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Health officials are also investigating the possibility of a second potential new outbreak of SARS among residents of Parry Sound, a small Ontario community, after a resident there developed SARS following a visit to an affected hospital in Toronto. About 70 Parry Sound residents are in quarantine while the ill patient, who is considered a possible SARS case, is now in a Toronto hospital. At the same time, health officials were investigating the possibility that the disease has affected a fifth hospital in the Toronto area since a new wave of illness was reported on May 22, suggesting that the potential for greater spread continued

This unusual feature of SARS will require highly sensitive tests, and it will probably be several months before doctors will be able to use a single test to determine whether a person must be isolated because he or she has SARS. There could also be business obstacles to developing tests. The market for such tests could be small if SARS does not remain a serious health threat. If it is found that SARS can be transmitted through blood, the market would grow because blood donations would have to be screened. Dr. [William Bellini] of the Centers for Disease Control is among those seeking a test for SARS. (Linda Spillers for The New York Times)(pg. F1); Dr. [Malik Peiris], top, and Dr. [Anthony S. Fauci] spoke at a SARS meeting in Maryland on Friday. (Photographs by Linda Spillers for The New York Times)(pg. F6)

Initially, health officials feared the worst from SARS - a global epidemic that could rival the 1918-19 influenza pandemic. Now, many health officials say that scenario appears unlikely and that SARS may be behind us. They express confidence that SARS can be contained. Much about SARS remains unknown. Among the questions are: How important are animals in its transmission? Is there a seasonal pattern to SARS? Will it return in stronger force next year? Because SARS is transmitted mainly from person to person, the health agency is deeply concerned that epidemiologists haven't determined the source of the virus in about half of new SARS cases in China

A major concern is the viral disease's volatility. Severe acute respiratory syndrome first erupted in Guangdong Province in China last November. Since then, SARS has been reported in more than 30 countries with unequal force. The United States and most other affected countries have prevented imported cases from spreading to other people. But across the border, in Toronto, SARS has hit with devastating force. Initially, health officials feared the worst from SARS -- a global epidemic that could rival the 1918-19 influenza pandemic. Now, many health officials say that scenario appears unlikely, that SARS may be behind us, and express confidence that SARS can be contained. Because SARS is transmitted mainly from person to person, the health agency is deeply concerned that epidemiologists have not determined the source of the virus in about half of new SARS cases in China. The health agency also wants to know what quarantine measures China is using and whether they are working better than elsewhere

Several patients in the American outbreak work for veterinarians or pet stores that sold prairie dogs and Gambian rats. No patients have died and four have been hospitalized. Laboratory tests performed at the diseases center in Atlanta on Sunday confirmed that the patients had been infected with the monkeypox virus, which belongs to the same Orthopox family that includes the viruses that cause smallpox and chickenpox. By quickly identifying the animals that can be infected with monkeypox, health officials hope to eliminate them before the disease becomes endemic in this country and in the Americas, [Stephen M. Ostroff] said. For this and other reasons, CDC advised people not to release live animals suspected of being infected with monkeypox into the wild. The agency also advised hospital workers caring for suspected monkeypox patients to follow standard infection control measures, including the gloves, gowns and N-95 masks that have been used to protect against SARS. The agency also advised veterinarians to take the same precautions in caring for sick prairie dogs, Gambian rats, other rodents and rabbits

There were 54 cases of monkeypox under investigation in four states Wednesday. Tests have confirmed monkeypox in nine of them. Of the 54, Indiana reported 23, Wisconsin 20, Illinois 10, and New Jersey one. Ten patients have been hospitalized, but officials at the disease center said they did not know how many had left the hospital. Studies conducted in Africa have shown that smallpox vaccine is about 85 percent effective in preventing monkeypox. The disease center said it was most effective within four days after the first exposure to an infected animal, and somewhat less effective for as long as two weeks after first exposure

The actions seek to control the first outbreak of monkeypox in the Americas and to prevent importing it and other diseases endemic elsewhere in the world. Imported rodents are believed to have brought monkeypox to the United States from West and Central Africa, where it is endemic. The vaccine is being recommended for pet owners, household members and friends who have had close contact with people or animals confirmed to have monkeypox, as well as for health workers investigating monkeypox outbreaks or involved in the care of infected people or animals. Because vaccinations under that program were a response to a theoretical threat, they excluded children, pregnant women and other categories of high-risk groups. But because infected animals have transmitted monkeypox to people in this country, ''the risk-benefit ratio of the vaccine changes'' and ''we are recommending a somewhat more aggressive approach'' to include broader groups, said Dr. David W. Fleming, deputy director of the Centers for Disease Control and Prevention

A health care worker in Wisconsin is suspected of having monkeypox in what would be the first known transmission of the viral disease between humans in this country, a Wisconsin state health official said yesterday. In issuing a definition of a case of monkeypox on Wednesday, the C.D.C. included these signs and symptoms: a rash consisting of raised bumps and pus-filled blisters spread over the body or confined to a small area, a fever of 99.3 degrees or higher, headache, backache, swollen lymph nodes, sore throat, cough and shortness of breath. In an interview this week in his office at the Bloomberg School of Public Health at Johns Hopkins University, Dr. D. A. Henderson, who led the program to eradicate smallpox worldwide, cited a study in Africa in which 209 people with monkeypox transmitted the disease to 47 people in the second generation of cases. The 47 transmitted monkeypox to 11 people in the third generation. The 11 transmitted the disease to 3 people in the fourth generation. One person was infected in the fifth generation before the outbreak died out

Everyone known to be infected, officials said, had been in contact with a pet prairie dog or other animal that had been with a pet prairie dog. They suspect a shipment of prairie dogs, sold in several states by a distributor, Phil's Pocket Pets, near Chicago, might have been infected by a pet Gambian giant pouched rat, native to Central or West Africa. Prairie dogs, which have become popular as exotic pets, are furry, sociable creatures that are often chestnut colored and about the size of a small cat or gopher

The people affected in 18 cases in Wisconsin -- three confirmed, six probable and nine suspected -- were exposed to the prairie dog as it was moved from place to place, said Dr. Jeffrey P. Davis, the Wisconsin state epidemiologist. ''The prairie dog was a super-transmitter if there ever was one,'' Dr. Davis said in a telephone news conference, referring to the term used when a single human or animal passes a virus to many people. ''The prairie dog was moved quite a bit from a pet store to a household to one veterinary clinic and then to a second veterinary clinic before it died,'' Dr. Davis said. One Wisconsin resident who apparently caught monkeypox from the prairie dog had ''minimal'' contact with the infected animal but slept in the same room as the caged animal, Dr. Davis said. Also, ''a substantial number of individuals in one particular veterinary clinic became ill as a result of'' direct contact, Dr. Davis said. ''We are trying to understand what that all means, precisely what the contact was.''