Listening to SARS: Lessons for Infection Control

Throughout recorded history, epidemics have relentlessly descended on societies, disturbing their previous harmony. Yet the arrival of these epidemics is usually greeted with disbelief as a shocking and unanticipated event. So it is with the severe acute respiratory syndrome (SARS), which has infected at least 8500 people in 30 countries and claimed the lives of 765 (9%). In its wake, the health care and national economic systems of some countries have been seriously disrupted. As hospitals respond, we suggest that they seize the opportunity to manage this outbreak in a way that prepares the medical community broadly for future epidemics.

Much has been learned about SARS since its recognition in southern China in February 2003. The etiologic agent has been identified as a novel coronavirus, new diagnostic tests have been developed, and the viral genome has been sequenced (1). Recently, an almost identical virus, although with 29 extra nucleotides, was isolated from palm civet cats bought in a food market in the city of Shenzhen (2). The civets are nocturnal members of the mongoose family, distantly related to feline cats, and considered a culinary delicacy in southern China. Unconfirmed reports suggest that the virus has also been isolated from several other exotic animals (3). Chinese food handlers, caterers, …