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Book Review
Behind the Mask: How the World
Survived SARS, the First Epidemic of the 21st Century
Timothy J. Brookes and Omar A. Khan
American Public Health Association, Washington, DC
IBSN: 087553046X
Pages: 262; Price: US $27.00
Suggested
citation for this article
Behind the Mask: How the World Survived SARS, the First Epidemic of the
Twenty-First Century recounts the outbreak of Severe Acute Respiratory
Syndrome (SARS) that swept through much of the world, especially Asia,
in 2003. The author does a superb job of telling the reader about what
was occurring before SARS appeared, what happened during the outbreak,
and what efforts are underway to prevent its return. The author has blended
research results and interviews with frontline staff, particularly healthcare
providers, into 20 nicely interlaced chapters. The stage for this commentary
is a timeline of events, starting November 16, 2002, with the first known
case of SARS in Guangdong Province, China, and ending in December 2003–January
2004 with 4 cases of SARS and the slaughtering of ≈10,000 civets
in Guangdong Province. Where possible, the author avoided the use of medical
terms and jargon and provides helpful lay translations where their use
was unavoidable. As a result, the book is accessible to readers both inside
and outside the healthcare arena.
The information presented in the book is, for the most part, current
and accurate; different views and beliefs are presented when necessary.
There are minor typographical mistakes as well as a few incorrect statements,
such as in chapter 1, page 6, where the author refers to past public health
efforts to eradicate viruses. The author states that smallpox virus and
poliovirus have both been eradicated and that both are now bioterrorism
agents. However, despite tremendous progress through efforts of many governments
and public and private entities, poliovirus has yet to be eradicated and
is not regarded as a bioterrorism agent at this time.
With regard to SARS, however, the author successfully portrays the human
side of the outbreak response—a response heralded as unparalleled by many
of the involved officials. Dr Carlo Urbani, the World Health Organization
(WHO) physician in Vietnam who worked tirelessly and who was an eventual
casualty of SARS, is among the many heroes who are featured in this book.
Lesser-known facts, such as the thought processes that led to identifying
SARS, are also provided. For example, before the SARS coronavirus was
shown to be the causative agent, the outbreak was thought to be caused
by either avian influenza or chlamydia. The reader is made aware of all
of the challenges posed by the SARS virus, such as the delay in recognizing
that there was an outbreak, the difficulties in diagnosing and reporting
the disease and obtaining specimens, the breadth and scope of national
and international collaboration and coordination, and not knowing the
causative agent.
This book does a nice job of giving readers a flavor of the experiences
faced by persons at WHO, persons at the country ministry level, individual
healthcare providers, and SARS patients. I highly recommend this book,
especially to anyone who was not directly involved in the SARS outbreak
response; they too can share the experience of the global community response
to a disease that was first recognized in 1 province of China.
Mehran S. Massoudi*
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Suggested citation
for this article:
Massoudi MS. Behind
the mask: how the world survived SARS, the first epidemic of the 21st
century [book review]. Emerg Infect Dis [serial on the Internet]. 2005
Dec [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol11no12/05-1058.htm
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