March 21, 2003 — In the United States, suspected cases of the mysterious pneumonia disease known as SARS (severe acute respiratory syndrome) have risen to 22 in 12 states . For the first time, CDC officials have said they believe the condition may have spread in the country.

Globally, suspected SARS cases in 14 countries have risen to more than 350, but World Health Organization (WHO) officials say they “Cautious” is optimistic about identifying the cause of the mysterious pneumonia and may soon be able to develop a test to screen for it.

During a briefing today, CDC Director Julie Gerberding, MD, acknowledged that at least two suspected SARS cases in the United States were caused by humans. He contracted the disease after traveling to a stricken area in Southeast Asia and then infected a healthcare worker in one case and a close relative in another.

California, Hawaii, Maine, Massachusetts, New Mexico, North Carolina, New York and other states have now reported suspected SARS cases , Rhode Island, Utah, Virginia and Wisconsin.

Gerberding also said that two Americans included in the 22 suspected U.S. cases had recently stayed on the same floor of a hotel in Hong Kong, which was suggested to be the Potential original source of infection. Earlier this week, officials said seven original SARS cases lived on the ninth floor of a hotel in Kowloon in February and were believed to be among the original spreaders of the disease. Hong Kong health officials have since closed the affected part of the hotel.

Gerberding said that by tracing so many SARS cases back to hotels, the outbreak is consistent with other naturally occurring infectious diseases because there is only a single source or Personally a very good launcher. But she said the CDC is open to the possibility of terrorism in the current global climate, and the authorities “ensure that no effort is spared in determining the ultimate cause of the problem.”

In another briefing in Geneva, WHO officials said at least two other labs had identified a virus initially identified May be the cause of the current SARS outbreak.

“We are now closer to the reality that this Paramyxoviridae virus is causing this,” said David Heymann, MD, executive director of the World Health Organization’s Division of Infectious Diseases. But he said it represented a range of different viruses, from some that cause measles and mumps to others that cause common respiratory infections, and sometimes may not even cause symptoms.

“Just because we found it’s spreading in some people doesn’t mean it’s not spreading in others. A line of research has to be done do to determine if that is the cause,” Heyman said.

WHO officials say many known forms of Paramyxoviridae have been ruled out, suggesting it may be a new form of virus.

Despite difficulties in determining the exact cause of SARS, investigators announced today a move toward developing a screening tool for suspected cases of SARS. The detection method has taken an important step. A laboratory has now successfully grown an infectious pathogen that appears to cause severe acute respiratory syndrome in the lab, officials said.

Virus growth stopped when researchers added blood from recovered SARS patients to cell cultures , but the blood of healthy people had no effect on the virus. This suggests that SARS patients have developed antibodies to the virus, which strongly suggests that the virus is a likely causative agent.

“It’s not just the light at the end of the tunnel,” said Dr Klaus Stöhr, a WHO virologist who coordinated the lab. s hard work. “It’s a real ray of sunshine.”

Gerberding said the virus appears to be particularly dangerous and can be deadly even in healthy people, Early isolation and early care are essential to control pneumonia and the respiratory illness caused by SARS.

But Gerberding added that there was encouraging news from Vietnam, where some of the first SARS cases were reported. In Hanoi, there are more reports of people recovering from severe acute respiratory syndrome and being discharged from hospital.

“So good supportive care can promote recovery without cause,” Gerberding said .

Until the cause of mysterious pneumonia was identified, WHO broadly defined a case of severe acute respiratory syndrome as:

• Fever over 100.4 degrees;
• One or more of the following respiratory symptoms: cough, shortness of breath, or difficulty breathing, or pneumonia on X-ray;
• and within the last 10 days before symptoms close contacts of known SARS cases, or a history of travel to one of the affected areas.

Most SARS cases were concentrated in Hong Kong, Vietnam and Singapore, but other suspected cases were reported in southern China, Taiwan, Switzerland, Canada, Germany, Slovenia, Spain, Thailand, Ireland, Italy and the UK.

Severe acute respiratory syndrome appears to be spread only through close personal contact with an infected individual, such as an infected individual’s family members or healthcare workers, Gerberding said. There is no evidence that casual contact with SARS patients can lead to infection.

Symptoms of mysterious pneumonia or respiratory illness caused by SARS within 2 to 7 days of exposure. The CDC health alert advises travelers to Southeast Asia to seek immediate medical attention if they develop a fever and respiratory symptoms (such as cough or difficulty breathing) within 10 days of traveling to the affected area. The associated travel advisory also states that U.S. citizens planning non-essential travel to areas affected by the SARS outbreak may wish to delay travel until further notice.

Click here for frequently asked questions about Severe Acute Respiratory Syndrome (SARS).