Reuters Tuesday April 1, 7:56 PM FACTBOX-Latest toll from deadly SARS virus by country

HONG KONG, April 1 (Reuters) - A pneumonia-like virus that has killed 63 people and infected almost 1,900 is being spread around the world by travellers.

The outbreak started in southern China late last year before showing up in Hong Kong, Singapore, Vietnam, Canada, Germany and elsewhere in recent weeks. Deaths have been reported in Hong Kong, Vietnam, Canada, Singapore and Thailand.

Hong Kong on Tuesday reported 75 more people were infected, bringing the total number of cases in the former British colony to 685. It also said one more patient had died, bringing the local death toll from the disease to 16.

Australian health authorities on Tuesday reported their first suspected case and Indonesia said it had its first three suspected cases. Canadian health officials reported 31 new cases on Monday.

ReutersTuesday April 1, 11:09 PM Number of SARS infections in Singapore rises

SINGAPORE, April 1 (Reuters) - A deadly respiratory virus has struck three more people, the government of Singapore said on Tuesday, as nurses screening arriving air passengers found seven sick enough to send to hospital. Four people have died from Severe Acute Respiratory Syndrome, or SARS, and at least 977 people have been ordered to stay home or risk fines, as the government moves to stamp out infection.

Total SARS infections in the tiny island republic of four million people reached 95 on Tuesday, 52 of whom have recovered. Two children are among 42 "suspect" cases, the Ministry of Health said, with 13 in serious condition.

Singapore ranks third worldwide in the number of its SARS cases, after Hong Kong and China, where the highly contagious disease first surfaced in November. It has also taken some of the world's toughest and swiftest steps to stem the outbreak.

Since late on Monday, nurses in surgical masks and medical gloves have met air passengers arriving from regions listed by the World Health Organization as affected by SARS -- including Hong Kong, Beijing, Hanoi, Toronto and Taiwan.

They quizzed travellers who looked ill.

In the first 12 hours of screening, seven were found sick enough to go directly to a hospital exclusively for SARS victims, state television reported.

POLYTECHNIC SHUT

Many are taking their own precautions, from wearing surgical face masks on the subway to working from home, to escape the virus, which has affected nearly 1,900 people in at least 12 countries, killing 63.

Singapore also announced plans to shut the Ngee Ann Polytechnic for three days, for "contact tracing", after one of its roughly 13,000 students was suspected of contracting SARS. Schools were shut last week for the first time since the 1940s.

As the government stepped up safety moves, the illness continued to take a social and economic toll of the country, which already faced rising unemployment and uncertainty in the crucial export sector because of war in Iraq.

American guitarist Carlos Santana and electronic music act Moby have scrapped concerts. Twelve percent of events lined up at Suntec International Convention and Exhibition Centre, one of the biggest sites of its kind, will be delayed or cancelled in April.

Sport, too, has been hit.

About three-quarters of the national rugby side will be quarantined for a week after returning from the annual Hong Kong Sevens rugby union tournament, rugby union officials said.

The 21 players and officials from the men's and women's teams showed no signs of disease, but officials were taking no chances.

Drug companies suspended visits by sales staff to clinics and hospitals and said they faced lower revenues after the outbreak.

It all adds up to economic pain.

BNP Paribas Peregrine estimates Singapore's economy is likely to be one of the worst-hit by SARS, slashing its 2003 growth forecast for the city state to 2.5 percent from four percent. (Additional reporting by Jacqueline Wong)

Reuters - By Tan Ee Lyn - Tuesday April 1, 9:53 PM Website hoax on killer virus triggers Hong Kong panic

HONG KONG, April 1 (Reuters) - A teenager's website hoax about the killer virus sweeping Hong Kong sparked panic food buying and hit financial markets on Tuesday, and the government said it was placing more than 200 people into isolation camps.

Indonesia, the world's fourth most populous nation, reported its first three suspected cases. One official said one of the patients had died but this could not be confirmed.

Severe Acute Respiratory Syndrome (SARS) has now affected almost 1,900 people in at least 12 countries, and 63 are known to have died.

In Hong Kong, where 685 people have been infected and 16 have died from the virus, the website hoax forced authorities to deny it would isolate the entire territory.

"We have no plan to declare Hong Kong an infected area. We have adequate supplies to provide the needs of Hong Kong citizens and there is no need for any panic run on food," Director of Health Margaret Chan told reporters.

The scare just added to the sense of dismay in the territory adjoining China's Guangdong Province, where the virus is believed to have originated four months ago.

As some supermarkets found frightened customers pulling canned and preserved foods from their shelves, Hong Kong medical teams hunted for the reason why over 200 people in one apartment complex in urban Kowloon had fallen ill with SARS.

Protected by white surgical coats, caps, masks and gloves, investigators combed through the Amoy Gardens apartments, home to almost a third of all cases in Hong Kong. Residents there were under official quarantine.

The government said it was evacuating more than 200 Amoy Gardens residents to special isolation camps.

The hoaxer had copied the format of the public internet portal of the Mingpao, one of Hong Kong's leading newspapers, and posted a message saying that the government would declare the city of seven million "an infected place".

The daily said it had identified the teenager responsible for the hoax. Police were investigating.

As the rumour spread, the Hong Kong dollar took a slight knock, and stocks fell for another day as investors calculated the loss to businesses in the tourism, airlines, property, and retail sectors.

PLAGUED APARTMENTS

Finding the cause of the Amoy outbreak is critical because it could prove or disprove a theory that the virus has mutated into an airborne plague, which could infect many more people much more quickly. Hong Kong found 75 new SARS cases on Tuesday.

So far, doctors believed it was only spread by contact with infected patients, through coughing, spitting, and sneezing.

The race to find carriers of the disease is on. Many Amoy Gardens residents had already fled their homes before the quarantine and the government is looking for them.

Hong Kong was also hunting passengers on Thai Airways flight TG 606 from Bangkok to Hong Kong on March 29, the latest infected flight after an 80-year-old passenger was diagnosed with SARS.

Controlling the disease could be a major challenge in Indonesia, a sprawling archipelago of some 17,000 islands and 210 million people, many of whom live in poverty in urban slums or villages with few health services.

But a spokesman for the World Health Organisation said it was encouraging that Indonesia appeared to have detected the disease.

"One way to contain the spread is to quickly identify cases. While it is bad news if it has arrived in Indonesia, it would be good news that the Indonesian authorities have identified it quickly," said Iain Simpson, a WHO spokesman.

With Hong Kong so badly affected by the SARS outbreak, businessmen were trying to assess the possible economic damage.

"If more and more housing estates are infected, this will bring Hong Kong to a standstill and our economy will definitely contract," said Alex Tang of Core Pacific-Yamaichi International.

"We may have to lower our estimates for corporate earnings as well," he added.

