SARS :: Severe Acute Respiratory Syndrome

"If the avian flu goes pandemic while Tamiflu and vaccines are still in short supply, experts say, the only protection most Americans will have is 'social distancing,' which is the new politically correct way of saying 'quarantine.' But distancing also encompasses less drastic measures, like wearing face masks, staying out of elevators...." (12Feb06, Quote #245)

"A domestic cat in Germany has become the first European Union mammal to die of the deadly H5N1 strain of bird flu.... Cats have been known to contract the virus from eating infected birds." (BBC News, "German cat gets deadly bird flu", Tuesday, 28 February 2006, 16:16 GMT)

SARS

[ Crowds are hazardous to our health! Protect yourself! ]

Above: Hong Kong concert audience, during SARS epidemic (01May03)

Severe Acute Respiratory Syndrome

n late 2002, a new disease emerged in southern China, SARS: Severe Acute Respiratory Syndrome. (Presumably you already know about it, dear reader). SARS apparently is of the same "family" as cold viruses (it's a "coronavirus"...). But it is apparently very different from any previously known coronavirus, so that scientists have not yet traced its precise provenance. (23May03: The source may have been found, See below

)

SARS infection is generally accompanied by pneumonia, and about 10% of the persons who catch it die from it. As of early May, 2003, there is only symptomatic treatment, and quarantine to try to keep the victim from infecting others. SARS is spread through the air, e.g., by coughing, or even by a person touching something an infected person has touched and then, e.g., rubbing their hand across their eye. Recently some persons who seemed to have recovered have relapsed, raising the possibility of them infecting others after being released from hospital or quarantine.

SARS seems most likely to have arisen in the same conditions of crowding and mixing of species as "normally"(sic) "only"(sic) give rise to each year's new edition of the flu: "[T]he first case of SARS... emerged [in November, 2002] in Guangdong, perhaps in the markets where all sorts of live animals, from chickens to cats, turtles and badgers, are sold for food."(Donald G. McNeil Jr and Lawrence K. Altman, "Health Agency Took Swift Action Against SARS", NYT on the Web, 04May03. See picures of one such market...) Germs have highly propitious conditions there for jumping from one species to another, including to humans. Of course the living conditions of the people are crowded along with the animals. It seems likely that SARS originated in some animal virus which mutated and jumped -- the very short hop -- to people "in the filthy, crowded markets of Guangdong" (Bradsher and Altman, NYT on the Web, 23May03).

"[T]he Pearl River delta, which encompasses Hong Kong, Macau and much of Guangdong, has a history of producing many of the world's biggest pandemics, including some of the most virulent strains of influenza that swept the world in the 20th century. SARS, or severe acute respiratory syndrome, is believed to have started in Guangdong.

"The delta, with 57 million people living in very crowded conditions, has long played a special role in the transmission of virulent diseases from animals to people. It is common for ducks, pigs, rodents and other carriers of disease to be in very close contact with people, sometimes under the same roof. Fine cuisine in Guangdong has also meant the consumption of a very wide range of wild animals, which may also carry diseases." (Keith Bradsher, "Hong Kong to Set Up a Research Center to Study SARS", NYT on the Web, 05May03)

It seems unlikely that SARS would have emerged without the crowding and promiscuous mixing of species. I think the message is clear and cogent: All situations in which persons crowd together are hazardous to our health. When crowding of other species and poor sanitary conditions are added, that surely makes things even worse. To return to the picture at the top of this page, the young persons would be far safer if they listened to the music on their personal stereos with a few friends, than wearing a surgical mask in a crowded concert audience.[fn.59c

]

When I express my opinion that crowds are always bad and should be eliminated from our lifestyle, people criticize me for having a negative attitude and wanting to make life boring. You, my reader, need to think about the pleasures of being lost in a crowd versus the pleasures of more individuated activities. We will have paid dearly for the former if SARS turns out to be an epochal epidemic, and, in any case, some persons have already suffered and died from it. A recent OpEd piece in the New York Times (30Apr03, p.A27) pointed out that there are many other public health threats afoot, including that one-third of the persons in the world have been infected with tuberculosis, and that there are increasing numbers of persons with TB that is resistent to all current medicines.

