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SARS, the First Pandemic of
the 21st Century1
James W. LeDuc*
and M. Anita Barry†
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and
†Boston Public Health Commission, Boston, Massachusetts, USA
Suggested
citation for this article
The 2003 outbreak of severe acute respiratory syndrome (SARS) shocked
the world as it spread swiftly from continent to continent, resulting
in >8,000 infections, with approximately 10% mortality, and a devastating
effect on local and regional economies. Three laboratories—one each in
Hong Kong, Germany, and the Centers for Disease Control and Prevention
(CDC) in Atlanta, Georgia, USA—nearly simultaneously isolated an apparently
new coronavirus as the cause of SARS. Through traditional virus isolation
and molecular techniques, CDC's team recovered the virus from specimens
and characterized it as a novel coronavirus. Specific nucleotide sequences
of the new virus were identified in specimens from SARS patients, and
an immune response to the agent was demonstrated in patients' sera.
The potential for global spread of SARS was quickly recognized by the
World Health Organization (WHO). The Global Outbreak Alert and Response
Network was activated to help identify and deploy volunteers from around
the world to assist the most severely affected nations, and WHO rapidly
issued several recommendations to help nations control outbreaks and prevent
spread.
Hong Kong was among the first cities affected by SARS, and its healthcare
community suffered greatly from the disease. Some lessons from their experiences
included recognition of the value of real-time information in a rapidly
progressing epidemic with a large number of cases and the need for frequent
patient updates, challenges of national efforts to maintain entry and
exit health screening among international travelers, and implementation
of home quarantine as an effective tool to interrupt SARS transmission.
In Toronto, Ontario, Canada, the public health department had responsibility
for SARS surveillance and case reporting, investigation and management
of possible cases, identification and quarantine of contacts, health risk
assessment, and communications, and they were a liaison with hospitals
regarding infection control. These were massive responsibilities. Serious
practical and legal challenges were encountered as the department successfully
implemented quarantine measures for the first time in more than half a
century. Daunting challenges were also overcome in disease surveillance
and reporting; meeting the needs for accurate, timely information and
guidance; and implementing effective infection control practices in healthcare
facilities. One of the most important lessons was an awareness of the
psychosocial problems among healthcare workers directly involved in facing
SARS.
1Presented at the International Conference
on Emerging Infectious Diseases, Atlanta, Georgia, February 29 –
March 3, 2004, by William Bellini, Centers for Disease Control and Prevention;
Guenael Rodier, World Health Organization; Thomas Tsang, Department of
Health, Hong Kong, China; and Barbara Yaffe, Toronto Public Health.
Suggested citation
for this article:
LeDuc JW, Barry MA.
SARS, the first pandemic of the 21st century. Emerg Infect Dis [serial
on the Internet]. 2004 Nov [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol10no11/04-0797_02.htm
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