AIRLINES HIT

Malaysia has just reported a three percent drop in daily passenger arrivals at Kuala Lumpur international airport "seven days before and after" SARS was detected in the region.

In and around Hong Kong, airline bookings are down 20 to 30 percent, and flights have been cancelled.

Thai authorities said on Tuesday tourists found in public places with SARS symptoms could face a maximum of six months in jail or a fine of up to 10,000 baht ($233) or both. But they said it would be difficult to enforce the order.

In Singapore, the Catholic Church drained containers of holy water at church entrances and switched to giving communion wafers to the hands of worshippers, instead of on to their tongues.

Some medical officials have issued pleas for calm. "I can't say this often enough, the risk to the general public is extremely low," said medical officer Sheela Basrur in Toronto. Canada has reported more than 120 cases of infection.

The hope held out by doctors is that the virus's detailed makeup will be pinpointed shortly. Some victims have been successfully treated using antibodies in serum from recovered patients, which suggests they developed some level of immunity.

The World Health Organisation has now reported confirmed SARS cases in China, Hong Kong, Taiwan, Singapore, Canada, the United States, Germany, Switzerland, Britain, France, Ireland and Italy.

Reuters - Tuesday April 1, 7:39 PM First German case of deadly SARS virus confirmed

BERLIN, April 1 (Reuters) - German health authorities said on Tuesday a 72-year-old man admitted to hospital in the west of the country was the first German citizen confirmed to have caught a deadly respiratory virus sweeping across Asia.

The man, recently back from a trip to Vietnam and Singapore, is the first German known to have Severe Acute Respiratory Syndrome (SARS), a flu-like illness that has killed 62 people worldwide and infected more than 1,700, most in east Asia.

Two cases were earlier reported in Germany, but both were transit passengers removed from planes after falling ill.

Germany has also reported four more patients presumed to have the virus, and 12 other suspected SARS cases are being examined.

The elderly German was not suffering from fever or any complications, according to the clinic in the western state of North Rhine-Westphalia that has him in isolation.

"Thorough inquries of the health authorities have given no indication that the patient had infected anyone before he was taken in for treatment," the clinic said in a statement after tests at Hamburg's Tropical Institute confirmed his condition.

Thomas Crampton/IHT International Herald Tribune Monday, March 31, 2003 People in complex ordered home for 10 days

HONG KONG The police locked more than 200 residents into their apartment complex Monday in Hong Kong as the government imposed drastic measures to combat the fast-spreading outbreak of a deadly atypical pneumonia.

Residents of the apartment complex, Amoy Gardens in Kowloon, now account for more than a third of all patients under treatment for the disease, severe acute respiratory syndrome, or SARS.

Hong Kong registered 80 new cases, 64 in the housing block on Monday. That brought the total number of infections to 610. With two more deaths Monday, Hong Kong accounts for 15 of about 60 deaths so far.

The authorities said that most of the residents of the contaminated block at Amoy Gardens had already fled, prompting fears that the disease would spread further into the community. Health officials issued an appeal for missing residents to return but said that contingency plans were now being drawn up for the creation of quarantine centers.

“With a large number of people infected, the unpredictability becomes larger, so we are planning for all different types of scenarios,” said Yeoh Eng-kiong, Hong Kong's secretary for Health, Welfare and Food. “We will consider setting up quarantine centers.”

Hong Kong, the hub from which the disease spread to more than 1,600 people in 15 countries, has reported by far the fastest growth in new cases. Fifteen people have died in Hong Kong of the disease and 610 have been admitted to hospital, including 80 new cases on Monday - the largest number reported in a single day in any country since the epidemic began to be tracked.

The disease has killed about 60 people worldwide, but doctors report that recovery rates have improved as they learn more about the treatment.

Hong Kong's once-bustling streets now resemble a hospital ward with many people who venture out donning surgical masks.

Many companies have encouraged employees to work from home and airlines have started canceling flights to the city.

The new outbreak prompted the government to enact the quarantine laws late last week which allowed the isolation of residents.

“We are imposing restrictions on personal freedoms,” Yeoh said when announcing Amoy Gardens quarantine. “This is something we have never done before and hope never to do again in future.”

Moving in shortly after dawn, 50 police officers wearing surgical masks cordoned off the building and informed residents of Block E in Amoy Gardens that they must remain isolated inside their apartments for the next ten days or face possible jail terms.

No one will be allowed in or out of the building unless health officials give written permission. The government will feed each resident three meals per day, advise on disinfection and follow through on reasonable requests.

“While residents were on the whole very, very cooperative, obviously there were some disagreements with discontented individuals,” Yeoh said.

The police delivered quarantine letters to 241 people in 108 apartments, but 156 other units were vacant. As the infection rate rose in the building over recent days, many residents fled.

“Those residents who do not get in touch with us will be tracked down and brought to a quarantine facility,” Yeoh said.

The Amoy Gardens outbreak has baffled government medical investigators by its speed and manner of spreading. The person who brought the infection into the apartment complex, a kidney patient who contracted the disease while being treated at Prince of Wales Hospital, visited his brother's apartment four times while infected.

The cases in the building first spread vertically, turning up in the same two units on multiple floors of Block E.

This pattern led investigators to suspect a common elevator, air supply or meeting place, but no route has been determined for certain.

Investigators have studied the water supply and said a nearby children's playground was being brought under scrutiny.

The outbreak repeats the disease's now-established but odd pattern of infection: Certain individuals leave a trail of victims while others infect almost nobody.

One emerging theory is that certain patients develop into so-called super-infectors with the ability to spread the disease more readily.

“The super-infectors may carry a more virulent strain of the virus,” said Henry Niman, a Harvard-based biomedical researcher studying the outbreak. “Even when circumstances are identical, some sick patients infect only a couple people while others infect more than 40 people.”

By Tan Ee Lyn and Vicki Kwong Monday March 31, 6:55 PM Quarantine as deadly virus spreads

A Taiwanese woman puts a mask on her kitten to protect her against a highly infectious pneumonia virus in central Taichung City on March 30, 2003. Taiwan's health department has banned all people with the highly infectious Severe Acute Respiratory Syndrome (SARS) from entering or leaving the island to try to halt the spread of a mystery pneumonia that has killed nearly 60 people worldwide. REUTERS/Stringer

HONG KONG (Reuters) - Almost 100 people in one Hong Kong apartment block are reportedly infected with a deadly pneumonia virus, raising fears that the disease is being spread through the air or water supply.

Authorities quarantined more than 200 people in one block of the Amoy Gardens housing complex on Monday in an effort to contain the virus, which has killed nearly 60 people worldwide and spread alarm across Asia.

About 210 of the 620 infected with Severe Acute Respiratory Syndrome (SARS) in all of Hong Kong live in Amoy Gardens and 150 of them are from Block E of the complex.

