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The World Health Organization has expanded its network of laboratories in an urgent effort to find the cause of a mysterious respiratory illness that has spread with the aid of international airplane travel from Asia to Canada and countries in Europe. The agency is coordinating scientists from 11 laboratories in 10 countries to seek the cause of severe acute respiratory syndrome, or SARS, which it says is a threat to world health. So far scientists at five laboratories have failed to identify any known infectious agent as its cause. 'The current outbreak is of concern to everyone,' Tommy Thompson, the U.S. secretary of health and human services, said at a news conference Monday after briefing White House and Defense Department officials about the ailment. Thompson oversees the Centers for Disease Control, one of the laboratories in the World Health Organization network. Dr. Julie Gerberding, director of the centers, in Atlanta, said that scientists at her agency were focusing the hunt either for an unusual known infectious agent that is difficult to grow in a laboratory or for a novel agent. No cases have been reported in the United States, Gerberding said. Doctors have reported 14 suspicious cases, she added, but 10 have been judged not to be SARS, and it is unlikely that the four others will turn out to be. Nevertheless, the four cases are being fully investigated because health officials do not want to miss one, Gerberding said. She declined to provide further details of the cases because state and local health departments, not her agency, were conducting the investigations. The number of cases rose to 111 in Hong Kong on Tuesday, and officials said that more cases were under investigation

Using electron microscopes, two laboratories in Germany and a third in Hong Kong reported finding particles that seem to belong to a large family of viruses, paramyxoviridae, that includes the viruses that cause croup, respiratory disease, measles, mumps and other ailments. Still, Dr. Klaus Stohr, a virologist and epidemiologist who is leading the health organization's scientific team investigating the illness, said that none of those viruses had caused a disease like the one under investigation, which doctors are calling severe acute respiratory syndrome, or SARS. Instead, the findings suggest that the virus might be a hitherto unknown member of the paramyxoviridae family. Yesterday, other scientists in the network raced to test throat swabs and sputum specimens from other SARS cases to see if they, too, could identify similar particles, said Dr. Stohr, the W.H.O. virologist

Chinese health officials have given the World Health Organization the first sketchy details about a mysterious respiratory ailment that is believed to have first broken out in Guangdong Province in November and that Chinese officials say has tapered off in recent weeks. It was the first official communication from China about the illness, and it provided a longer-term view to the health organization of how the illness has behaved since the first cases were detected. Although the new information hinted that the outbreak may be tapering off for unknown reasons in Guangdong, World Health Organization officials said they needed more information to be certain. 'If it has burned out, it certainly will give us optimism over its control' elsewhere, said Dr. David Heymann, a health agency official. 'That is why we need more information to know what the natural history of the illness has been since November.' The World Health Organization, an agency of the United Nations, on Saturday declared the ailment 'a worldwide health threat.' The agency calls the ailment severe acute respiratory syndrome, or SARS, and says it has caused at least nine deaths in six countries in recent weeks. The spread of the ailment, a form of atypical pneumonia, has been aided by international travel. New cases, including those of many hospital workers, are being reported daily in affected countries, a World Health Organization official. Laboratories in at least five countries have failed to detect any known infectious agent as a cause of the illness. The illness generally starts with the sudden onset of a fever of 101.4 degrees Fahrenheit (38.6 centigrade) or higher, muscle aches, headache, sore throat, dry cough and shortness of breath. X-rays show pneumonia or respiratory distress syndrome. Laboratory tests show low numbers of white blood cells and platelets, which help blood clot. A 32-year-old doctor from Singapore and his 62-year-old mother-in-law were being treated for pneumonia in isolation in a German hospital after having attended a medical conference in New York. Officials believe the doctor may have contracted the illness in treating the first two cases in Singapore, where 20 cases now have been reported. The doctor had a fever and a slight cough, and the mother-in-law had a high fever, doctors at the Johann Wolfgang Goethe-University Hospital in Frankfurt said. They said the doctor's 30-year-old wife, who is pregnant, has shown no symptoms of the ailment

As a mysterious respiratory illness spread to more countries, the World Health Organization took the rare step of issuing a health alert, declaring the ailment 'a worldwide health threat' and urging all countries to help in seeking its cause and control. The agency said that in the past week it had received reports of more than 150 new suspected cases of the illness, now known as severe acute respiratory syndrome, or SARS. The syndrome has caused at least nine deaths, the last victim a nurse in Hanoi. Some victims have recovered, but no one has done so in the past two weeks. The ailment apparently does not respond to anti-viral and antibiotic drugs. Reported cases have come from Canada and six countries in Asia Hong Kong and elsewhere in China, Indonesia, the Philippines, Singapore, Thailand and Vietnam, the health organization said. There have been no reports of the illness in the United States, but Saturday a sick passenger and two companions who traveled from New York City were removed from a flight after it arrived in Frankfurt and put in isolation in a German hospital. The ill passenger was a doctor from Singapore who treated one of the earliest cases there and who flew to a medical meeting in New York City, said Dick Thompson, a spokesman for WHO. The doctor may have gone to a hospital in New York the agency is not certain which one before flying back to Singapore via Frankfurt with his wife and another doctor. Before boarding the flight, the doctor called a colleague in Singapore to describe his symptoms, and the colleague notified the World Health Organization. The cause of the ailment has not been identified. Scientists do not know whether it is a virus or even an infectious agent

