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Canada: 'SARS knows no boundaries'

CDC officials head to Canada to confer on illness

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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OTTAWA, Canada (CNN) -- With the number of probable SARS cases rising daily worldwide, health officials said Tuesday that they are doing everything they can to control the disease, while warning it has the potential to spread further.

In the words of one Canadian official: "SARS knows no boundaries."

The severe acute respiratory syndrome has prompted a health care emergency in Canada, where more than half of the 139 probable SARS cases involve health care workers. The health ministry said 14 deaths from the disease have occurred throughout Canada.

Worldwide, 3,947 probable cases with 229 deaths have been reported to the World Health Organization from 25 countries, according to its Web site.

U.S. Centers for Disease Control and Prevention personnel were traveling to Toronto, Ontario, on Tuesday to lend their expertise in controlling the spread of SARS, Health Ministry official Dr. Paul Gully said.

"SARS transmission in Toronto has been limited to specific transmission settings such as households, hospitals and specific community settings," according to the CDC's Web site.

Gully said Canadian and CDC health officials will try to determine why the SARS virus has been able to spread in health care settings despite stringent precautionary measures.

Experts will examine whether current precautions are inadequate or whether there was a breakdown in how precautions were applied.

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

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

Further straining containment efforts is the fact that several Canadians have knowingly 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," he said.

In addition, precautions to protect health care workers haven't worked in every case.

"We thought we had it right. We thought we had our workers protected, and it worked for a good deal of time. What we didn't count on was the extreme risks that some incubations put people at," said Dr. James Young, the Ontario commissioner of public safety.

He said the breakdowns forced authorities to "re-evaluate our isolation techniques." As a result, authorities are advising health care workers to wear face shields, two pairs of gloves, and double gowns, among other safety measures.

The CDC, Young said, will conduct what amounts to an "external audit" of Canada's safety techniques and "give us their ideas and their recommendations."

Tony Clement, Ontario's minister of health and long-term care, said the government will provide "any and all resources to win that fight" against SARS.

"SARS knows no boundaries," he said. "SARS affects all people and has the potential to affect all nations, unless we remain vigilant in our fight."

'Disaster in China'

The situation in Canada is far less disturbing than what is going on in mainland China, where 2,001 cases and 92 deaths have been reported, according to the WHO.

"We're going to have to consider" an outright ban on travel there, Low 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."

The United States is in a better position than many other countries to stem the spread of SARS, but it is still not possible to predict how broadly the illness will extend, said the CDC's director, Dr. Julie Gerberding. (Full story)

"One of the advantages we have is that of time," she 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.

-- CNN medical correspondent Elizabeth Cohen contributed to this report.

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