A staggering 92 people were reported infected on Monday in the block, located in the midst of the teeming Kowloon district of the territory, one of the most densely-populated areas in the world.

"We are now examining all possible angles, to see if it is airborne or in the (building's) water mains," a government spokeswoman said.

Dozens of health workers in full surgical gear stood guard at the entrance of the apartment block to stop any residents from leaving as policemen in masks cordoned off the area.

But residents said many families had already fled.

The city's largest bank, HSBC, ordered about 50 of its headquarters staff to stay home for seven days as a precautionary move after a teller fell ill, and activated a back-up dealing room to run until the end of the crisis.

Hong Kong and Singapore have closed all schools in a bid to contain the disease and quarantined those who have been exposed. Besides these two cities, deaths have also been reported from Vietnam, Canada and from China, where the disease was believed to have originated in November.

A doctor from the World Health Organisation, who was infected in Vietnam after he had identified the virus, died in a Bangkok hospital at the weekend, the latest victim.

The disease has triggered tighter screenings at many airports and a growing number of countries have advised citizens against unnecessary travel to the worst-affected areas.

MORE CAN BE INFECTED

Singapore has closed schools and quarantined 945 people, with hundreds of others advised to stay home, as new infections from the flu-like virus showed no sign of letting up. On Monday it sent nurses to the airport to check incoming passengers.

The U.S. Centres for Disease Control and Prevention warned on Saturday that the virus may wreak havoc.

"The potential for infecting larger numbers of people is great," said its director Julie Gerberding. "We may be in the early stages of what could be a larger problem."

Cases have also surfaced in the United States, Germany, Britain, France, Japan, Ireland, Italy and Taiwan.

More than 1,600 people have been infected worldwide, but some have since recovered. About four percent of the people who catch it die from the disease.

While Australia played down the dangers of the disease saying it has not had even one confirmed case, neighbouring New Zealand gave its health authorities more power to contain any outbreak.

Indonesia and Thailand, where the WHO doctor died of the disease, were taking no chances.

In Thailand, incoming passengers showing any symptoms of the disease will be quarantined for 24 hours and demand for masks from the public has been overwhelming.

In a hospital in Jakarta, staff were handing out face masks to all visitors on Monday. "If the outbreak occurs in Indonesia, it will be very difficult to control as many regions are still not aware of the danger," one doctor said.

The high number of cases at Amoy Gardens has raised fears the virus could be airborne rather than carried by droplets from sneezing or coughing.

Health Minister Yeoh Eng-kiong said: "Up till today, it is spread through droplets. But no one can rule out that it could be airborne, because viruses change all the time."

Apart from scaring away tourists, the epidemic has disrupted business in Hong Kong. A growing list of shops, banks, offices have shut after employees were found infected.

Some expatriates have departed quietly, taking their families with them on home leave.

Hong Kong said all residents in the apartment building would be quarantined for 10 days and anyone showing symptoms of the disease -- a high fever, chills and breathing difficulties -- would be sent to hospital.

But entire families from 154 units in the building have already fled. "Those who have left must contact us...every infected person has the potential to cause another big outbreak like the one at Amoy Gardens," Yeoh told a news conference.

AP Friday March 28, 3:02 PM Vietnam Family Handles Mystery Illness

Nguyen Hong Duc, right, and his father-in-law Nguyen Ton carry plastic bags containing food to Duc's wife Tran Le Thuy at Bach Mai Hospital where she receives treatment, in Hanoi, Vietnam, in this March 19, 2003 file photo. Thuy was admitted with symptoms of a mysterious pneumonia after giving birth last month at the Hanoi French Hospital, where the outbreak began. Duc and wife Thuy have been forced to stay completely away from their newborn son to protect his fragile immune system from a deadly mystery virus Thuy caught at the French hospital.(AP Photo/Doan Bao Chau, File)

Nguyen Hong Duc is a brand new father who should be rocking and cuddling his first little one, but he's too afraid to even risk a quick glimpse _ let alone a hug or kiss.

Duc and his wife, Tran Le Thuy, 28, have been separated from their newborn son to protect his fragile immune system from a deadly mystery disease Thuy caught after giving birth last month.

The disease, known as severe acute respiratory syndrome, is now spreading worldwide. The World Health Organization says 1,408 people have fallen ill and 53 people have died. The United States has 51 suspected cases.

Duc and Thuy's excitement over their first-born was short-lived once Thuy got sick four days after her Caesarean section. She had fever, coughing and difficulty breathing.

When her fever broke, she was sent home, but soon developed an even higher temperature. Within days, she would learn she had a new unexplained illness that had spread through Hanoi's French Hospital.

As her condition worsened, the French hospital was no longer an option. It closed its doors to new patients after the mystery disease spread from a patient to several medical workers.

Duc had no choice but to hand their son over to his parents and take his wife to the busy Bach Mai Hospital where he soon found himself muzzled by two masks to keep from catching the disease. He and Thuy and two other couples shared the same hospital room. The wives all had the mystery ailment, and their husbands took care of them day and night.

The situation is typical for Vietnam; there simply aren't enough doctors and nurses, so Bach Mai allows family members to provide the care inside the hospital. During this outbreak, that tradition has presented new challenges for a team of international disease experts sent here to keep the disease from spreading.

"I'm so worried about my baby," Duc said, his voice shaking. "My wife and I have stayed separated from the family. We're taking care of ourselves."

But Duc has stayed healthy despite the long days at the hospital. And his parents provide reassurance _ the baby is also well.

Health officials are impressed and curious at how a hospital with limited doctors and nurses has managed to keep itself mostly free of the disease that spread throughout the other one.

At Bach Mai, many patients recovered quickly after only a mild form of the illness.

"What we expect is that we would see cases among the relatives, but, surprisingly, we have not seen any secondary cases," said Jesper Aagesen, a clinician from a Swedish group serving on the World Health Organization's outbreak team. "That is very strange."

Aagesen theorized that perhaps the virus weakens after cycling through several victims before burning itself out; or maybe the high-quality surgical masks are enough to prevent the spread of infection.

Whatever the case, he considers Vietnam lucky to have quarantined those inside the French hospital where the virus first spread with fury before anyone even had a clue it existed. The staff there isn't allowed to leave or see their families. They also have been forced to continue working as they watch more colleagues fall ill. Two doctors and two nurses have died.

Yves Nicolai, general director of Hanoi's only international hospital, says its only hope of reopening will come after all of the patients are discharged and at least 20 days of decontamination is carried out.

Right now, though, the main focus of medical workers in this city remains on containing the outbreak and sending recovered patients home to their loved ones.

