PerspectiveEpidemiology

The SARS Wake-Up Call

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Science  15 Mar 2013:
Vol. 339, Issue 6125, pp. 1287-1288
DOI: 10.1126/science.1236434

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Summary

In February 2003, a 64-year-old doctor was treating patients with atypical pneumonia in his home town of Guangzhou, in Guangdong Province, China (1). He himself had developed a respiratory complaint but felt well enough to travel to Hong Kong and go sightseeing with his brother-in-law. Unknown to him or anyone else, his symptoms were the early stages of "severe acute respiratory syndrome" caused by a previously unknown coronavirus (SARS-CoV) (2). The doctor, who had been staying in a hotel during his visit, checked into a Hong Kong hospital, warning staff that he had contracted a virulent disease. He succumbed 10 days later. During his short illness he had infected his brother-in-law (who died shortly after), at least two hospital nurses, and seven hotel guests including three from Canada, Singapore, and Vietnam. One hotel guest admitted to a hospital infected at least 88 health workers and 18 medical students. Another patient discharged from the same hospital started an outbreak affecting more than 200 residents of a housing estate. Infection continued to spread rapidly and widely. Within 5 months, 8096 people had been affected in 30 countries and 774 died, a fatality rate of about 1 in 10. As the emergency unfolded over the following 134 days, it stimulated renewed debate about how countries should work together to combat public health crises that run across national boundaries.