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Last Updated

09 Apr 2003

Source: Associated Press, April 9, 2003

Singapore Woman Linked to 100 SARS Cases

By YEOH EN-LAI, Associated Press Writer

SINGAPORE (AP) -- Esther Mok went to Hong Kong to shop but came home carrying a deadly flu-like virus that has since spread to more than 100 people in Singapore and killed both of her parents and her pastor. Miraculously, she has survived.

Mok, a 26-year-old former flight attendant, was one of three original cases of Severe Acute Respiratory Syndrome, or SARS, to emerge in Singapore early last month.

Mok was very sick - and very contagious - when admitted to a Singapore hospital on March 1, but doctors had no idea that she was suffering from the strange form of pneumonia that had already killed dozens in China.

She had regular visits from her family and members of her church - all oblivious to the fact that they were exposing themselves to SARS.

Her father, mother and pastor have since died of SARS. Her uncle is in intensive care battling the illness. Mok's grandmother and brother are also sick but in stable condition.

In fact, all but a handful of the 118 reported cases in Singapore have been traced to Mok, and health officials have dubbed her a SARS "super spreader."

Two other Singaporean women also traveled to Hong Kong in February and developed SARS after exposure to a Chinese doctor, Liu Jianjun, while staying at the Metropole Hotel. They have not infected others, the health ministry said.

"Esther Mok infected the whole lot of us," health minister Lim Hng Kiang said at a recent press conference.

Two other so-called super spreaders, Canadian Kwan Siu-Chiu and American Chinese businessman Johnny Chen, fell ill after a stay at the Metropole hotel and have helped spread the illness around the world. Unlike Mok, both died.

"We don't know why some people are able to spread it so easily and some don't," said Chew Suok Kai, health ministry's director of epidemiology and disease control.

Experts from Atlanta's Centers for Disease Control will be in Singapore later this week to further analyze data from SARS patients here in a bid to find out how the "super spreader" phenomenon works, Chew said.

"There are so many things we want to know about this disease but don't know yet. One of the key things we are working on is how the super-spreader spreads," said Chew.

Mok herself has recovered and could be released from a hospital, but authorities are reluctant to let her go, fearing the media frenzy that is likely to greet her.

Like "Typhoid" Mary Mallon, who famously infected dozens of people in the New York area in the early 1900s and was forced by the government to live alone on an island, Mok is living her own modern-day exile in a hospital room networked with televisions and telephones.

Mok's quarantine prevented her from attending the memorial services of her parents, Joseph and Helen, but she has not been alone. Mok's sister, Rebekah, has taken a leave of absence to be with her, said Pastor Humphrey Choe of the family's church, the Faith Assemblies of God.

"We are all praying for her and for everyone involved," said Choe, adding that the church has rallied around Mok.

Since this island nation of 4 million people first reported its SARS outbreak a month ago, it has quarantined about 1,000 people, ordering them to stay home for 10 days or risk prosecution. Nine people have died and 118 have been reported to have the illness.

"I feel sorry for her but you might wonder whether Singapore would be so badly affected had she not been in the wrong place at the wrong time," said deliveryman Gary Sivalingam.

Severe Acute Respiratory Syndrome, or SARS, has killed over 100 and sickened over 2,600 worldwide, mostly in Asia.