Duc says it's been a stressful time for everyone in his family. He hasn't seen his mother since going to Bach Mai, but his father often meets him in front of the hospital to bring Thuy food.

Duc said nothing will be better than having his family at home together.

Little Nguyen Quang Nguyen turned 1 month old Thursday, and Thuy has fully recovered from the illness. Her doctors say she will be allowed to go home any day. Duc says his prayers have been answered.

"She's very excited to go back home," he said. "She wants to see the baby."

HONG KONG (Reuters) - Asian governments have quarantined more people and beefed up health checks as they battle to contain a deadly and highly contagious pneumonia virus that has killed 54 people worldwide and infected around 1,500.

Singapore nearly doubled the number of people ordered to stay home to 1,514 as it tried to break the cycle of the deadly severe acute respiratory syndrome (SARS) virus, which has claimed two lives in the city state.

It is also blamed for 34 deaths in China, 11 in Hong Kong, four in Vietnam and three in Canada.

"We're facing an unprecedented situation, this is a nine-eleven (September 11) for health, and we're not going to go back to the pre-SARS situation for some time -- we're in for the long haul," said Singapore Health Minister Lim Hng Kiang.

Thailand and South Korea became the latest countries to issue travel warnings urging their citizens to avoid visiting China, Hong Kong, Singapore and Vietnam -- worst hit by the disease -- until the health crisis was brought under control.

The epidemic has forced the cancellation of concerts, holidays and business travel to many parts of Asia, in a blow to the region's already sickly economies.

A Singapore analyst said lost retail sales and hotel bookings would cost the city $1.1 billion (700 million pounds) if the crisis lasted three months, but others accused the region of over-reacting.

"They're bombing Iraq and you still see people walking around on the street out there," said Chinese businessman Wang Junyao, the head of a private dairy company. "And the foreign media says you shouldn't go to China ?"

China, where the virus emerged late last year, has been accused of hiding the problem but the World Health Organisation said the country had now agreed to make detailed daily reports.

OFFICES CLEARED

In Hong Kong, computer giant Hewlett-Packard Co closed one of its main offices and sent 300 workers home after an employee was suspected of having contracted the disease. HSBC bank sent home 26 workers from an elite private banking counter at its headquarters building after a teller caught the deadly disease.

The WHO has stressed the need to screen travellers in places where the virus has killed people, including China's Guangdong province, neighbouring Hong Kong, Singapore, Hanoi and Toronto.

Thailand said people visiting the worst-affected countries should wear a mask.

"Avoid visiting crowded public places like shopping malls or cinemas," said Thai Public Health Minister Sudarat Keyuraphan.

SARS, which scientists say is caused by a new virus strain, has been carried to parts of Asia, Europe and America by travellers.

Desperate to halt infections, Singapore and Hong Kong, which have the highest number of infections outside mainland China, closed schools and quarantined those who may have been exposed to the virus, including the family and friends of patients.

British rockers the Rolling Stones called off two concerts in Hong Kong but the city's annual Rugby Sevens tournament, which usually draws about 40,000 spectators, began on time on Friday.

At least three Hong Kong universities said they would shut their doors from Saturday, and a second hospital chief was admitted to hospital on suspicion of having caught the disease.

CHILDREN GO SHOPPING

But the school closures may not work as planned. Instead of staying home, many Singapore children left at a loose end headed to shopping centres and cinemas.

"My mum said to watch out for places which are crowded and where people might be sick," said Laura Van Langen, 11, who was out shopping with three friends. She and her friends said they were not worried about the virus.

Hong Kong's health department said on Friday it had recorded 425 infections so far. People unrelated to existing patients have fallen ill, a sign the virus is spreading widely in the city.

Companies have begun issuing surgical masks to front-line staff. Bus drivers have been wearing them for the past week.

Malaysia reported on Friday its first suspected SARS case, a nurse working in neighbouring Singapore. It said it would post health inspectors at border crossings to the city-state to screen visitors for the symptoms of the disease -- high fever, a cough, chills and breathing difficulties.

Singapore, Taiwan and the Philippines have imposed strict health checks to ask air passengers if they had come from affected areas. Hong Kong's tougher checks begin on Saturday.

Hong Kong is a major world transportation hub. The airport handles about 550 flights a day and some 90,000 passengers.

In the Philippines, the government said it would ask people arriving from infected countries to voluntarily quarantine themselves at home for seven days after arrival.

"We are wearing masks and we are in our own country, we have to protect our own country from this disease," said Teresa Sakdalan, a Filipina who arrived from Hong Kong.

BEIJING, March 26 (Reuters) - China dramatically raised the death toll from a mystery pneumonia to 34 on Wednesday with nearly 800 people infected and revealed the first deaths in Beijing, where hospitals have been secretly placed on high alert.

Most of the deaths were in the southern province of Guangdong, where officials said the outbreak peaked in early March, but Beijing, where officials had denied any cases, admitted three people had died of the disease.

The Beijing city health department said in a statement eight people -- all from either Hong Kong or the northern province of Shanxi -- had contracted the disease and three of these died. But it said the disease had not spread into the general population in the city of 14 million.

The government of Guangdong, which borders Hong Kong, said in a statement 792 people had contracted atypical pneumonia in the southern province by the end of February.

In Guangzhou, the provincial capital of 10 million people, 24 had died and 680 had contracted the disease. The other seven deaths were spread among six other Guangdong cities, which had reported no new cases in March, the provincial government said.

Officials in Guangzhou said the number of cases dropped dramatically in the city this month.

World Health Organisation (WHO) officials said that although the Guangdong outbreak was "very similar" to the mystery pneumonia that has killed 19 people around the world, it was too early to say if the two were the same disease.

China reported in early February that 305 people had been infected and five had died in Guangdong. Until Wednesday, it had said the outbreak had been contained.

Fears about the outbreak, compounded by rampant rumours about the little-understood disease, sent people as far north as Beijing flocking to pharmacies to stock up on immune-system boosting drugs and other remedies.

SECRET ALERT

The Beijing government had previously insisted there had been no cases in the city, although officials admitted two people from Shanxi died of atypical pneumonia in the city earlier this month.

But Beijing, hoping to head off panic, quietly put its hospitals on alert and laid out a plan to prevent the deadly disease from spreading in the city of 14 million people.

Television, newspapers and radio -- all controlled by the Communist Party or the government -- had made no mention of the disease in Beijing. But concern in the city was mounting before Wednesday's announcement.

Waiting rooms at hospitals and clinics were filling up with parents checking out the sniffles and coughs of their children.

People on the street talked about the "dreadful disease" they had heard about from Phoenix Television, a Hong Kong satellite station, and wondered aloud why state media had been silent.

Initial symptoms of the disease include high fever, dry cough, chills and severe breathing problems. Healthy, athletic adults can end up on a respirator within five days.

