A MYSTERIOUS deadly type of pneumonia is travelling the world by airliner and there is no known cure.

Bioterrorism is being considered as a possible cause of the outbreak, which has killed nine people and infected more than 150 others on three continents. British doctors have been told to look out for the flu-like symptoms and guidance is being prepared for hospitals to treat patients in isolation.

The illness, known as Severe Acute Respiratory Syndrome (SARS), has infected scores of doctors, nurses and medical staff who have been treating the victims.

The World Health Organisation has taken the exceptional step of issuing an “emergency travel advisory”, urging travellers to see their doctor if they develop symptoms.

There was concern yesterday as travellers flying into Hong Kong, where there has been a severe outbreak, arrived at the airport wearing face masks to avoid infection.

There was confusion, too, in Germany when a passenger became ill before his plane landed in Frankfurt. German officials kept 220 passengers in quarantine for several hours until it was agreed that they could be released.

Scientists have yet to prove that the outbreaks in various countries are definitely related and they do not even know whether the illness is caused by a virus or bacteria. The first clues appeared in Guangdong province, southern China, where five people died and 302 were infected with an “atypical pneumonia” in January and February.

The movements of a 49- year-old Chinese-American businessman will be studied by health experts as they try to trace the spread of the illness. On February 26 he flew to Hanoi, Vietnam, after spending time in Shanghai and Hong Kong. Two days later he fell ill. On March 6 his condition deteriorated and he was taken to hospital in Hong Kong, where he died last Thursday.

In his wake he left an outbreak of pneumonia in Vietnam, infecting 37 workers at the Hanoi French Hospital. Among them was a nurse who died on Saturday. Eleven others are being treated at another hospital in Hanoi.

The disease spread to Singapore, where three people who had visited Hong Kong were reported to have developed the symptoms last Thursday.

By yesterday ten of their relatives and friends and seven health staff who cared for them were admitted to hospital with the illness.

In Toronto Sui-chu Kwan, an elderly woman, died on March 5 and her son, Chi Kwai Tse, 44, died on Thursday after the family had visited Hong Kong. Four relatives and a close family contact also have the illness. Two people in British Columbia have also become infected.

In Taipei three people became ill, including a 64-year-old woman who arrived home via Hong Kong after visiting the Chinese mainland.

Hong Kong is sensitive about being seen as the source of the disease because of the potential devastation to its tourist industry.

Shoppers in the former British colony have stripped shelves of surgical masks and traditional Chinese flu remedies as 42 people, many of them medical staff, have been taken into hospital.

Three hospital wards have been cleared, a specialist heart clinic has had to reduce its services and non-urgent operations are being cancelled to keep intensive-care beds free.

Yeoh Eng-kiong, the Secretary for Health, Welfare and Food, tried to calm visitors yesterday, saying: “You are not more likely to get pneumonia coming to Hong Kong than any other cities.”

Reports in Hong Kong have pointed out that some local people developed pneumonia after visiting Hangzhou in eastern China and Zhuhai in southern China. The disease reached Europe at the weekend when a Singaporean doctor flying home from a medical conference in New York became ill before his plane made a planned stop at Frankfurt. He had treated some of the victims in Singapore.

The 32-year-old man’s condition was deteriorating yesterday, although it is not yet certain that he and his mother-in-law, who has a fever, have SARS. His pregnant wife is healthy but in quarantine.

German officials took the unprecedented measure of keeping passengers in quarantine for much of Saturday before releasing them to continue their journeys. The authorities finally conceded that their risk of infection was “extremely low”.

Other passengers were allowed to continue their journey to Singapore on a different aircraft and given medical advice when they arrived. The original aircraft will be disinfected and the material around the sick man’s seat destroyed.

The risk of bioterrorism is being taken seriously on both sides of the Atlantic. The Department of Health said: “The pattern of infection certainly looks like a naturally occurring illness but obviously we are keeping an open mind. It would be ridiculous for us to rule anything out at this stage.”

Julie Gerberding, director of the Centres for Disease Control and Prevention in Atlanta, Georgia, said: “We have an open mind and will be keeping an open mind.”

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