Taiwan has posted another record jump in new SARS cases as the flu-like virus spread to an offshore island and forced another hospital in the capital Taipei to close its doors.
The confirmed SARS case on the outlying Penghu island is worrisome evidence that the deadly respiratory disease has spread to areas outside the main Taiwan island, which already has the world's third highest number of SARS deaths and infections.
The Department of Health on Sunday reported five more deaths from Severe Acute Respiratory Syndrome and 36 new infections, bringing the island's death toll to 40 and probable cases to 344.
On the Penghu archipelago, some 40 km (25 miles) west of Taiwan, a hospital was shut with more than 100 medical staff and patients under quarantine after a man and his wife who visited a SARS-hit hospital on the main island were found to have contracted the disease.
The couple developed SARS symptoms after returning home from the SARS-stricken Chang Gung Memorial Hospital in Taiwan's southern Kaohsiung city, which has quarantined 110 health workers.
The couple's infections sparked fear among residents of Penghu where medical facilities are considered inadequate.
"We only have two major hospitals. If what happened in Taiwan happens here, I don't know what we can do," said Irene Kao, a resident of Penghu.
In Taipei, the Municipal Gan-dau Hospital was closed off on Sunday and said it was likely to quarantine some 200 medical staff and patients after a janitor was diagnosed with SARS.
Taiwan's growing number of SARS infections comes against an improving backdrop elsewhere, with the World Health Organisation saying the outbreak was coming under control in Hong Kong, the worst hit area after China.
Singapore, which has the world's fourth-highest number of SARS fatalities, is hoping to be taken off the WHO's list of SARS-affected regions on Sunday after reporting no new cases for 20 days, or two incubation periods.
Taiwan had been relatively free of the virus until an outbreak at a Taipei hospital in late April caused the number of infections to rocket.
On Saturday, Taiwan offered its "most sincere apology" to Japan after one of its doctors visited Japan earlier this month and was confirmed to have contracted SARS after returning home.
The visit by the 26-year-old doctor, who works in Taipei's Mackay Memorial Hospital which is battling to contain SARS outbreaks, sparked fears he could have spread the disease to Japan, which has had no confirmed SARS cases.