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Mystery Respiratory Illness Continues to Spread, Quarantine Issued

Health officials sealed off an apartment building and quarantined all 240 residents Monday after reporting an alarming jump in new cases of a mystery flu-like disease.

More than 600 people in this city are believed to have the dangerous respiratory infection, and almost half of those live in the Amoy Gardens apartment complex. Officials reported 92 new cases in the complex on Monday.

Severe acute respiratory syndrome, or SARS, has prompted officials in Asian countries to enforce little-used quarantine laws, close schools and impose new health screenings on travelers.

The disease, which has no proven treatment, also continued spreading in other affected hot spots, such as Singapore and Toronto.

Doctors and nurses in Singapore donned special respirator suits designed for handling germ warfare attacks so they could get close to patients infected with SARS.

In Canada, where a health emergency has been declared in Ontario province, Toronto authorities reported that at least two children had been hospitalized with the disease, and three others were showing symptoms of it. But they would not give details.

Worldwide about 60 people have died — at least 15 of those in Hong Kong. Government officials are pondering setting up quarantine centers if the disease cannot be contained.

The World Health Organization said Monday that experts hope to pinpoint the cause soon, and signs continue to point the coronavirus, which causes about one-fifth of all colds.

Hitoshi Oshitani, the WHO coordinator for SARS, said he believes scientists will determine the cause soon, possibly within days.

"But this doesn't mean we will find the specific treatment for this disease within the short time period," he said.

In fact, the Centers for Disease Control and Prevention said Saturday that no current drugs were working against the disease.

In a new and perplexing twist, the germ inside the Hong Kong apartment building seemed to be spreading upward, a WHO official said Monday.

"They are finding that the infections are in people living in apartments on top of each other, only in one area of this apartment block. It's only two apartments, but from floor zero to 35. Not all of those apartments are affected, but most of the families affected are living in that small area of that apartment building," virologist Klaus Stohr said at WHO headquarters in Geneva.

That differs from the pattern seen earlier at the Metropole Hotel, where the disease first spread to Hong Kong. There, guests staying on the ninth floor became infected.

"That was horizontal, and now you have a vertical connection," Stohr said. "You can talk about water pipes and sewage pipes, about drafts which move up and down — that's pure speculation. These are hypotheses that are being looked into."

The 240 residents under the apartment quarantine have been ordered to stay inside until midnight on April 9.

They will get regular medical exams and three free meals a day, but some grumbled they should be compensated for lost time at work. Anybody who leaves without permission could be fined or jailed.

Police wearing white surgical masks erected metal barricades and strips of tape. Workers piled up supplies of rice and toilet paper to be taken to those confined inside.

Hong Kong's health secretary, Dr. Yeoh Eng-kiong, appeared emotional and had trouble speaking as he said "a very exceptional circumstance" had forced the drastic response.

"We haven't done it before and we hope we won't do it again," he told a news conference.

But some noted that many apartment residents already fled in fear as dozens of people became sick, raising the possibility SARS would spread further. Another 18 buildings in the complex were not sealed off despite having multiple SARS cases, but Yeoh said no other buildings were hit as badly.

"This isolation is clearly a political decision," said Leung Ping-chung, an orthopedic and traumatology professor who has been monitoring the Prince of Wales Hospital in Hong Kong, where dozens of staff have been sickened.

"If isolation is effective to control the spread of the disease, we can say that this decision came too late," Leung said. "And who can say for sure who should be isolated?"

Scientists still maintain that close contact is necessary to spread the disease. Usually that means being infected by droplets from someone coughing or sneezing. But they explained other variables.

Coronoaviruses, such as the common cold, have been known to survive up to three hours outside the body, said Dr. David Heymann, WHO's communicable diseases chief.

"So if someone were to cough on a door handle, someone else would come and open that door and contaminate their fingers with the virus, then touch their eyes or mouth. They could infect themselves, but it's still direct contact," Heymann said.

Intensive care staff at Singapore's Tan Tock Seng Hospital began using respirator suits, called Jupiter units, to allow close contact with SARS patients there, said Dr. Dessmon Tai.

"In the past, we never had to use this," Tai said, his voice echoing inside the visor as he showed off a Jupiter unit.

The epidemic has caused a spate of canceled concerts, tournaments and other public events. The International Ice Hockey Federation called off the women's world championships in Beijing.

"Life is more important than hockey right now," said Danielle Goyette, a forward for defending champion Canada.