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SARS Baffles Health Community - 2003-04-30


The Virus known as SARS continues to spread around the world. At last check, a dozen countries had reported cases. So far, the official death toll from SARS around the world is over 230 people. The United States has remained relatively unscathed, with no fatalities so far. But just north of the U.S. border in Toronto, Ontario SARS infections have grown and have been the cause of at least 20 deaths making Canada the most infected country outside Asia.

The World Health Organization even issued a warning against travel to Toronto, slowing tourism and forcing the cancellation of several business conferences.

SARS is in the same family as the common cold and pneumonia. The symptoms resemble a cold: fever, headache, body aches maybe a cough or shortness of breath. And although the prognosis for SARS is grimmer than for a cold, Judy Gerberding, Director of the Centers for Disease Control, told CBS-TV that people shouldn't necessarily be alarmed if they happen to have similar symptoms.

"The first thing is have you traveled to the part of Southeast Asia or other countries where this disease is epidemic? If you haven't traveled or you're not in contact with someone who has recently traveled. Then right now you wouldn't have to worry about SARS, at least in this country. If you have that travel history or exposure, then the symptoms are pretty nonspecific. The illness starts like a common cold or any viral illness. It can progress to become a phenomena syndrome and it's that phenomena that we're concerned about," Ms. Gerberding said.

However, the CDC Director said if a patient is concerned, it doesn't hurt to contact a physician.

Estimates of the SARS fatality rate have fluctuated widely, especially by country. However, over the last three weeks, the World Health Organization's estimates stayed fairly constant at about four percent of those infected. That number may not sound high, but it does have Dr. C.J. Peters at the University of Texas Medical Branch in Galveston, quite concerned.

"Our paradigm here should be the 1918 influenza outbreak. It represented an entirely new disease. It had exchanged genes with other influenza strains and shaken itself up to become a new disease against which nobody had any immunity. The mortality from that virus was about 1% of all those who were ill. And yet in spite of the relatively low mortality it's believed to have killed 20-40 million people worldwide," she said.

He said if this virus is as contagious as the one in 1918, no country will be immune from SARS.

The airline industry has been the focus of how SARS has traveled from country to country so quickly. Some airlines in Asia are screening every passenger taking their temperature to weed out potential carriers of the disease.

Mark Cabana is an English teacher with the Peace Corps who recently returned from Mainland China. He was called home 27 months before he was originally scheduled to leave, because of the SARS outbreak. He said that when compared to Asia, at U.S. airports, the approach to finding potential carriers of SARS virus has been a bit more subdued.

"No, there was no quarantine period, which they've done in other places like Toronto and Hong Kong. But for us if we were just exhibiting any symptoms, they wanted us to talk to the medical office. So even people that had a slight cough or low fever were checked out by the medical staff," Mr. Cabana said.

However, it can take a few days for the symptoms of SARS to show up, which can make spotting infections in the airport more difficult. So what can be done to keep SARS under control? Richard Preston has written several books on smallpox, anthrax and other diseases. He said that past experiences with viruses similar to SARS have shown that in some cases, vaccines have caused even more ill effects than the actual virus itself. In addition, a vaccine will likely take a minimum of a year to develop. Mr. Preston told NBC that public policy may be the best answer to SARS and illnesses like it.

"Within a decade or so, the human species, 60 percent of the people are going to live in cities. It's going to be an urban population. This SARS virus looks like an urban virus and it's going to be very important to have a strong and very vigilant public health system," he said.

According to the CDC, SARS appears to spread by close person-to-person contact which can include touching the skin of other people or objects that are contaminated with infectious droplets and then touching your eyes, nose, or mouth. It may also be possible that SARS can be spread more broadly through the air or in other ways that are currently not known. If you must be in close contact with someone who has the disease, wash your hands frequently and consider wearing a surgical mask.