Humanitarian Resource Institute:  A U.S. & International Resource on the Scope of Humanitarian Assistance
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May 26, 2003

Stephen M. Apatow
Director of Research and Development 
Humanitarian Resource Institute Biodefense Reference Library
Eastern USA: (203) 668-0282   Western USA: (775) 884-4680
Internet: http://www.humanitarian.net/biodefense
Email: s.m.apatow@humanitarian.net

SARS: ASSESSING THE THREAT - WHY ARE SO FEW "PROBABLE" CASES REPORTED TO THE WORLD HEALTH ORGANIZATION

The article "City reels as suspected new SARS cases discovered," 25 May 2003 (Toronto Business Times) outlines a key point that differentiates exposure to the SARS coronavirus from diagnosis and reporting of the case as "probable."

"The existence of the virus, however, does not necessarily mean the cases are in fact SARS, as several people have tested positive for the coronavirus without actually being diagnosed with the disease."

"Clinically, these people are compatible with SARS," acting medical officer of health Dr. Barbara Yaffe said. "However, there is no clear epidemiological link."

The article "Unseen victim causes Sars outbreak," 26 May 2003 (Times UK) emphasizes the significance of one missed case:

A Laundry worker in a Taiwan hospital who developed Sars had the disease undiagnosed for six days and may have exposed 10,000 other people to the virus. The worker, who died on April 29, has created an epidemic in Taiwan that has so far infected 570 people and killed 72.

In the context of globalization and threat to the international community, physicians, veterinarians and epidemiologists need to play a key role in strategic planning and development for emerging infectious diseases.   This ideal is a complicated objective, as outline in the paper "International Law, Communicable Diseases and the Geopolitical Objective of Minimal Interference with World Trade and Travel:"

"Public health is no longer the prerogative of physicians and epidemiologists. International health law, which encompasses human rights, food safety, international trade law, environmental law, war, and weapons, human reproduction, organ transplantation, as well as a wide range of biological, economic, and sociocultural determinants of health, now constitutes a core component of global communicable disease architecture."

If the current challenge was a smallpox outbreak, experts would agree that the consequences would be catastrophic, and with the HIV/AIDS variable, no room for error.  Add to this the reality that travel advisories would not be the major concern, the system shutting down would be.

For additional information and reports, visit the SARS: Epidemiological Tracking web site.


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