Anger and disbelief were the two main responses from Canada Wednesday, after the World Health Organization issued a global travel advisory on Toronto over the SARS outbreak.

All levels of government, the medical community and the business world were shocked by the advisory, which saw dozens of countries issue their own travel warnings, including Australia, Britain, Italy and France.

Toronto Mayor Mel Lastman, who had been uncharacteristically silent on the city's SARS outbreak, was almost spitting with rage over the advisory.

"I've never been angrier in my life," Lastman told a news conference. "I'm shocked. The medical evidence before us does not support this advisory.

"I can't believe (the WHO) issued a press release saying they're not coming back for three weeks. I want them here tomorrow. I want them to investigate Toronto tomorrow. I think they are doing this city and this country a disservice," Lastman yelled.

The travel warning, which also includes Beijing and China's Hani province, will be active for at least three weeks -- double the maximum incubation period for the potentially deadly flu like illness.

In Ottawa, federal Health Minister Anne McLellan urged the WHO to lift the advisory, saying it is not appropriate "based on our understanding of the circumstances on the ground.

"We are going to work very strenuously with the WHO to see if we can get this travel advisory issue clarified in the coming hours," she told reporters in Calgary.

Meanwhile, Health Canada has fired off a letter to the Geneva-based WHO demanding an explanation. The reasons it gave Wednesday for the advisory included the size of the city's outbreak, the fact it had spread from health care workers into the community and that people travelling from Toronto had exported the disease to other countries.

In an interview with CTV Newsnet on Wednesday night, Maria Cheng of the WHO, who is originally from Toronto, said "the WHO has a great confidence in the Canadian public health-care system.

"We just feel at this time that to stem the spread of SARS, we wanted to do everything possible."

Nova Scotia changes tune

Just hours after the WHO issued its travel warning, the government of Nova Scotia also advised people to put off any non-essential travel to the city, citing the WHO warning.

Later in the day, Nova Scotia Health Minister Janes Purves did a swift about-face.

"Based on information we received tonight by conference call, I would say I may have erred on the side of caution," Purves said after speaking with her federal and provincial counterparts Wednesday night.

That will likely do little to calm public health officials in Ontario, including Dr. Colin D'Cunha, the province's chief medical officer of health. "I'm just shaking my head in disbelief.

"We believe this (WHO) decision was made without consulting the province -- we believe it was an over-reaction," D'Cunha told reporters, as he outlined the extraordinary precautions the city had taken to fight SARS.

He noted that of the 267 probable and suspect cases of SARS in Ontario, only 124 remain in hospital or in quarantine at home.

There were some angry words earlier in the day from Dr. Donald Low, chief microbiologist at the Toronto's Mount Sinai Hospital, who called the travel advisory "a bunch of bullshit.

"It's inappropriate. The impact on the city ... you won't be able to take this mark off," he said.

Low said the spread of SARS into a religious community in Toronto had occurred more than two weeks ago and there had been no further spread of the disease from that group.

"Everybody has been saying this is a critical week. They could have waited another four or five days and they'll see that in fact there are no new cases ... what I'm seeing is reassurance, and not reason to close down the city.''

Dr. Sheela Basrur, Toronto's chief medical officer of health, said SARS in Toronto was "primarily a disease of health care workers largely in hospital settings."

"It has occurred in some community settings, but not to any great extent. And to categorize us as close to Beijing or other parts of China is a gross exaggeration of the facts," she said.

WHO speaks out

WHO communicable diseases chief Dr. David Heymann issued the agency's travel warning advising people to avoid unnecessary travel to Shanxi, Beijing and Toronto.

"These areas now have quite a high magnitude of disease, a great risk of transmission locally -- outside of the usual health workers -- and also they've been exporting cases to other countries,'' Heymann said.

In an interview from Thailand, he said Toronto had "an exportation which set up a cluster of five cases in health workers in another country." He offered no other details.

Ontario Health Minister Tony Clement said the WHO issued the travel advisory because three suspected cases of SARS were exported from Toronto to the U.S. and the Philippines.

Clement insisted there was no need for the advisory, adding he wanted to convince the WHO that Toronto is winning the battle against SARS.

"The best way that we can convince WHO -- and by extension the world -- that Toronto is a safe place is to win the battle against SARS. We're going to fight this and we're going to win it," Clement said.

WHO spokesperson Dick Thompson cited the transmission of cases outside of hospitals as one reason Toronto was added to the travel advisory.

"The reason that the recommendation was put in place was because of the exportation of cases, transmission outside the hospital setting and ... the large number of cases," Dick Thompson told The Canadian Press in a telephone interview from Geneva.

"We realize there is an impact on the community," he added, "but this is a temporary recommendation. It will be reviewed in three weeks."

Damage done?

Toronto, which was the first place outside Asia where SARS was detected, has been a special concern to health officials because of the disease's continued spread there despite tough measures.

WHO spokesperson Isabel Nuttall told a video press conference Wednesday the Canadian and Chinese governments were informed of the travel advisory 24 hours before it was issued.

The WHO warning is a further worry to Toronto business people, who fear it will devastate a local economy already reeling from the financial repercussions of the SARS outbreak.

Rick Naylor, head of Accucom, a company that organizes trade shows to Toronto, fears his sector won't be alone in feeling the negative impact of the WHO travel warning.

"The ripple effect is huge because the hotel industry, the restaurant industry, sporting events -- everything filters out of that,'' Naylor said.

"The economic impact is huge -- it's not just the conventions, it's the offshoot businesses that are affected," he added.

Low agreed, saying the damage had been done.

"Can you imagine somebody booking a conference in Toronto for a year from now? What executive is going to put their neck on the line for Toronto? Why take the risk?" asked Low.

Catherine Swift, president of the Canadian Federation of Independent Business, called the WHO's warning reckless.

"When I read the actual wording of the World Health Organization comments, I really thought they were excessive given the situation here in Toronto from all of the facts that we've seen," she said.

"To over-emphasize this and do more damage simply out of a fear factor as opposed to reality is unquestionably irresponsible."

The WHO travel advisory on Toronto came a day after the city was added to a U.S. travel warning list.

The U.S. Centers for Disease Control and Prevention (CDC) is recommending travellers to Toronto avoid settings where SARS is most likely to be transmitted, such as health care facilities, and be on the lookout for symptoms such as fever, muscle aches, and dry cough.

Other developments:

• Health officials announced a 16th death from SARS in Ontario, and said the death was not unexpected. It is the second time in two days that a SARS patient has died of the illness.
• Alberta has offered to take in Ontario patients who require immediate surgeries if the SARS outbreak in Toronto creates a backlog.
• Air Canada is easing its rules for passengers who re-book flights to and from Toronto on discounted tickets so they aren't hit with a penalty if they want to leave Toronto sooner than planned.
• Major league baseball says it will recommend teams visiting Toronto take precautions. During the all-star break, players will be advised against signing autographs, visiting hospitals, using public transportation and mingling with large crowds.
• China orders all public schools in its capital closed, leaving almost two million students to study at home following a major jump in the number of reported SARS cases in the city.
• Bank of Canada governor David Dodge says SARS will hurt Canada's economy, but it's too soon to say by how much.

With reports from Canadian Press