An ounce of prevention

April 25, 2003

HALTING THE SPREAD of an epidemic is not a job for sissies. It requires aggressive action, blunt truth and sometimes painful precautionary measures.

So, as much as we might sympathize with Toronto officials for the economic damage their city is suffering from a World Health Organization warning on travel there, the travel advisory seems justified.

News that a Maryland doctor may have inadvertently brought severe acute respiratory syndrome, or SARS, home with him from the Canadian city underscores that there is no more time for dithering.

Authorities in Toronto believed as recently as two weeks ago that their isolation and quarantine efforts had controlled contagion of the flu-like ailment. Now, with 16 dead and scores more probable cases in the metropolitan area, they acknowledge SARS may have slipped their grasp.

With the advantage of advance warning, Maryland health officials are taking steps to avoid a major SARS outbreak here.

Three possible local cases -- including the doctor and two women, one of whom has been determined not to have SARS -- were isolated along with family members. Medical personnel throughout the region are on the lookout for others with the telltale symptoms: a high fever, dry cough, body aches and recent travel to Toronto or Asian countries where the epidemic began.

With development of a vaccine at least a year away, and much still unknown about the way SARS is spread, far more sweeping steps such as the quarantines imposed in Toronto and Hong Kong may become necessary.

At this point, the first level of defense probably rests with individuals.

The disease appears to pass between people at close range who breathe the same air or touch the same objects. SARS may also linger on surfaces such as light switches long after contact with an infected person.

So, you can protect yourself much as you would from a cold. Wash your hands frequently with soap and hot water. Avoid sick people with respiratory ailments, especially if they are coughing or sneezing. Be alert to your own possible symptoms, and report them to your doctor.

There's no need for anyone here but medical workers to start wearing protective masks. Or to cower at home rather than going about the normal activities of life.

In fact, the U.S. Centers for Disease Control and Prevention says it's not even recommending against travel to Toronto, like its global counterpart did. Just try to stay out of the hospitals there, the CDC says, because that's where the contagion has mostly spread.

Another example of how to chart the course between precaution and panic comes from Elliot Pellman, medical adviser to the major-league baseball players who compete with Toronto's Blue Jays.

It's OK to play in Toronto, he says. Even to sign autographs. But don't accept a ball or picture to sign from just anyone. And use your own pen.

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