Part II

f the intensive promiscuity of crowding created SARS, the extensive promiscuity of fast, easy global travel enabled SARS to spread over the whole earth in just a few weeks. All sorts of foreign organisms are spreading all over the earth with often devastating ecological consequences. Businessmen and tourists carry the diseases on intercontinental jets, while other creatures stow away in the cargo or are even intentionally imported by people who for whatever reasons traffic in the exotic. "Feb. 21, [2003, SARS] escaped China when a 64-year-old Guangdong doctor checked into the Metropole in Hong Kong and infected guests who would spread it to Toronto, Hanoi, Singapore and elsewhere in Hong Kong."(McNeil and Altman, loc. cit.) The second thing that needs to change in our lifestyle, is to minimize people and things travelling around.

Unlike crowding, of course, travel cannot be eliminated. But the quantity of it can be minimized so that increasingly rigorous measures to prevent the spread of disease and the invasion of alien organisms become feasible. Long ago, the telephone company urged us to let our fingers do the walking. The Internet and other technologies such as teleconferencing[fn.68

], enable us to access almost the whole world without going anywhere, giving new relevance to the medieval monastic dictum: "Peregrinatio in stabilitate" (to go on an adventure without leaving your home town).

"New disease strains spreading rapidly from person to person and country to country are, in part, an effect of this age of interconnectedness, a time of easy travel and gregarious habits." (Daniel Schorr, "Conspiracies of Silence", Christian Science Monitor online, 25Apr03)

obody ever caught tuberculosis (or SARS) or any other communicable disease from communicating with a person on the other end of a telephone conversation or email. No exotic species ever invaded an alien ecosystem through its picture on a computer monitor.

Donald Trump, for one, describes himself as a 'germ freak' who would prefer that people bow in greeting, Japanese style, rather than extend a germ-covered hand."(Amy Cortese, "An Arsenal of Sanitizers for a Nation of Germophobes", NYT on the Web, 27Feb05; See also: "Germs Never Sleep") In this one item, I agree with Mr. Trump. I also think we, again like the Japanese, should encourage persons to wear face masks to help avoid spread of infectious diseases (See picture at top of this page

H1N1 Digression

n early 2009, a new pandemic emerged, apparently from a pig farm in Mexico: H1N1 "Swine Flu". This new virus spread all over the world, sickening many thousands, killing (as of the end of 2009) ca. 11,500, and apparently also infecting millions without serious symptoms. A vaccine was developed for this new (so far unusually mild) pandemic, but it was almost the end of the year before supplies became plentiful. (See, e.g, http://news.bbc.co.uk/2/hi/health/8434273.stm.)

Doing some shopping this morning (Saturday, 19 Dec 2009), I noticed a sign in a pharmacy saying they were giving H1N1 shots from 10 to 2. It was 9:20, and I decided to stay to get one (I was #2 in line, so I did not have a long wait). So I got a H1N1 "Swine Flu" shot this day. (Note: I got a "Swine Flu" shot the last time there was a pig virus scare, back in the 1970's -- I suffered no ill effects from it.) I'd rather have gotten an H5N1 "Bird Flu" shot, but, so far, there is still no vaccine for that far more worrisome disease, which is still around and still killing persons, although it also still has not [yet] mutated into a form easily transmissible from person to person, which has always been feared because of its extremely high mortality rate; and it also still has not shown up in the United States.

(December 2004) What's next? Maybe H5N1, aka: "bird flu". Currently widespread among birds in Asia, with isolated cases in other species incl. humans ~ has potential to repeat the great 1918 Influenza Pandemic. 12 February 2006: Please read my: Quote #245, about public health officials concerns if a deadly "bird flu" epidemic does happen in the United States.