The Beijing government issued a circular on Monday telling doctors and nurses how to spot and treat potential cases that may be linked to the disease, dubbed severe acute respiratory syndrome (SARS).

"This disease has the potential threat to spread," said the circular, seen by Reuters.

"In order to respond effectively to an atypical pneumonia outbreak, protect the health of the masses and ensure social stability in the capital, this preparatory plan has been drawn up," it said.

"Social stability" is the phrase often used by the Communist Party to describe any potential threat to social order.

"SPEAK WITH ONE VOICE"

The plan designates one hospital to which all suspected cases should be referred and says investigative teams and a policy group will be set up if cases are found.

If more than five people had the disease, the policy group would be expanded to include propaganda and police officials, and a group of specialists would be established, it said.

The circular told doctors to "speak with one voice" in propaganda work and "be relaxed outwardly but vigilant inwardly" when face to face with potential sufferers, but made no mention of any public campaign to alert people.

"That's the Chinese way," said one doctor when asked about the secrecy.

Le Figaro Hongkong: de notre envoyé spécial Régis Arnaud [31 mars 2003] L'épidémie de pneumopathie flambe à Hongkong

Si les principaux foyers de la maladie restent localisés en Asie, et notamment à Hongkong où l'épidémie semble flamber actuellement, un nombre croissant de pays dans le monde déclare des cas suspects. Plus de 50 personnes sont mortes de ce syndrome aigu respiratoire sévère (Sars) encore dit pneumopathie atypique et près de 1 500 autres en ont été frappées depuis l'identification de l'épidémie en tant que telle, le 12 mars dernier. Malgré les mesures prises dans tous les aéroports du monde pour identifier et isoler les voyageurs en provenance d'Asie du Sud-Est présentant des symptômes suspects, l'agent infectieux en cause a bénéficié sans conteste des lignes aériennes mondiales pour se déplacer. Après le Canada, les Etats-Unis ont déclaré à leur tour, dimanche, plusieurs cas probables. Samedi, Carlo Urbani, âgé de 46 ans, le médecin expert de l'Organisation mondiale de la santé, le premier à avoir identifié le Sars chez un homme d'affaires américain au Vietnam, est décédé à son tour à Bangkok de cette affection.

En France, pour l'instant, le seul malade probablement atteint du Sars, hospitalisé au centre hospitalier de Tourcoing depuis une semaine, immédiatement après un voyage à Hanoï, semble aller mieux. Par ailleurs, une équipe de médecins militaires est arrivée hier après-midi à Hanoï pour prendre en charge les malades encore hospitalisés à l'hôpital franco-vietnamien, un des premiers centres de l'épidémie. Un spécialiste des maladies infectieuses, deux anesthésistes, un psychiatre, quatre infirmières et un logisticien doivent prendre le relais des onze médecins et infirmiers envoyés notamment par le Samu il y a une quinzaine de jours. L'établissement ne gérait plus dimanche que quatre malades, deux médecins français, dont un quasi guéri et deux infirmières vietnamiennes.

Un avion militaire avait d'abord été prévu par Paris pour rapatrier les malades français et le personnel du Samu. Pour des raisons de sécurité, le gouvernement a finalement choisi de prendre en charge les malades sur place. «Nous sommes déçus de l'annulation de l'évacuation sanitaire, regrette le docteur Yves Nicolaï, directeur de l'hôpital. «Après avis de l'équipe du Samu sur place, et compte tenu des recommandations du CDC sur le transport des malades, il a été jugé plus sûr d'envoyer une équipe du service de santé des armées pour prendre le relais du Samu sur place», précise le professeur Lucien Abenhaim, directeur général de la Santé. La situation épidémiologique semble s'être nettement améliorée au Vietnam où aucun malade n'a été décelé depuis plusieurs jours et où la grande majorité des personnes atteintes ont guéri.

Les autorités sanitaires françaises déconseillent de se rendre à Honkkong et dans plusieurs villes chinoises, notamment Pékin et Biong-Dong.

M. P.

D'ordinaire l'hôpital Prince of Wales ne désemplit pas le dimanche, jour des visites. Mais cette fois cet austère bâtiment des faubourgs de Hongkong est vide et silencieux. Les murs du hall d'entrée désert sont couverts de cœurs découpés dans du papier, où sont écrits des vœux de rétablissement et des messages d'encouragement au personnel soignant. «Ce que vous faites est formidable. Dieu vous bénisse», a ainsi écrit Creamy Yung le 21 mars.

C'est dans l'hôpital Prince of Wales que le gouvernement de Hongkong a identifié un des foyers de la pneumonie atypique qui a déjà provoqué 56 décès sur 1 610 cas à travers le monde. Pour l'ex-colonie seulement, on dénombre 13 victimes sur 530 malades (60 pour la seule journée de dimanche). La dernière victime est une femme de 74 ans décédée hier. Six membres des professions médicales et 36 habitants d'un même ensemble immobilier figurent parmi les 60 derniers malades recensés. Si 17 patients ont pu quitter l'hôpital dimanche, cinquante-deux restent hospitalisés en unités de soins intensifs. Et les autorités sanitaires prévoient que la semaine sera difficile. «Progressivement de nouveaux cas vont apparaître», certifie Leong Che Hung, président de l'autorité de tutelle des hôpitaux.

Le gouvernement a longtemps paru dépassé par les événements, se bornant à appeler la population au calme. Depuis vendredi, il a lancé une vaste opération «propreté» très médiatisée dans laquelle il cherche à regagner sa crédibilité perdue, mais aussi à solliciter les Hongkongais pour contenir l'épidémie. Il a décrété la fermeture des écoles pour une semaine; instauré des mesures de quarantaine inédites en trente ans; et a décidé que tous les malades atteints de pneumonie atypique seraient dirigés vers un unique hôpital, le Princess Margaret.

Dimanche, plusieurs ministres ont couru la ville pour sensibiliser les professions qui risquent de porter et de propager le virus. Comme les chauffeurs de taxi de cette petite station, sermonnés par le ministre des Affaires culturelles Ho Chi Ping qui les enjoint, manches retroussées et masque sur le visage, sous l'œil bienveillant des caméras, à nettoyer le plus possible leurs véhicules. Ou bien les poissonniers du marché de Sai Kung, visités par le même ministre quelques heures plus tard, à qui l'on demande de rester vigilants. «Si nous sommes tous ensemble, le gouvernement et le peuple, alors nous pourrons arrêter la maladie», explique-t-il.

