A new infectious disease challenge: Urbani severe acute respiratory syndrome (SARS) associated coronavirus.

Abstract

Most community acquired pneumonias are bacterial and the hospitalised patient, often elderly, is rapidly rendered pathogen free by broad spectrum antibiotics. There is no particular threat of pathogen transmission to other patients or to hospital nurses or doctors. It was therefore an unpleasant and unexpected surprise when a cluster of hospital staff and trainee medical students in a Hong Kong hospital became ill with cough, breathlessness and a high temperature. These were all contacts with a 64-year-old doctor who had been admitted into the hospital with the initial diagnosis of community acquired pneumonia. This was the first indication in Hong Kong that a viral not bacterial infection, having apparently arisen in the nearby and adjacent province of Guangdong several months earlier, had spread to the colony.1 A WHO epidemiologist, C. Urbani, categorised the new clinical syndrome severe acute respiratory syndrome (SARS) in Vietnam in February and later died of the virus which is now named after him. As politicians are apt to tell us, the rest is history. Whilst acknowledging that the scientific and medical communities will be in the lower range of a long ladder of step by step learning, it is already clear that modern molecular virology can identify a new virus and devise molecular testing with speed. However, on the negative side there is international and national panic. It is important that the scientific community appreciates how a modern society in the 21st century reacts to an infectious disease threat. This information will be of value to the WHO, which has issued a template plan for preparation in the event of a global outbreak of a much more contagious and life threatening disease, namely emergent influenza A virus.