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Canadian hospital may be hit by SARS

Health authorities closed a hospital to new patients Monday because of a possible fresh cluster of SARS cases and reinforced orders for all staff treating patients in the Toronto area to wear gloves, masks and gowns.

At least 14 patients at Lakeridge Health Center in Whitby, Ontario, 70km east of Toronto, were under investigation for symptoms of SARS.

Some were dialysis patients, and all had pneumonia-like symptoms consistent with SARS, but officials said it was too soon to confirm the cause of the illness.

"We certainly hope they aren't SARS and we hope it's something that's treatable," said Dr. James Young, the Ontario commissioner of public safety. "We have to assume they may be SARS."

Health care workers, family members and others who had contact with the 14 patients were going into 10-day home quarantine as a precaution, while the hospital was closed to new patients.

"We're not going to wait until we get some lab tests back. We're going to act now like this is SARS," said Dr. Donna Reynolds of the health center.

A second SARS outbreak in Canada's largest city has been mostly brought under control. Officials reported 66 probable cases Monday, down two from the previous day, of the illness that has killed 33 patients since first appearing from Asia more than three months ago.

Health officials warn that more patients in critical condition could die instead of recovering.

Toronto authorities thought they had the illness under control after the initial cluster in March and April had mostly disappeared by mid-May. An undiagnosed case at North York General Hospital then led to a further spread among other patients, family members and health care workers.

There was no immediate known link between the possible Whitby cluster and previous severe acute respiratory syndrome cases. Two brothers were being treated for the contagion at an affiliated hospital in Oshawa, Ontario, near Whitby, but officials said they were unable to connect them to the Whitby hospital.

Concern over possible hidden cases of the disease and reports that some hospitals were failing to require staff to wear protective garb brought the latest directive for all Toronto area hospitals, Young said.

It reinforces previous regulations by authorities, including immediate reporting of suspected SARS cases and for all staff dealing with patients to wear the extra layers of protective clothing.

"We want to ensure ourselves we don't have any hidden cases anywhere," Young said. "We're trying our best to cover things we can't even think about, and in this case, that's what happened. The unthinkable happened."

On Friday, health officials closed the maternity ward at Toronto's Mount Sinai Hospital after a medical student who helped deliver babies there came down with SARS symptoms.

Officials said Monday that none of the patients, newborn infants or others from the maternity ward had displayed symptoms of the illness so far.

Young said Mount Sinai was one of the hospitals where authorities had eased on the SARS precautions.

"We've unfortunately learned the hard way that you have to place a huge safety net over everything because this is a very, very difficult virus to identify and isolate," he said.

Also Monday, several Ontario nurses wearing masks with "muzzled, silenced and ignored" written on them demonstrated at the Ontario legislature for an independent inquiry of how health officials handled the SARS outbreak.

Nursing groups have complained their members were ignored when they raised concerns about the second SARS outbreak last month. They also want better pay and working conditions to confront the illness.

The second cluster of SARS cases landed Toronto back on a World Health Organization list of SARS-affected cities or regions. The UN agency also previously issued a travel advisory for Toronto, but rescinded it a week later after Canadian officials complained it was unwarranted and promised better screening of international travelers.

Health care workers have complained that authorities dropped their vigilance in May in a rush to proclaim Toronto safe after the initial outbreak of SARS.

The SARS outbreak has hurt Toronto's crucial convention and tourism industry, with hotels, restaurants and theaters saying business is down due to a lack of visitors, especially Americans.
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