Can we halt the deadly SARS?

AS CONCERN grows over the continuing spread of severe acute respiratory syndrome, or SARS, the key question is whether the disease can be contained. The answer will depend on how the virus spreads and evolves, which is still uncertain, and on whether healthcare systems, particularly in developing countries, can spot SARS and respond effectively.

So far, more than 1900 people in 22 countries have contracted SARS, of whom 63 have died. While China, Hong Kong and Singapore are hardest hit, some experts fear that poor public health monitoring in some countries may mean the number of cases is actually much higher.

The World Health Organization is bracing itself for outbreaks in countries currently claiming to be unaffected by SARS, including Cambodia, Indonesia and the Philippines. "We genuinely believe they have no cases at the moment. But we take the possibility of new outbreaks in this region very seriously," says Peter Cordingley, a spokesman for the WHO's Western Pacific headquarters in Manila.

The disease has so far been detected mainly in countries with good healthcare systems. But David Heymann, head of infectious diseases at the WHO in Geneva, says infected people may well have travelled to a country where an unexplained high fever and cough will not immediately draw attention. But the fact that SARS often infects healthcare workers could give it away, he says.

Even where healthcare facilities are good, it is extremely difficult to monitor an infection with such common symptoms and for which there is not yet a lab test. "With influenza, there is a well-defined test and a worldwide network set up to monitor it- and still there are nasty holes in that network," says Alan Hampson of the WHO Collaborating Centre for Reference and Research on Influenza in Melbourne, Australia.

India could already have undiagnosed cases, he says, as it only started checking airline passengers for SARS on 31 March. "Any country where the healthcare infrastructu

Contact: Claire Bowles
New Scientist

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