SAN JOSE, Calif. -- Five passengers on a flight from Tokyo were cleared of a mystery illness from Asia after the jetliner was stopped on the tarmac in what first looked like a public health emergency.
American Airlines Flight 128 from Tokyo to San Jose stopped short of the gate and was flanked by ambulances after the airline alerted the San Jose airport about the scare, said Todd Burke, a spokesman for the airline. After 10 hours in the air, the 125 passengers and 14 crew members waited as health officials in surgical masks came on board.
But when doctors had cleared all five people hours later, the situation turned into a testament to fears surrounding little-understood severe acute respiratory syndrome, or SARS, which has killed more than 60 people worldwide.
"It took a tremendous amount of resources to do this," said Dr. Karen Smith, the Santa Clara County health officer who boarded the plane. "If every flight from Asia has someone coughing on it and has to go through the same procedure, I just don't see how that's feasible."
Doctors cleared two passengers on board and sent three others to a hospital. Those three did not appear particularly ill and were discharged, said Tad Hurst, an emergency room doctor at Santa Clara Valley Medical Center.
Of primary concern was whether they had spent time in areas where SARS outbreaks have occurred -- in mainland China, Hong Kong, Singapore and Hanoi, Vietnam. Initial reports were that four of the five who reported feeling sick may have boarded in Tokyo after flying from Hong Kong, said Joy Alexiou, a spokeswoman for the Santa Clara County Public Health Department.
Seventy cases of SARS are suspected in the United States, but no one has died. Worldwide there are about 1,800 cases.
U.S. health officials are not considering quarantines so far because the disease is not spreading as rapidly as in Asia and the related outbreak in Toronto. Health officials said Tuesday that two more people in Canada have died because of the illness, bringing the country's total deaths to six.
In Hong Kong, some 240 residents of an apartment complex where SARS has spread were taken to quarantine camps Tuesday. But such measures don't yet appear warranted in the United States, said Tommy Thompson, secretary of the U.S. Department of Health and Human Services.
"We are in the business of protecting the public health of all citizens," Thompson said Tuesday. "If there is a virus that is explosive ... and the only way to control it is by quarantine, we have to consider it. But we're not there yet."
At this point, the main worries to health officials are the ability of SARS to quickly spread to large clusters of health workers caring for ill patients and the death rate, which is about 3.4 percent. That death rate is half that of West Nile fever, which was 6.7 percent last year, but is still considered relatively high by health officials.
Health officials initially issued a global alert, in part, because of fears that a new strain of influenza had appeared that might rival the magnitude of the 1918-19 pandemic that killed 20-million people worldwide. It now appears that SARS is not influenza.
SARS usually starts like any other acute respiratory infection, with a fever of 100.4 degrees Fahrenheit or higher, malaise, headache, difficulty breathing and dry cough. Chest X-rays tend to show what doctors call "atypical pneumonia" in a lower lobe of a lung. In the next few days, the pneumonia often spreads to another lobe.
Then about five or six days later, the symptoms improve in about 80 to 90 percent of patients and worsen in the remainder. Many of the sickest patients need intensive care.
Also, doctors do not yet know how long a patient can disperse the virus. In most cases, doctors are making only educated guesses as to when it is safe to let SARS patients leave the hospital.