Cette opération «séduction» ne tranquillise pas les Hongkongais, qui vivent pour la plupart avec un masque en permanence sur le visage, évitent de s'adresser la parole dans les ascenseurs et s'abstiennent de se rendre dans les endroits très fréquentés. Dimanche, de nombreux Hongkongais ont déserté les rues, centres commerciaux et cinémas pour suivre l'appel du gouvernement à «un jour de nettoyage ménager». Même les bonnes philippines ont préféré renoncer à une manifestation contre une réduction de salaire imposée par le gouvernement. Une mise en quarantaine imposée à plus de 1 000 personnes qui ont été en contact avec des malades devrait être de rigueur dès aujourd'hui.

Les chercheurs n'ont pas encore déterminé la nature du virus. Mais ils sont certains qu'il se propage très facilement, par le simple contact d'un bouton d'ascenseur, de la main courante d'un Escalator ou de postillons lors d'une conversation. «Notre mode de vie nous rend très vulnérables. Nous partageons tout, nous vivons en communauté», estime Carmen, une hôtesse de la compagnie aérienne locale Cathay Pacific. Carmen ne portait pas de masque dans son service, mais des passagers se sont plaints. «Ça ne sert à rien, le masque, soupire sa collègue Vénus. De toute façon on ne sait rien de ce virus. La seule chose qui soit certaine c'est qu'il faut éviter le huitième étage du Prince of Wales!»

Autour de Hongkong, centre de transit majeur de la région, les pays réagissent de diverses manières. Taïwan, la Thaïlande et le Vietnam déplorent tous des victimes, mais conservent leur calme. Plus vigilant, Singapour a assigné à résidence les ressortissants victimes du virus, sous peine d'amendes très sévères. La Chine, très probable point de départ de la maladie, est la cible de toutes les critiques pour avoir bloqué l'information et laissé le virus se propager depuis des mois. Les premiers cas de pneumonie atypique sont apparus dès novembre dernier dans la région de Canton, proche de Hongkong. Mais Pékin a attendu la semaine dernière, sous la pression de l'Organisation mondiale de la santé, pour publier des données sur l'épidémie. Pour la seule région de Canton, de loin la plus touchée, Pékin compte 31 victimes sur 792 cas. Le gouvernement chinois a promis de publier dorénavant région par région des bulletins quotidiens sur l'état d'avancement de la maladie. Mais dimanche soir il persistait à refuser l'accès à la région de Canton aux équipes de l'OMS. Tandis que la presse locale, elle, n'évoque que très peu ce sujet.

Le Soir Le 31/03/2003, 19 h 31 Un militaire belge présente les symptômes

Un militaire belge rentré de Hanoi il y a six jours présente les symptômes de la pneumonie atypique (syndrome respiratoire aigu sévère, SRAS) et a été hospitalisé à Liège, a-t-on appris lundi auprès du ministère de la Santé. «Il répond à la définition de l'OMS: fièvre, symptôme respiratoire et contacts avec quelqu'un qui toussait dans une région considérée comme endémique», a déclaré à l'AFP le Dr René Snacken, responsable du dossier au cabinet du ministre belge de la Santé Jef Tavernier.

Le militaire a été admis au Centre hospitalier universitaire (CHU) de Liège, où des examens sont actuellement en cours, a-t-il précisé. Deux cas suspects avaient été signalés en Belgique il y a quelques jours, mais les examens médicaux avaient écarté l'hypothèse d'une pneumonie atypique, a également indiqué M. Snacken.

Selon le communiqué de l'hôpital, «d'importantes mesures préventives ont été immédiatement adoptées: le patient se trouve dans un isolement complet, protégé par un double sas» et des «consignes très strictes sont appliquées par le personnel soignant». Le patient bénéficie en outre d'une thérapie antivirale. Les autorités de la Santé publique ont été avisées «afin que toutes les mesures soient prises pour assurer l'isolement et/ou la surveillance de toute personne ayant eu des contacts avec la personne soupçonnée d'infection», indique encore le communiqué du CHU de Liège. L'infirmière qui a reçu sans protection le militaire aux urgences dimanche, a été mise en quarantaine, a précisé lundi après-midi le médecin-chef du CHU, Christian Bouffioux, cité par Belga. L'épouse du militaire, son fils et un troisième membre de sa famille font également l'objet d'un suivi médical. Ils doivent en outre porter un masque, utiliser de la vaisselle désinfectée à l'eau de javel et limiter au maximum leurs déplacements en dehors de leur domicile et les contacts avec autrui, a-t-on indiqué de même source.

La Défense sur ses gardes

Le ministère de la Défense a annoncé lundi avoir pris des mesures de précaution pour son personnel. Les membres du personnel de la Défense ne pourront ainsi se rendre dans une zone atteinte par la maladie qu'avec l'autorisation formelle du ministre de la Défense, André Flahaut, ou du chef de la Défense (CHOD, anciennement chef d'état-major général), le général August Van Daele, a indiqué un porte-parole du ministère à l'agence BELGA. Quant aux membres du personnel revenant de l'une de ces zones (Canada, Chine, dont Hong Kong, Singapour et Vietnam), ils devront se faire examiner par les spécialistes de l'hôpital militaire Reine Astrid (HMRA) de Neder-over-Heembeek, a-t-il ajouté.

AFP, Belga

L'Organisation mondiale de la santé (OMS) a décidé de prendre les choses en main pour lutter contre le syndrome respiratoire aigu sévère (SRAS), appelée "pneumonie atypique". En ce qui concerne la Chine, cinq experts de l'OMS ont appelé vendredi les autorités sanitaires chinoises à publier des rapports quotidiens sur la pneumonie atypique originaire du sud du pays. Actuellement, le dernier bilan en date pour la province du Guangdong, foyer du syndrome respiratoire, est vieux de quatre semaines, avec 792 cas dont 31 mortels. Envers Hongkong, le Vietnam, Singapour et Taïwan, l'OMS a préconisé jeudi de filtrer les passagers dans les aéroports des pays les plus touchés par l'épidémie.

Ainsi, onze personnes présumées atteintes du SRAS ont été empêchées de monter à bord de vols à destination de Bangkok, d'après les autorités sanitaires thaïlandaises. Vendredi, Singapore Airlines a annoncé qu'une de ses hôtesses qui s'était occupée d'une famille singapourienne touchée par l'épidémie avait été hospitalisée avec de la fièvre. Par précaution, la compagnie a consigné au sol tout l'équipage de cabine du vol concerné et qui avait relié New York à Francfort le 14 mars.

Les choses se présentent mal pour la compagnie Singapore Airlines. Son action a chuté vendredi à son plus bas niveau en 16 mois en raison de l'impact sur le trafic aérien de la pneumonie meurtrière. Peu après l'ouverture de la Bourse, l'action valait 9,05 dollars de Singapour, en retrait de 35 cents ou 3,7 % sur la clôture de jeudi. C'est son plus bas niveau depuis son cours à 8,80 dollars le 13 novembre 2001. En fin de matinée, l'action avait refait un peu de terrain, n'abandonnant que 30 cents à 9,10 dollars sur la clôture de la veille.

