SARS has killed two more people in Toronto and concern about the deadly virus shut down a Toronto-area high school on Wednesday, sending staff and students into quarantine and raising fears it may have spread from hospitals to the broader community.
Health officials in Toronto, however, said they had not found evidence of a spread into the broader community but warned that they expect to see a rise in the number of cases and deaths in coming days.
The Toronto area is the only place outside Asia where people have died of SARS. There have been 29 deaths to date and there are currently 12 probable and 20 suspect cases.
Doctors said seven patients are in critical condition and about 50 others are being monitored for possible infection.
More than 5,000 people, including 2,000 from the high school, are now in quarantine in the Toronto area after SARS resurfaced six days ago.
Before then, Toronto had thought it had beaten the disease -- no new cases were reported from mid-April to mid-May.
Health officials said a student at the school in Markham, just north of Toronto, appeared to have symptoms of SARS, and that prompted the quarantine call. One of the student's parents worked at Toronto's North York General Hospital, regarded as the center of the latest outbreak.
"The risk of getting SARS in this kind of setting (a school) is very low," said Dr. Murray McQuigge, a consulting physician in the region where the school is located. "We are not aware of any other student in this school who is symptomatic right now."
Doctors think that the latest outbreak erupted after health authorities eased stringent hospital rules on wearing masks and gloves after the initial outbreak appeared to have passed.
Nurses said this week they had noticed patients with SARS-like symptoms after the rules were relaxed, but doctors and hospital administrators did not listen when they reported the news.
"Unfortunately, they were not taken seriously," Doris Grinspun, executive director of the Registered Nurses Association of Ontario said, describing it as "ridiculous" that no one paid attention.
The World Health Organization this week put Toronto back on its list of SARS-affected areas after being off the list for 12 days. But the UN agency stopped short of recommending that travelers avoid Toronto.
Federal Health Minister Anne McLellan advised that there "is absolutely no reason not to visit Toronto, to eat in the restaurants and go to shows and lead life in a normal way."