Chinese doctors today reported two deaths in Beijing and 20 people stricken in Shanghai by a disease with symptoms similar to severe acute respiratory syndrome.
The doctors' statements cast doubt on Chinese government pronouncements that the spread of the disease, also known as SARS, had been limited to Guangdong province, in southern China, where it is believed to have originated. State-controlled media have been banned from reporting about the disease since mid-February. A few English-language publications in China have printed articles that reflected the government position.
An official with the World Health Organization, based in Geneva, said it was informed by Chinese officials that no cases of the disease had occurred outside of Guangdong. The official, Henk Bekedam, said that the WHO had asked China to begin issuing a province-by-province breakdown for SARS and that the government had yet to respond.
Chinese doctors said there were cases in Beijing at least 10 days ago and Shanghai hospitals had some at least a month ago.
On Thursday the WHO reported a total of 350 cases outside China, including 10 deaths, up from 306 cases the day before. Italy and Ireland joined the list, each reporting one case. Most of the new cases are from Hong Kong, hit hardest with 203 cases and six deaths.
China often plays down or bans the reporting of news that could be construed as shedding a bad light on the government. Local governments often take the lead in suppressing bad news because officials worry it will cost them their jobs. For years, Henan province has denied the seriousness of its AIDS problem because of concerns that it would reflect poorly on the government and affect the "investment environment," a Chinese researcher said.
"SARS is no exception," he said. "We are seeing the government go into crisis mode. When it does that, all information is shut down. In the absence of information, the common people are left to rumors and panic."
SARS is believed to have erupted in southern China in November, and by January it was causing widespread panic buying of vinegar and herbal drugs even though the government moved to suppress news media reports. Chinese media lobbied hard with the government for the right to report and on Feb. 9 the government relented, releasing the information that 305 people had been infected, and five had died, in Guangdong.
The government has neither updated that information nor provided blood, tissue or sputum samples from patients in China to international researchers seeking the source of the disease. A team of WHO experts is scheduled to arrive in China on Sunday to work with Chinese experts looking for a cause.
Researchers in Hong Kong have tentatively concluded that the disease was brought there by a Chinese doctor who stayed in a Hong Kong hotel Feb. 21-22. The doctor had treated SARS cases in Guangdong.
Visitors to or guests at the hotel subsequently carried the disease to a Hong Kong hospital, and to Vietnam, Singapore and Canada. Three of the seven people who stayed on the hotel's ninth floor, including the doctor, died from the disease.
Until now, Chinese health officials had publicly cast doubt on whether the Guangdong disease was linked to the Hong Kong eruption and its spread around the world. But now, said Bekedam, "we're able to say there's more likely a link to Guangdong."
Chinese doctors said a man and his wife died in Beijing in early March after exhibiting symptoms similar to acute respiratory syndrome. The couple died at Hospital 302, the Chinese army's infectious diseases hospital. The deaths were first reported by the Agence France-Presse news agency on Wednesday, and doctors said today that the man who gave AFP the information had been fired. Doctors also said a third patient, a reporter who had traveled from Guangdong, was also believed to be seriously ill with the disease.
In Shanghai, a doctor familiar with the situation at several city hospitals said 20 people have contracted the illness, half of them workers at medical facilities. According to the doctor, the hospitals treating such patients have notified the Shanghai Bureau of Health. But a senior official in the section responsible for epidemic control at the bureau denied that any cases have been found in the city. "There is absolutely not a single case," said the official, Song Guofan. "There would be no need for us to cover this up."
At Renji Hospital in Shanghai, near People's Square, a man said to be in his forties was breathing tonight only with the aid of a respirator, and his prognosis was poor. "He's dying," a doctor said.
According to the doctor, the patient has been in the hospital for about a month and previously traveled to Guangzhou, Guangdong's provincial capital. Chest X-rays and tests revealed that the man had contracted the same type of atypical pneumonia that has accompanied the virus elsewhere.
Hospital staff, aware of the outbreaks in Guangzhou and of the possibility that the illness might spread through the air, at first refused to treat the man and three other patients who arrived shortly thereafter, the doctor said. The hospital chief threatened to fire any staff who refused to treat such patients. Doctors and nurses now don surgical masks all over the hospital and wear multiple layers of clothing to protect themselves against infection.
Staff writer Rob Stein in Washington contributed to this report.