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"Severe Acute Respiratory Syndrome (SARS)"Good morning. Mr. Chairman, Mr. Waxman, Members of this Committee: thank you for inviting me to testify today on Severe Acute Respiratory Syndrome, or SARS. My colleagues and I are committed to doing everything we can to protect the health of all Americans. Right now, responding to the SARS outbreak is one of our top priorities. More than 250 researchers and staff from the Centers for Disease Control and Prevention are working around the clock in laboratories and on location in several affected nations to understand this new disease, devise appropriate protections, and work with state and local health departments in their efforts to do the same. Scientists from the National Institutes of Health are working with their colleagues at CDC and the World Health Organization to develop diagnostic tests and to explore a broad range of ideas for treatment and the possible development of vaccines. It was researchers at CDC who identified the virus that we think causes SARS-a coronavirus. Obviously, identifying the virus is critical to this development of antivirals and vaccines. As you probably know, Mr. Chairman, it looks like SARS began in the Guangdong Province of China last fall. From there, it apparently spread to one floor of a hotel in Hong Kong by a physician from Guangdong who himself became ill caring for his patients. We are trying to improve our understanding of the condition of this man and the residents of this hotel floor in order to learn more about how this disease is spread. Unfortunately, the infection was carried to other countries by travelers who stayed on that floor at the same time. Worldwide, thousands of people have already been infected, and 103 have died. As of yesterday, there were 154 suspected cases in the United States. We can be thankful that all of them are still alive. Of those 154, definitive diagnostic information is currently only available from 5 of the cases, as demonstrated by two different laboratory tests: 4 have evidence of coronavirus antibodies (indicating that they were indeed exposed to this novel virus), and 1 has a positive culture of the virus. Of the 154, 53 have been hospitalized at some point, but only 1 has required a ventilator. 31 have tested positive for pneumonia. Let me stress that these are suspected cases. Once we have a good test, many of them may turn out not to have SARS at all. Other countries have not been as fortunate. According to the World Health Organization, the worldwide SARS total, not counting the United States, is 2523 cases. The early symptoms of SARS are a fever of more than 100.4 degrees, a headache and muscle ache, and a cough. People with severe cases may have difficulty breathing. CDC has asked people who have these symptoms to consult a health care provider for a diagnosis. The incubation period, from exposure to symptoms, is probably 2-7 days, though a few reports suggest up to 10 days. SARS seems to be transmitted by coughing, sneezing, and personal contact. American health care providers have been very good about protecting themselves when interacting with patients they suspect are suffering from SARS. They have also provided excellent supportive care. As we speak, CDC and NIH are developing 3 diagnostic tests, which we will send to state laboratories as soon as they are ready. Two antibody tests require two samples of serum-one taken as early as possible, and the other about 3 weeks later. When comparing these two samples from a given patient it is possible to tell who has been exposed to this virus. We are also developing a polymerase chain reaction test (PCR) for use as a diagnostic test. Rapid and accurate communications are crucial to ensuring a prompt and coordinated response to any infectious disease outbreak. For this reason, strengthening communication among clinicians, emergency rooms, infection control practitioners, hospitals, pharmaceutical companies, and public health personnel has been of paramount importance to CDC for some time. In the past three weeks, CDC has held multiple teleconferences with state health officials to give them the latest information on SARS spread, implementation of enhanced surveillance, and infection control guidelines. CDC has also appreciated receiving their input in the development of these measures and processes. In addition, we have issued travel advisories to people returning from China, Hong Kong, Singapore, and Vietnam. We have distributed more than 200,000 health alert notice cards to airline passengers entering the United States from these areas, alerting passengers that they may have been exposed to SARS. Mr. Chairman, these cards advise people to monitor their health for 10 days, and to consult a doctor if they develop fever or respiratory symptoms. So far, Mr. Chairman, the lessons we can draw from SARS are that surveillance is critical, and that surveillance works. Early detection of a pattern of symptoms gave scientists critical time to start investigating this disease. In addition, we know that we have much more to learn about this virus and this disease so that we can develop the tools that we need to prevent, treat, and contain it. We continue to work around the clock and to learn more about every aspect of SARS. I want to assure you that this is not business as usual. We will not rest until we understand how to detect, treat, and prevent this disease. I look forward to your questions. Last Revised: April 10, 2003 |
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