No cases have been reported in the United States, Dr. [Julie L. Gerberding] said. Doctors have reported 14 suspicious cases, but 10 have been judged not to be SARS, and it is unlikely that the four others will turn out to be, Dr. Gerberding said. So microbiologists at major laboratories often use molecular biology methods known as DNA probes to identify an agent. If SARS is a co-infection, say by a bacteria and a virus, ''we should be able to figure it out,'' Dr. Gerberding said. But, she added, even the most sensitive DNA technology can fail to detect a microbe if it is present in tiny amounts. The second feature was the rapidity and severity with which pneumonia developed in some patients. Even among patients who suffer a system illness with influenza, ''it is quite unusual to develop pneumonia,'' Dr. Gerberding said. ''Here we had a very high proportion of individuals developing pneumonia, and that signaled something unusual,'' requiring a closer look

In recent weeks scientists at laboratories in at least five countries have failed to detect the avian flu strain in any SARS case. Dr. David L. Heymann, executive director in charge of communicable diseases for the W.H.O., said, ''We have not ruled out influenza definitively.'' But many experts are wondering whether they are confronting a previously unknown infectious agent, possibly one of animals that has jumped species to humans. For reasons not fully understood, SARS has exerted its heaviest toll so far on health care workers in third world countries like Vietnam where there are relatively few trained personnel. The ninth victim of SARS was a nurse who died in Hanoi late last week. The incubation period of SARS seems to range from two to seven days, most commonly four to five days. That is shorter than the period for influenza, which can spread in less than a day. In controlling outbreaks of known diseases, health officials use that kind of information to detect healthy carriers of an infectious agent or people who have mild cases that do not normally require medical attention. But without any tests for SARS there is no way to find such carriers, if any exist. So far chest X-rays have been the only way to detect mild cases

In recent weeks, scientists at laboratories in at least five countries have failed to detect the avian flu strain in any SARS case. Dr. David L. Heymann, executive director in charge of communicable diseases for the WHO, said: 'We have not ruled out influenza definitively.' But many experts are wondering whether they are confronting a previously unknown infectious agent, possibly one of animals that has jumped species to humans. For reasons not fully understood, SARS has exerted its heaviest toll so far on health-care workers in Third World countries such as Vietnam, where there are relatively few trained personnel. The ninth victim of SARS was a nurse who died in Hanoi last week. If SARS turns out to be a new strain of influenza virus, the standard vaccine shot that people received a few months ago is unlikely to be protective. The reason is that mutations in the influenza virus allow it to escape the defenses of the immune system

The WHO, an agency of the United Nations, on Saturday declared the ailment 'a worldwide health threat.' The agency calls the ailment severe acute respiratory syndrome, or SARS, and says it has caused at least nine deaths in Canada and five other countries in recent weeks. Laboratories in at least five countries have failed to detect any known infectious agent as a cause of the illness. The illness generally starts with the sudden onset of a fever of 101.4 degrees or higher, muscle aches, headache, sore throat, dry cough and shortness of breath. X-rays show pneumonia or respiratory distress syndrome. Laboratory tests show low numbers of white blood cells and platelets, which help blood clot. 1 PIC | 1 1. A woman and child wore protective masks as they waited at an emergency room of a Hong Kong hospital yesterday. 2. Investigating a mysterious illness -- Health officials said yesterday that were analyzing samples from a mysterious pneumonia like illness that has affected hundreds of people in seven countries and caused nine deaths.; Credit: 1. Associated Press 2. SOURCE: World Health Organization | ASSOCIATED PRESS

The Singapore doctor called a colleague in Singapore before leaving for home via Frankfurt. The colleague notified W.H.O. officials, who arranged to have the doctor hospitalized in Germany. Yesterday, hospital officials said his condition had worsened slightly but that he was awake, alert and asking to read newspapers. According to information gathered by the Chinese government over recent months but released to the W.H.O. only yesterday, SARS has behaved differently from past outbreaks of influenza, which can cause atypical pneumonia, or nonbacterial pneumonia. Chinese scientists at first thought the cases might be avian influenza but could find no evidence of any influenza virus. The current outbreak, in Guangzhou, the capital of Guangdong province, involves clusters of cases, particularly among hospital workers and family members of patients. Because the report appears to conflict with earlier reports from the W.H.O. that the epidemic in Guangdong had ended and the government's statement that the outbreak was confined to Guangzhou, Dr. [David L. Heymann] said the W.H.O. was asking for clarification

As a mysterious respiratory illness spread to more countries, the World Health Organization has taken the rare step of issuing a health alert, declaring the ailment 'a worldwide health threat' and urging all countries to help in seeking its cause and control. The agency said that in the past week it had received reports of more than 150 new suspected cases of the illness, now known as severe acute respiratory syndrome, or SARS. The syndrome has caused at least nine deaths, the latest victim a nurse in Hanoi. Some victims have recovered, but no one has done so in the past two weeks. The ailment apparently does not respond to anti-viral and antibiotic drugs. Reported cases have come from Canada and six countries in Asia Hong Kong and elsewhere in China, Indonesia, the Philippines, Singapore, Thailand and Vietnam the health organization said. There have been no reports of the illness in the United States, but on Saturday a sick passenger and two companions who traveled from New York City were removed from a flight after it arrived in Frankfurt and put in isolation in a German hospital. On Sunday, doctors at the hospital were monitoring the condition of the male passenger, his wife and another traveling companion. The 32-year- old man showed symptoms of pneumonia and was being treated with antibiotics, Dr. Hanns-Reinhardt Brodt said at a news conference, The Associated Press reported. X-rays and laboratory tests showed that the man a doctor from Singapore who treated one of the earliest cases there and who was returning from a medical meeting in New York City had 'worsened slightly' overnight, Brodt said. The doctor may have gone to a hospital in New York before flying back to Singapore via Frankfurt, according to the World Health Organization