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The SARS hoopla

By Carol Devine-Molin
web posted April 14, 2003

A couple kisses goodbye at Hong Kong Airport on April 13 after taking off their masks which wear to protect against the flu-like Severe Acute Respiratory Syndrome
A couple kisses goodbye at Hong Kong Airport on April 13 after taking off their masks which wear to protect against the flu-like Severe Acute Respiratory Syndrome

This entire SARS scare is reminiscent of the plagues and pestilences noted in the Bible's book of Revelation. In almost apocalyptic terms, the worldwide news media is ablaze with stories that SARS (Severe Acute Respiratory Syndrome) is poised to become a pandemic that will ravage the world. And, truly, everyone is abuzz with talk of SARS. Is this just the outcome of media sensationalism or an accurate reflection of reality? Is SARS among the worst illnesses out there? Or, are other disease outbreaks creating even greater problems for society? Let's step back and take the larger view.

The 1999-2000 influenza season was among the most dreadful in recent years, culminating in approximately 60,000 flu deaths, with many linked to pneumonia complications. According to the CDC, at the heart of the 1999-2000 influenza was a strain of the virulent A (H3N2) Sydney-like virus, which had been prevalent throughout the late 1990's. My neighbor, who is a nurse, later advised me that the elderly were "dropping like flies" in the nursing homes throughout the region (NYC and surrounding suburbs) during that particular winter.

Ah, I remember it well! I was one of the unfortunate who suffered a significant bout of the flu in early February 2000 that knocked me out of commission for about ten days, and continued to sicken me for the entire month. I've never been that ill in my adult life – For three days, I coughed my head off and endured the debilitating chills and fever that are the ubiquitous symptoms of influenza. Mind you, I had the flu in prior times, but nothing that ever approach this severity.

But the worst part was my breathing difficulties and the concomitant sleep deprivation brought about by extreme physical discomfort and a constant dry cough. It just felt that my lungs were filled with an insidious paste. By night three I said to myself "Well, is this where I begin to actively hallucinate or do I just die?" My chest was throbbing--It was too painful to even breathe, let alone cough. And, yes, I was kicking myself for not getting that flu vaccination. Just when I though I couldn't take it anymore, some needed relief set in. During the middle of the third night, I was able to sleep for two hours straight. And when I awoke, I was almost euphoric – I had endured the most ghastly symptoms and I was on the road to recovery. Yes, of course I was praying throughout this personal calamity and I said to myself as I rallied, "Praise be to God"!

Family members had offered to travel down from upstate New York to assist me, but I would have none of it. I wouldn't dare expose them to this real-life nightmare, and I just stayed holed-up in my Westchester condo for more than a week. My family tells me that in the midst of everything, I was doing my best Capt. Kirk staccato imitation over the phone, as I exhorted them: "Must-get-flu-shot!", "Must-not-get-flu!" Moreover, I always try to look on the bright side, and thought, "Hey, I ought to lose at least ten pounds from all of this", and I certainly did.

Now why would I evoke the memory of such an awful episode? I'm just underscoring that seasonal influenza has been a substantive problem for years and our nation has managed to deal with it. And I have no doubt that we'll properly address this new-found SARS disease as it develops. To date, there have been an estimated 3000 SARS cases worldwide resulting in over 120 deaths, located in seventeen nations and on three continents. It doesn't sound like that many cases, but SARS has the capacity to spread rapidly. Canada (especially Toronto), China, Hong Kong, Singapore, Taiwan and Vietnam are considered hotbeds of SARS activity. And it goes without saying that Toronto is right across the US border and presents notable concerns.

Therefore, if, (and this is the really big "if") SARS cannot be adequately contained and becomes rampant, we must adequately prepare ourselves. The World Health Organization indicates that the development of proper diagnostic testing, a suitable vaccination, and effective medications for SARS are staunchly underway. It may take years, but we have to begin now. And President Bush has already signed an executive order permitting the quarantine of SARS infected individuals and those possibly exposed to the illness. In Canada, authorities are reportedly keeping people under house quarantine with electronic monitoring devices.

Where did SARS come from? SARS is a pneumonia-like illness that emerged from the "viral stew" in the countryside of Guangdong province in China, where people, pigs and poultry live in close proximity under filthy conditions. Sounds lovely, doesn't it? Reportedly, this region generates unusual viral outbreaks triggered by mutant strains of human and animal viruses. To reiterate, SARS is not an ersatz, biologically engineered virus that's a product of germ warfare, as had been previously speculated upon, but a naturally occurring phenomenon. Recent discoveries suggest that SARS is caused by a newly emergent form of the coronavirus. But there's more -- Apparently, this SARS virus is unusual since it's combined with bacterial pathogens. That said, bacterial Chlamydia has been found in the lungs of some SARS patients in China. Very interesting!

SARS symptoms are largely akin to those of influenza including coughing, sore throat, muscle aches, fever, and chills. However, SARS is more closely associated with respiratory problems, shortness of breath, and atypical pneumonia in about 25 per cent of the cases, culminating in a death rate of 3-5 per cent. Any type of pneumonia, whether SARS related or not, involves inflammation and fluid within the lungs resulting from bacterial, viral, fungal, or parasitic infections. SARS is currently being treated with a cocktail of antiviral (oseltamivir, ribavirin) and antibiotic medications, sometimes in conjunction with steroids. SARS is thought to be primarily transmitted by airborne "droplet transmissions" that can also contaminate objects. However, the spread of this illness is also linked to cockroaches, especially in highly populated urban centers such as Hong Kong.

In conclusion, here are some hopeful remarks, regarding the status of SARS research, from the speech of Dr Mark Salter at the World Health Organization's April 11th news conference:

  • "At the present moment in time, 17 laboratories around the world from 9 countries are involved in dealing with, identifying, and developing tests for the diagnosis of the causative agent of SARS".

  • "And when we have definitive evidence to suggest that the coronavirus is the primary causative agent, the next step that everyone will be anticipating is the development of a vaccine. Discussions are currently ongoing within the laboratories as to how this can be taken forward."

  • "The aim of the collaborating group over the coming weeks will be to bring this information together in a systematic form so that we can actually rule out those therapies that are ineffective and push forward with those therapies that are proving to be effective".

Carol Devine-Molin is a regular contributor to several online magazines.

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