26 September 2003

U.S. Will Be Prepared for Next SARS Outbreak, Health Officials Say

Active hunt underway for effective medicines, vaccines

By Charlene Porter
Washington File Staff Writer

Washington -- Top U.S. health officials said September 26 they can't predict when and if another outbreak of severe acute respiratory syndrome (SARS) will strike, but they'll be ready when it does.

"Preparedness is absolutely essential," said Centers for Disease Control and Prevention Director Dr. Julie Gerberding in a news conference at the agency's Atlanta, Georgia headquarters. "We have to learn to expect the unexpected."

SARS, a previously unknown disease, first appeared in late 2002. By the first quarter of 2003, it had escalated into an outbreak most concentrated in several Asian nations, but appearing ultimately in 29 countries. More than 8,400 people took ill with the flu-like disease; almost one thousand died.

Even as the global health community rushed during those first months to contain and control a poorly understood, virulent disease, it was evident that SARS was likely to follow the pattern of other respiratory ailments -- becoming dormant in warmer months and re-emerging in colder months. With those colder months now drawing closer in the Northern Hemisphere, health officials are taking steps to respond more rapidly than during the first outbreak.

U.S. Secretary of Health Tommy G. Thompson explained the far-reaching effort. The Department of Health and Human Services "is continuing to work with the free market medical community as well as the scientific community to make sure that our nation will be fully prepared if SARS re-emerges," he said.

Gerberding said effective SARS preparedness depends on collaboration between laboratories, public health officials and ministers of health in many countries. "We're all talking about SARS preparedness collectively. One country or one agency can't do this alone. It requires global connectivity to be successful."

At the same time, significant research is under way at the nation's premier health research agency -- the National Institutes of Health (NIH) -- to develop better tools for accurately diagnosing SARS and for curing it.

"NIH is screening existing antiviral drugs and other compounds to see if any of them will work against SARS," Thompson said. He said the various research agencies involved in this effort "have been able to go through more than 1,000 compounds. ... They plan to screen as many as 100,000 compounds." The screening process has identified some substances that show promise doing battle against SARS, and Thompson said more intensive research is under way.

Individual citizens can also contribute to the SARS prevention effort by getting a flu vaccine, health officials point out. SARS and flu are marked by similar symptoms -- fever, headache, body ache, and respiratory distress. When presented with a coughing, feverish patient, health care providers need to be able to determine whether the illness is common flu or potentially fatal SARS as quickly as possible. Reducing the number of flu cases through a widespread vaccination campaign will help achieve that. Gerberding emphasized, however, that flu can be diagnosed definitively while such tests are still lacking for SARS, which is caused by a coronavirus related to flu.

These two prominent health officials were unwilling to offer odds on the probability of a SARS recurrence, but Gerberding seemed to have few doubts.

"As an infectious disease expert ... I've never seen a pathogen emerge and go away on its own, so I think we have to expect that somewhere, sometime this coronavirus is going to rear its ugly head again," Gerberding said. The CDC director also indicated that Asia is a likely place for SARS to begin its re-emergence, though she said the past cannot be used to predict the future.

Whatever happens, Gerberding said the global health community is in a better position today to cope with SARS than when it first appeared as an unknown killer. In fact, she suggested that SARS may signify a new development in global health that will be marked by the frequent emergence of previously unknown diseases "[T]his preparedness for SARS is going to pay off sooner or later, because if it's not SARS it will be something else and we'll be ready for it."