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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

The passenger is a doctor from Singapore who treated one of the earliest cases there, and who flew to a medical meeting in New York, 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 WHO. In an emergency advisory issued Saturday, the WHO, an arm of the United Nations based in Geneva, said 'there is presently no indication to restrict travel to any destination.'

Although health officials have suspected avian influenza, which has infected a small number of people sporadically in Hong Kong since 1997, laboratory tests haven't detected that rare strain, known as influenza A(H5N1). As a result, laboratory scientists are focusing on the possibility of a previously unknown infectious agent. WHO and U.S. officials urged all travelers to be aware of the main symptoms and signs. In addition to the breathing problems, the illness can cause a dry cough and other flulike symptoms that apparently develop about two to seven days after exposure. They usually start with a sudden onset of high fever and go on to include muscle aches, headache, sore throat and shortness of breath. A woman, Kwan Sui-chu, died shortly after her return. Five other family members who hadn't been to Hong Kong have since become ill; four still are in the hospital while the fifth, Kwan's son, Chi Kwai Tse, died March 13, according to Toronto Public Health officials

The agency said that in the last 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. Some victims have recovered, but no one has been up, around and healthy in the past two weeks. It apparently does not respond to anti--viral and antibiotic drugs. The cause has not been identified. Scientists do not know whether it is a virus or even an infectious agent. Although health officials have suspected avian influenza, which has infected a small number of people sporadically in Hong Kong since 1997, laboratory tests have not detected that rare strain, known as influenza A(H5N1). Laboratory scientists are focusing on the possibility of a previously unknown infectious agent. 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