Toronto is becoming known as a SARS hotspot in such locations as Manila, Riyadh, and London. Canada's largest city is also the first area in the West to be added to a U.S. travel warning list.

The U.S. Centers for Disease Control and Prevention (CDC) added Toronto to its list of countries with suspected or documented community transmission of SARS on Tuesday. Health Canada is working with the CDC to produce an information leaflet for travellers.

CDC spokesperson Dr. Julie Gerberding said the alert is designed to advise travellers of what they should be on the lookout for. Symptoms of SARS include fever, muscle aches, and dry cough.

"This alert is being distributed at Toronto International Airport," Gerberding said, adding that pamphlets would soon be distributed at border crossings as well.

Previously the CDC only asked people who recently travelled to affected areas in Asia, such as mainland China, Hong Kong, Singapore or Hanoi, Vietnam, to monitor their health.

The agency is recommending travellers to Toronto avoid settings where SARS is most likely to be transmitted, such as health care facilities. There is no known treatment for SARS and fear is growing that it will spread.

SARS goes south

So far, the United States has reported 39 probable SARS cases. A series of SARS cases south of the border involve patients who fell ill after travelling to Toronto.

A New York state elementary school teacher and part-time bartender is suffering from SARS symptoms after travelling to Toronto last week.

The Canandaigua man checked himself into hospital with a high temperature, shortness of breath and headache. The man is now at home and has been ordered to remain in isolation for 10 days.

North Carolina's newest case involves a woman from Wake County who also developed symptoms after visiting Toronto. So far, seven suspected cases have been reported in the state.

A Pennsylvania was released from hospital on Monday after recovering from SARS symptoms. Investigators are examining his contacts to members of a Catholic sect in Toronto that were recently quarantined.

Elsewhere, the Philippine government confirmed that a nursing assistant who died last week was probably the country's first SARS victim.

The 46-year-old woman died 11 days after returning from Toronto where she worked at a long-term care facility.

The woman's father, who was suffering from colon cancer, developed a fever and was quarantined following her death. The man died on Tuesday and is considered a suspected SARS case.

On the defence

As for how Torontonians feel about SARS, a recent Gallup poll reveals that most residents are not alarmed. But the city's tourism industry is taking a major hit and some residents say they're being singled out when they travel.

Dr. Mark Berber, a psychiatrist, said that customs officials wanted to make sure he hadn't been exposed to SARS patients during recent flights to Florida and Bermuda.

Berber also said one of his friends who took a flight from Las Vegas to Chicago that included a routine stopover in Toronto had unusual homecoming.

"Because the flight went via Toronto, he wasn't allowed to go back to work in the office until he had a 10-day quarantine period at home," Berber said. "That, I think, is over-reacting. That's unreasonable."

Meanwhile, American-based Crystal Cruises is refusing to allow Toronto residents aboard its ships. The company is also rejecting passengers from Hong Kong, mainland China, Singapore and Vietnam.