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Commentary
The Impressive and Rapidly
Expanding Knowledge Base on SARS
James M. Hughes*
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Suggested citation
for this article:
Hughes JM. The impressive and rapidly expanding knowledge base on SARS.
Emerg Infect Dis [serial online] 2004 Feb [date cited]. Available
from: URL: http://www.cdc.gov/ncidod/EID/vol10no2/03-1043.htm
Three days after issuing a global alert (1) about cases
of atypical pneumonia in several countries in southeast Asia, the World
Health Organization (WHO) introduced the term SARS to the world’s lexicon
(2). Familiarity with the newly coined acronym for “severe
acute respiratory syndrome” was immediate, fueled by fear and by virtually
continuous coverage by the media.1 This intense
reaction and scrutiny would generate multifaceted outcomes, enabling widespread
collaboration and communication to help curb the tragic health consequences
while wreaking economic, social, and even political havoc in many areas.
With similar speed, the clinical, public health, and research communities
worldwide mounted an aggressive response to the new disease. Under the
leadership of WHO, members of normally competitive groups worked together,
often communicating several times a day, to acquire and share knowledge
to stop the spread of disease. Events unfolded rapidly, requiring implementation
of traditional control measures while generating in a matter of weeks
an impressive body of knowledge about an unknown member of the coronavirus
family. Scientific journals played a major role in this endeavor, expediting
online publication of peer-reviewed data and other evolving information.
The articles in this special SARS issue of Emerging Infectious Diseases
are representative of this sustained involvement and commitment, with
respect to both scope of authorship and range of topics. This diversity
also illustrates the substantial contributions of many disciplines to
the growing knowledge base on SARS. The articles describe findings from
clinical and epidemiologic investigations, laboratory research, and social
and behavioral studies, and discuss lessons learned both locally and globally.
More than a decade ago, the Institute of Medicine (IOM) issued a report
(3) on the continued risks of infectious diseases, outlining
factors contributing to the increased emergence of such threats in a globalized
era and steps that should be taken to adequately address them. Ironically,
within a week of WHO’s unprecedented global alert (1),
the IOM released an updated report (4) on emerging microbial
threats, expanding on the severity and scope of the problem. The new report
describes issues affecting disease emergence such as international travel
and commerce, environmental changes, poverty and inequity, and the adaptability
of microbes, and strongly emphasizes the need for increased surveillance
and response capacity on a global level. The emergence of SARS reinforced
the urgency of the situation, serving as an impetus for fundamental changes
in the way the global health community interacts and bringing the message
home to policymakers and the public.
Maintaining this motivation for change is essential. Efforts are needed
to strengthen health systems nationally and internationally and to encourage
and strengthen multidisciplinary collaborations among clinical, public
health, research, and veterinary specialists worldwide. In addition, while
technologic advances have increased access to and sharing of new information
in unprecedented ways, we must recognize that the most vulnerable populations
often do not have access to such information and look for new ways to
convey essential health messages. Finally, as experience has so clearly
demonstrated, vigilance for the unusual on the part of clinicians, laboratory
workers, public health officials, and others, including the public, will
continue to be a critical initial step in recognizing and responding to
future emerging global microbial threats.
References
- World Health Organization. WHO issues global alert
about cases of atypical pneumonia. Press release issued by WHO, March
12, 2003. [cited 2003 Dec 13] Available from: URL: http://www.who.int/csr/sars/archive/2003_03_12/en/
- World Health Organization. World Health Organization issues emergency
travel advisory. March 15, 2003. [cited 2003 Dec 13] Available from:
URL: http://www.who.int/csr/sars/archive/2003_03_15/en/
- Lederberg J, Shope RE, Oaks SC Jr, editors, for the Committee on Emerging
Microbial Threats to Health, Division of Health Sciences Policy, Division
of International Health, Institute of Medicine. Emerging infections:
microbial threats to health in the United States. Washington: National
Academy Press; 1992.
- Smolinski MS, Hamburg MA, Lederberg J, editors, for the Committee
on Emerging Microbial Threats to Health in the 21st Century, Board on
Global Health, Institute of Medicine. Microbial threats to health: emergence,
detection, and response. Washington: National Academies Press; 2003.
1December 31, 2003, a National Library of
Medicine PubMed search using the term SARS produced >1,500 results;
a popular Internet search engine produced more than 5.3 million.
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James
M. Hughes
Director, National Center for Infectious Diseases, Centers for Disease
Control and Prevention, Atlanta, GA, USA |
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