Small world

March 23, 2003

IT CAME FROM southern China, is spread by close human contact and causes a sudden high fever and flu-like symptoms -- and sometimes death.

The larger world first learned early last week of this apparently new disease, dubbed SARS -- for Severe Acute Respiratory Syndrome. Thanks to rapid air travel, by the end of the week hundreds of suspected cases had cropped up around the world, including at least 22 in the United States. And the world tally of SARS-linked deaths had risen to at least 10.

This virus' quick spread is only the latest scary reminder that as the world grows ever smaller, it also becomes more vulnerable to such outbreaks -- for which much more aggressive vigilance is needed everywhere, including the United States.

In the 1960s, some health experts were predicting infectious diseases would soon be history. But that's been followed by waves of serious outbreaks from newly identified microbes, pathogens jumping from animals to humans or antibiotic-resistant viruses -- from the 1976 U.S. Legionella outbreak to organisms in the 1990s jumping to people from horses and pigs.

Experts now fear a global flu epidemic akin to the 1918 outbreak that killed more than 20 million people. These days, there's also the ready prospect of a lethal epidemic from bioterrorism.

Last week's news of SARS' spread coincided with the release by the Institute of Medicine, a Washington nonprofit, of a major report on these growing threats and the need for more resources and political commitment worldwide for early detection and alerting systems. Unfortunately, China's slow reaction to its initial SARS cases last November illustrates these needs.

For months, China kept a lid on information about the outbreak, even as it saw at least 300 cases and rising citizen panic. Eventually a Chinese doctor exposed to SARS visited Hong Kong, where he infected a half-dozen others who then had a big role in spreading the disease around the world.

It wasn't until February that Chinese officials formally told the World Health Organization about SARS. And it's particularly telling that in less than a week from the news of SARS' spread, researchers already may have developed a diagnostic test for the pathogen, believed to be a new virus from the family of microbes that causes mumps, and that has jumped from animals to people before. This would be a key step in gaining control of SARS.

Imagine how much more contained this disease might be right now if China had more promptly lived up to its global health responsibilities.

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