Les choses risquent d'ailleurs d'empirer depuis que les Etats-Unis ont fait savoir jeudi qu'ils allaient limiter les déplacements officiels dans les pays asiatiques frappés par la pneumonie. Selon le département d'Etat américain, tous les voyages non officiels de responsables américains vers la Chine, Hongkong, Singapour et Taïwan sont suspendus jusqu'à nouvel ordre.

Le gouvernement américain s'inquiète de la propagation du SRAS sur son continent. A ce propos, au Canada, plusieurs nouveaux cas possibles du SRAS ont été recensés jeudi en Ontario, province la plus peuplée du Canada, portant à 39 le nombre total dans le pays, ont indiqué les autorités sanitaires. La maladie a déjà tué trois personnes en Ontario, dont une mère et son fils qui avaient voyagé en Asie, continent ou le SRAS est apparu en premier. "L'Ontario a relevé 28 cas probables et 10 cas suspects du SRAS" en date de jeudi, a déclaré à la presse Colin D'Cunha, commissaire à la santé publique de l'Ontario, ajoutant que ce bilan prenait en compte les trois personnes décédées. L'état de santé des personnes actuellement soignées "s'est soit stabilisé, soit amélioré", a-t-il indiqué. Ailleurs au Canada, un seul autre cas possible de la maladie a été recensé, en Colombie-Britannique, sur la côte Pacifique.

Au total, plus de 1 300 personnes dans le monde ont contracté le SRAS, une maladie d'origine virale encore mal connue qui a fait plus de 50 morts dans 14 pays.

Avec AFP

A l'université de Hongkong, des progrès ont été accomplis pour mettre au point un test de dépistage du virus responsable de la maladie.

Une équipe du département de microbiologie de l'université de Hongkong a annoncé, samedi 22 mars, qu'elle avait réussi à cultiver l'agent viral responsable de l'épidémie de pneumonie atypique partie d'Asie du Sud-Est. Cette maladie, qui donne un tableau clinique de syndrome respiratoire aigu sévère (SRAS) avait touché, au 22 mars, de manière possible ou probable 386 personnes dans 15 pays et fait onze morts, selon l'Organisation mondiale de la santé (OMS).

Depuis lors, un mort est venu s'ajouter à Hongkong et un autre au Canada et une quatorzième victime a succombé à Hanoï. Un médecin qui travaillait à l'hôpital français de Hanoï, l'un des foyers de l'épidémie, est arrivé en France en provenance du Vietnam porteur de symptômes "compatibles" avec un SRAS. Ce serait le premier cas "probable" sur le territoire français.

L'avancée des scientifiques hongkongais représente un pas en avant important dans la lutte contre l'épidémie. Ils ont travaillé à partir d'un prélèvement de tissu pulmonaire d'un patient mort après avoir été en contact avec un médecin originaire de la province du Guangdong, dans le sud de la Chine, mort lui aussi.

La mise en culture est une étape importante car elle devrait permettre la mise au point d'un test diagnostique spécifique du virus. L'équipe de Hongkong a déjà utilisé une version préliminaire du test sur les sérums de huit personnes atteintes. Le test s'est révélé capable de détecter des anticorps attestant de la présence du virus. Il permettrait d'établir avec certitude le lien, encore éventuel, entre l'épidémie qui a touché au cours des mois précédents le sud de la Chine. Reste à identifier formellement le virus.

De nouveaux arguments sont venus renforcer la piste d'un membre de la famille des paramyxovirus. Des chercheurs canadiens du laboratoire national de microbiologie de Winnipeg ont indiqué, vendredi 21 mars, avoir retrouvé du métapneumovirus humain (HMPV) chez six de leurs huit compatriotes atteints du SRAS.

Faisant partie des paramyxovirus, le métapneumovirus a été isolé pour la première fois en 2001 par une équipe hollandaise, chez des jeunes enfants hospitalisés pour une infection bronchique aiguë de type bronchiolite, proche de celles dues au virus syncitial respiratoire (un virus de la même famille que les paramyxovirus).

En réexaminant des prélèvements sanguins plus anciens, B. G. van den Hoogen et ses collaborateurs ont pu prouver que le HMPV était déjà présent dans la population pédiatrique depuis plus de 50 ans.

Une équipe britannique a montré en 2002 que l'on retrouvait du HMPV chez des patients de tous âges présentant un tableau clinique proche de celui de la grippe, mais non porteurs du virus respiratoire syncitial. D'autres travaux ont indiqué qu'une co-infection par le HMPV et le virus respiratoire syncitial était loin d'être rare.

Dans le cas de l'épidémie de pneumonie atypique, des arguments décisifs pourraient venir des prélèvements effectués sur des personnes malades à Hanoï par le virologue Jean-Claude Manuguerra à la demande des autorités sanitaires françaises.

Ces échantillons font l'objet de différentes études conduites tant par l'unité 404 de l'Inserm, dirigée à Lyon par Fabian Wild, que par l'Institut Pasteur de Paris. Selon la direction générale de la santé et l'Institut de veille sanitaire, au 21 mars, 112 notifications de patients en provenance d'Asie du Sud-Est présentant une symptomatologie évocatrice avaient été recensées. Sur ce total, 106 ont pu être écartées sur la base de l'évaluation clinique, radiologique, biologique et épidémiologique. Six personnes faisaient encore l'objet d'investigations supplémentaires.

Dimanche 22 mars, en cours de journée, la direction générale de la santé indiquait qu'un membre de l'équipe soignante ayant travaillé dans l'établissement privé de Hanoï où deux personnes sont décédées avait été hospitalisé au centre hospitalier de Tourcoing (Nord).

Examiné par les services médicaux de l'aéroport Roissy-Charles-de-Gaulle, il présentait des symptômes compatibles avec un SRAS. Après des examens complémentaires, cet homme a une pneumonie bilatérale, mais est porteur d'une hyperleucocytose (élévation des globules blancs), contrairement à ce que l'on observe dans un SRAS. Les investigations continuent.

