ATLANTA -- Nine more people in the United States are suspected of having the mysterious flu-like illness that has sickened hundreds in Asia, the federal government said Friday.

A total of 22 people in this country now are suspected of being sickened by severe acute respiratory syndrome, or SARS, said Dr. Julie Gerberding, director of the Centers of Disease Control and Prevention. Eleven suspected U.S. cases were announced by the CDC on Monday and two more were added Wednesday.

"We need to be highly vigilant," Gerberding said. The suspected cases involve people who recently have been to Asia and developed fever and respiratory problems.

People who have had close contact with ill patients can also contract SARS, Gerberding said. In one case, an ill traveler from Asia may have infected two health workers. Another traveler to Asia is suspected of spreading the illness to a family member.

The CDC Web site listed six cases in California; three in Hawaii; two each in the states of North Carolina, New York and Virginia; and one case each in Maine, Massachusetts, New Jersey, New Mexico, Rhode Island, Utah and Wisconsin. Federal officials have said those who haven't recently traveled to Asia don't have to worry about the illness.

Symptoms include coughing, shortness of breath, an X-ray indicating pneumonia or difficulty breathing, accompanied by a temperature of at least 100.4 degrees; close contact in the past 10 days with someone who has SARS or a visit in the past 10 days to one of the locations where the disease has turned up -- primarily eastern Asia.

The CDC has handed out 35,000 fliers warning of the illness to travelers returning from Asia. This week, U.S. health officials intercepted five planes or boats with sick passengers.

Ill passengers were isolated and taken to health care facilities. The other passengers were required to give officials information of their whereabouts for the next two weeks so they can be notified if needed, said Dr. Marty Cetron, a CDC quarantine expert.

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On the Net

CDC SARS info: www.cdc.gov/ncidod/sars

World Health Organization: www.who.int/en/