As the first major global outbreak of the 21st century, severe acute respiratory syndrome (SARS) showed both how quickly a disease can spread in an era of increased travel and how it can be effectively contained by well-coordinated public health response. SARS was first reported in southern China in November 2002 as a case of unusual pneumonia. For months, China tried to cover up the outbreak from the rest of the world, fearing economic repercussions for businesses and tourism. Finally, in February 2003, China’s Ministry of Health notified the World Health Organization (WHO) of more than 300 cases involving five deaths, which was a serious underestimate but a step in the right direction.
Once the WHO was allowed to enter the country and investigate the disease, the international community coalesced in an unprecedented manner and solved the mystery in record time. A month after China officially reported the cases, the WHO issued a global travel advisory. By the end of March, more than 80 healthcare personnel from across a dozen countries were sharing their findings via the internet. Researchers raced to sequence the new virus and attempted to find a reliable vaccine.
On April 16, 2003, the WHO announced that a number of its labs had identified the coronavirus as the pathogen responsible for SARS. The coronavirus primarily infected the respiratory and gastrointestinal tracts and was often a cause of the common cold. In the case of SARS, a specific strain of the coronavirus was believed to have crossed over from either bats or Asian palm civets (cat-like mammals found in the jungles of Southeast Asia). The virus spread via droplets from the coughs and sneezes of sick patients, as well as through contaminated objects.
SARS had an incubation period of five to ten days, followed by fever, dizziness, headaches, and muscle pain. Most people recovered after about a week, but in a minority of cases, the respiratory system deteriorated, resulting in a hacking cough and an insufferable shortness of breath. SARS soon traveled from southern China to Hong Kong, an international travel hub that enabled the virus’ rapid spread to Vietnam, Singapore, and Canada. The case fatality rate was around 15% in May of 2003, and in total, around 8,000 cases resulted in over 700 deaths.
The WHO’s travel advisory and sensationalist headlines had a huge negative impact on the region’s tourism and retail. By one estimate, some $10 billion was lost in Asia as a result of SARS. Nevertheless, effective measures such as compulsory masking, cancellation of large gatherings, and the dissemination of public health information on the web successfully contained the spread of the virus. By the 100th day of the global outbreak, the number of cases had diminished to just a handful. Within five months of China’s initial report, on July 5th, the WHO officially declared that SARS had been controlled worldwide.
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