Paul Benkimoun

Un virus venu d'Asie L'Express du 20/03/2003 - Santé publique Alerte au virus inconnu par Vincent Olivier, Estelle Saget

Mortelle dans 5% des cas, la pneumopathie atypique découverte en Asie mobilise les autorités sanitaires mondiales. Mais garde ses secrets

«S'il s'agit d'un virus d'origine grippale, alors c'est très inquiétant.» Lucien Abenhaïm, le patron de la Direction générale de la santé (DGS), ne cachait pas son appréhension, ce lundi 17 mars, face à la presse: la nouvelle forme de pneumonie qui sévit depuis deux semaines dans le Sud-Est asiatique présente de nombreux signes alarmants - au point d'ailleurs que l'OMS (Organisation mondiale de la santé) a lancé une procédure d'alerte à l'échelle mondiale. D'ores et déjà, on dénombre une cinquantaine de personnes atteintes au Vietnam, une centaine à Hongkong, des cas en Chine, en Thaïlande et même au Canada. Plusieurs sont décédées. En France, la DGS a mis en place un numéro vert (0-800-150-160) - qui est déjà saturé - et les voyageurs revenant de cette zone géographique présentant une fièvre inexpliquée ainsi qu'une gêne respiratoire sont invités à appeler le Samu - mieux vaut en effet, rappellent les autorités sanitaires, éviter de se rendre directement à l'hôpital, afin de ne contaminer personne.

«L'hypothèse est qu'il passe par les liquides corporels»

Quel est ce microbe? D'où vient-il? Comment se transmet-il? «A ce jour, personne au monde n'est capable de le dire», reconnaît Lucien Abenhaïm. D'autant que les premières analyses, effectuées à Hanoi par une équipe de l'OMS, n'ont donné aucun résultat. De nouveaux prélèvements ont donc été réalisés sur 28 autres patients, et envoyés au CDC (centre de contrôle mondial des maladies infectieuses), basé à Atlanta, aux Etats-Unis. De son côté, le ministère français de la Santé a financé l'envoi de quatre biologistes en Asie et dépêché à Hanoi une équipe du Samu, un épidémiologiste et un virologue de l'Institut Pasteur, le Pr Jean-Claude Manuguerra. Cette équipe, arrivée avec plusieurs valises contenant des tests pour toutes sortes de microbes, doit effectuer ses propres prélèvements sur les malades atteints, afin de tenter d'identifier le virus. Si elle n'y parvient pas, les échantillons obtenus seront envoyés à Paris, avant d'être éventuellement comparés avec ceux d'Atlanta.

Une salle d'attente dans un hôpital de Hongkong. Le territoire compte déjà une centaine de malades.

En l'espace de quelques jours, la traque est devenue mondiale. Hanoi a vu débarquer des équipes française, américaine, britannique, allemande et australienne. Et Hongkong, une délégation japonaise. Les médecins de Toronto, eux, font leurs investigations sur un voyageur tombé malade une fois rentré dans son pays, et sur sa famille. Dans leur enquête, les chercheurs n'ont pour l'instant que deux maigres indices. Le temps d'incubation de la maladie est de cinq à sept jours, un délai supérieur à celui de la grippe classique, qui se manifeste au bout de deux jours au maximum, entraînant un décès dans 5% des cas environ, selon le Pr Abenhaïm. En outre, le microbe ne s'est, jusque-là, transmis que d'un malade au personnel soignant ou, plus rarement, à un membre de la famille. «L'hypothèse est qu'il passe par les liquides corporels, par exemple le sang ou le produit de lavage broncho-alvéolaire», affirme le Pr Bruno Lina, du centre de référence pour les virus respiratoires à l'université Claude-Bernard de Lyon.

Comment le microbe a-t-il pu passer au travers des premiers tests sans être repéré? Il peut s'agir d'un agent resté à ce jour inoffensif, donc inconnu des chercheurs, et devenu soudainement pathogène. Il y a deux ans, les scientifiques ont ainsi identifié un nouveau virus responsable de la bronchiolite des nourrissons, le métapneumovirus. «Celui-ci arrive plutôt à la fin de la liste des microbes suspectés dans cette mystérieuse épidémie, mais il sera testé comme les autres», précise le Pr Lina. Autre piste: le coupable serait une bactérie ou un virus humain déjà connu, mais qui aurait subi une mutation naturelle le rendant indétectable par les tests disponibles.

Troisième hypothèse: un virus des oiseaux serait passé à l'homme. Dans ce cas, la piste chinoise est la plus sérieuse (lire l'article "Le péril chinois"). En février, 300 cas de pneumopathies, «assez similaires à celles que nous observons actuellement», précise Lucien Abenhaïm, avaient été détectés dans la région de Canton. Or le «cas index» - c'est-à-dire le premier malade repéré - isolé à Hanoi avait justement effectué un voyage dans cette zone récemment. Est-ce un indice? Les autorités de Pékin ont en tout cas demandé officiellement, le 17 mars, à l'OMS d'envoyer une équipe d'experts sur place. La Chine pourrait bien voir confirmer sa réputation de berceau des nouveaux virus menaçant la planète.

Surpeuplée, la Chine est la marmite idéale pour fabriquer de vilains virus: le petit dernier vient de Hongkong

Il en va du vaccin de la grippe comme de la mode automne-hiver. A chaque saison sa nouveauté. L'injection, qui comprend les trois virus - inactivés - les plus redoutés dans l'hémisphère Nord, vient d'arriver dans les pharmacies. Et cette année, c'est un microbe chinois qui fait l'originalité de sa composition, les deux autres souches ayant déjà été sélectionnées en 2001.

Le petit dernier, venu de Hongkong, a remplacé un compatriote en perte de vitesse, originaire, lui, de la province du Sichuan. Année après année, la Chine s'impose comme le berceau de nouveaux agents infectieux assez actifs pour répandre la grippe à l'échelle de la planète. Ce pays surpeuplé constitue la marmite idéale, où se mélangent les ingrédients nécessaires à la fabrication d'un méchant virus. La zone est survolée par les oiseaux migrateurs, premier maillon de la chaîne de transmission à l'être humain. Ceux-ci entrent facilement en contact avec les canards ou les porcs, qui abondent dans un pays où se pratique encore l'élevage de subsistance. Passé des animaux domestiques à l'homme, le microbe se reproduit et mute facilement grâce à la densité de population des grandes villes de la côte. «Un nouveau virus doit trouver dans les quatre jours une personne saine à infecter pour ne pas disparaître», rappelle le Dr Jean-Claude Manuguerra, codirecteur du Centre national de référence pour la grippe à l'Institut Pasteur, à Paris. Aujourd'hui, le réseau mondial de surveillance de la maladie permet de repérer le lieu de naissance des virus et de les pister dans leur carrière internationale. Ainsi, on sait tout de la vie et de la mort d'une souche baptisée «A Wuhan 371-95», isolée pour la première fois en 1995 dans la grosse ville industrielle chinoise du même nom. Pendant deux ans, ce microbe casanier n'est pas sorti de sa région d'origine. Mais, en 1997 et 1998, il a été détecté successivement en Asie du Sud-Est, à Dakar (Sénégal), à Johannesburg (Afrique du Sud), et finalement à Cherbourg. Un joli parcours, qui lui valut d'entrer par la suite dans la composition du vaccin, avant de disparaître. Le nouvel élu venu de Hongkong devrait connaître un destin similaire.

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