SARS," Gerberding said. "So the average traveler is not going to be at risk."

CDC: No travel warning to Canada

Although the CDC plans to alert U.S. travelers to Canada not to go to hospitals or other health care settings where people with SARS could be, "so far we haven't had the public health indications for a broader travel advisory to that country," Gerberding said.

Dr. Donald Low, an infectious disease specialist at Toronto's Mount Sinai Hospital, said public health workers in Canada suffered a setback to their efforts to contain the disease when an infected woman got on a commuter train last weekend and might have exposed others.

"She was in the early stage of her illness, so hopefully she was not too infectious," he said.

Further straining containment efforts is the fact that several Canadians have broken their quarantine orders, but Low said he was not giving up the fight to contain the spread.

"The next two weeks will be telling. It's going to be some really tough work ahead of us."

The situation in Canada is far less disturbing than that in mainland China, where 1,959 cases and 86 deaths have been reported. "We're going to have to consider" an outright ban on travel there, he said.

"It's just a disaster in China, and it's becoming one in Hong Kong. We're not going to let it get to that stage in Canada."

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