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Cause of illness identified

Fast-spreading respiratory disease becomes global menace.


"Because of an extraordinary collaboration among laboratories from countries around the world, we now know with certainty what causes SARS."

—Dr. David L. Heymann

Scientists have definitively identified the cause of Severe Acute Respiratory Syndrome, or SARS, as a new form of the coronavirus, the World Health Organization announced April 16.

"The pace of SARS research has been astounding," said David Heymann, executive director of the WHO Communicable Diseases Program. "Because of an extraordinary collaboration among laboratories from countries around the world, we now know with certainty what causes SARS."

"The people in this network have put aside profit and prestige to work together to find the cause of this new disease and to find way new ways of fighting it," said Dr. Klaus Stoehr, a WHO virologist who coordinated the research effort of 13 laboratories in 10 countries. "In this globalized world, such collaboration is the only way forward in tackling emerging diseases."

To date, SARS has killed at least 217 people and infected more than 3,800 worldwide, according to WHO statistics updated on April 21. SARS has also claimed the life of the WHO physician, Dr. Carlo Urbani, who first identified the disease in Hanoi, Vietnam, on Feb. 28.

As of April 18, at least 225 cases have been reported in the United States, although no deaths have been reported yet, according to the Center for Disease Control in Atlanta. California has the most suspected cases -- 45, according to the CDC.

More than 1,900 suspected cases of SARS have been recorded in mainland China, where the disease is believed to have originated in November. Another 1,402 cases were reported in Hong Kong as of April 21, according to WHO.

But cases have turned up in South Africa, Kuwait and Ireland, as well as Canada, where 12 people have died from the disease.

"At this moment, public health authorities, physicians and scientists around the world are struggling to cope with a severe and rapidly spreading new disease in humans," Heymann said. "This appears to be the first severe and easily transmissible new disease to emerge in the 21st century."

The rapid spread of the disease led to the quarantine of airplanes, hospital wards and apartment complexes, especially in Hong Kong, and prompted WHO to issue, for the first time, a global health alert on March 12. It also led to a declaration from President Bush that added SARS to the list of diseases (e.g. cholera, smallpox and ebola) which warrant quarantine.

The symptoms of SARS, according to WHO, are the rapid-onset of a high fever, muscle aches, headaches, breathing problems and sore throat.

Health officials, who originally thought SARS could only be transmitted by direct contact, think it may also be transmitted through the air, and by contaminated objects.

"We believe, based on what the investigations have shown so far, that the major mode of transmission still is through droplets spread when an infected person coughs or sneezes and droplets are spread to a nearby contact," said Dr. Julie L. Gerberding, CDC Director, during a telebriefing with reporters March 29.

"But we are concerned about the possibility of airborne transmission across broader areas and also the possibility that objects that become contaminated in the environment could serve as modes of spread. Coronaviruses can survive in the environment for up to two or three hours, and so it's possible that a contaminated object could serve as a vehicle for transfer to someone else."

There is also the possibility that certain people may be so-called "superspreaders" of SARS meaning that one person may be capable of infecting dozens if not hundreds of people. That such a method of transmission is possible is still only speculation, according to the CDC.

Gerberding said at the same telebriefing that no effective treatment has yet been determined.

However, about half of the people infected worldwide have recovered from the disease. And Heymann thinks that careful international cooperation may stop SARS from becoming a epidemic.

"In a world were all national borders are porous when confronted with a microbial threat, it is in the interest of all populations for countries to share the information they may have as soon as it is available," Heymann said. "In so doing, they will allow both near and distant countries all neighbours in our globalized world to benefit from the understanding they have gained."

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