If you are interested to keep abreast of infectious disease developments, you may wish to subscribe to global infectious disease news mailing list: ProMed.

Go to World Health Organization (WHO) website.
Go to U.S. Centers for Disease Control and Prevention website.

Read instructions how to wear face mask (N95 respirator).

See Guangzhou China butcher shop w/ many different species live animals for sale.
Find out how a less lethal disease can kill more people.

How can we fight the new global terrorism (political, not epidemiological)?

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30 December 2009CE (2009-12-30 ISO 8601)
v03.12

"HONG KONG, May 23 -- A virus virtually identical to the one believed to cause SARS in humans has been found in a catlike tree-dwelling animal whose meat is a delicacy in southern China.... Yuen Kwok-yung, a microbiologist at Hong Kong University, said the disease appeared likely to have jumped to people from civets, but that the civets could have contracted the virus from another species.... The raising and slaughter of civets and other exotic animals should be strictly regulated to prevent further outbreaks of SARS and possibly other new diseases, he said. But a total ban on consumption of them is unlikely to succeed because the consumption of wild animals is so much a part of Chinese culture, he contended. 'It is very difficult to stop a culture, it has been there for 5,000 years,' Professor Yuen said." (Keith Bradsher and Lawrence K. Altman, "Scientists Find Animal Link for SARS Virus", NYT on the Web, 23May03)

[ Is this catlike animal the source of SARS? ]

Note: Civet "cats" are not felines.

(07Jan04, NYT on the Web)

"HONG KONG, June 20 -- Three months ago, SARS appeared poised to sweep the world.... Today, SARS is disappearing almost as fast, and almost as unpredictably, as it arrived.... SARS appears to have been controlled mainly through one of the oldest of medical tools: isolation. This has been done through better infection controls in hospitals, as well as by the early quarantining of the close personal contacts of infected individuals, so that if they later fell sick, they would not spread the disease to even more people. The approach succeeded because SARS appears to be transmitted mainly by fairly large droplets that travel no more than five feet through the air, instead of staying airborne and potentially floating through several floors of a building, as smallpox can.... Another lesson of the SARS epidemic... is the need for prompt and accurate reporting. China's disastrous experience -- covering up the first cases of SARS and then watching the disease spread worldwide -- 'made clear to the public, as seldom has happened, that honest, accurate information is necessary for rational health policy,' said Dr. Barry R. Bloom, the dean of the Harvard School of Public Health.... [Toronto, Canada] Health officials were dealt a further blow on Wednesday when scientists... said they had found that 120 people from the Toronto area tested positive for the SARS coronavirus but were never considered SARS patients, raising the possibility that the stubborn virus still lingers in the city." (Keith Bradsher with Lawrence K. Altman, "Isolation, an Old Medical Tool, Has SARS Fading", NYT on the Web, 21Jun03)

"HONG KONG, Monday, Jan. 5 [2004] -- Officials in Guangdong Province in southeastern China ordered this morning the immediate killing of every civet cat [a relative of the mongoose] in captivity in the province after researchers found that a Guangdong man had fallen ill with a new strain of SARS virus that is genetically similar to a strain found in civet cats.... The [civet cat] feces carry extremely high concentrations of the virus... Dr. Zhong Nanshan, China's top expert on SARS, said.... Dr. Zhong warned that with the beginning of the dry season here in southeastern China, civet cat feces could dry up and become windblown dust that would raise a risk of airborne infection." (Keith Bradsher with Lawrence K. Altman, "China to Kill 10,000 Civet Cats in Effort to Eradicate SARS", NYT on the Web, 05Jan04; Ed. note: Might one call this policy: "Kicking the civet cat" -- since the problem might well not exist if people left wild animals in the wild instead of looking for gastronomic exotica?) Further: "World Health Organization officials urged caution and warned that such a massive slaughter, if done improperly, could pose serious hazards, including the possibility of more infections." (Jim Yardley, "Health Officials Warn of China's Plan to Kill Cats Over SARS", NYT on the Web. 05Jan04)[fn.84

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