AIDS TREATMENT NEWS Issue #390, April 4, 2003
John S. James
Almost everyone has now heard of SARS (severe acute respiratory syndrome), a new disease that can cause a serious and sometimes fatal pneumonia. As we go to press (April 2, 2003) the news is changing very rapidly. Just a week ago it looked like SARS might be dying out -- but then Hong Kong reported over 50 new cases in one day. Conferences and other public events are being postponed or cancelled in that city and some other parts of Asia. This disease could end on its own, or it could become a worldwide pandemic and kill many people. Currently there are over 80 suspected cases in the U.S., most acquired from travel abroad.
SARS is believed to be caused by a previously unknown virus. Some but not all patients have severe breathing difficulties and need a respirator. So far the fatality rate has been about 4%. Recently Hong Kong physicians reported success in treating seriously ill patients with antibodies from those who had recovered -- a well-known technique that has been used successfully with other infectious diseases.
At this time experts believe that SARS is spread mostly by close personal contact, as in hospitals or homes, especially by coughing or sneezing. Some patients appear to be much more contagious than others. No one knows how well the infection can travel through the air in public places. It might also be spread by objects recently handled by an infected person.
One place to start is a Web page by the U.S. National Library of Medicine: http://www.nlm.nih.gov/medlineplus/severeacuterespiratorysyndrome.html
For more detailed information, see the U.S. Centers for Disease Control and Prevention (CDC) page: http://www.cdc.gov/ncidod/sars/
We have not yet seen any HIV-specific information about SARS.
We suggest that more be done to support people in complying with public-health directives -- especially travelers far from home who are asked not to fly if they have possible symptoms. If they fear being stranded in a foreign country thousands of miles from home with no place to stay, uncertain medical care, and problems getting a flight home when they recover, they will have strong incentive to lie and conceal their illness. It would cost little for public-health systems to help make arrangements for the few travelers affected at this time.
New diseases will become increasingly serious due to crowded populations, massive air travel, and possibly bioterrorism. Proper support for public health, long neglected by governments that care only for the rich (who can afford private medicine), will become a life-or-death issue for everyone.
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