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Severe Acute Respiratory Syndrome
by Sue Wilson
If it weren't for the daily drama of the televised war in Iraq, the mysterious flulike illness from Asia known as SARS, for Severe Acute Respiratory Syndrome, would probably be capturing more local interest.
But, aside from a flurry of rumor-fueled panic in Chinatown, which has experienced a dropoff in tourism due to fears about SARS, New Yorkers seem phlegmatic about the risk posed by the new disease. "It sounds like the flu," said Katherine Bruni, 35. "You know, it'll kill the people the flu kills... the very old, the very young, people with compromised immune systems... I'm not that worried about it, personally."
SARS, may, in fact, be worse than the flu - although there have been no deaths among the 148 suspected SARS cases spread over 30 states in the U.S., SARS has so far shown a mortality rate of about four percent elsewhere in the world, as compared to about one percent for common influenza.
According to the World Health Organization, there were 2,671 suspected SARS cases in 19 countries as of April 8, and 103 people have died. China, where the illness emerged about three weeks ago in Guandong Province, has been hardest hit, with 1259 cases and 53 deaths, according to the health organization. Other countries in Southeast Asia, including Hong Kong, Vietnam and Singapore, are also experiencing substantial outbreaks. On March 15, the World Health Organization issued a global travel alert, cautioning that travel to Vietnam or Hong Kong might pose a health risk. It was the first time the U.N. agency had ever issued such a global alert. The U.S. Centers for Disease Control and Prevention have also issued a travel advisory urging people to avoid discretionary visits to Hong Kong, Singapore, Vietnam, and mainland China.
Seven New York City residents have contracted the disease, all while traveling in Asia recently, city health officials report. Ranging from a one-year-old boy to a 91-year-old woman, they all had mild cases and are recovering. So far, there have been no cases of SARS spreading from person to person in New York City.
Rumors of His Death Exaggerated
Chivy Ngo, owner of the Bo Ky restaurant on Bayard St. in Chinatown, notes that he is very much alive and well, despite rumors last week that he and several workers at his restaurant had died of SARS after Ngo supposedly traveled to Asia. Ngo's "death" was falsely reported last week in a mass-circulated e-mail, and business at his restaurant dropped off to nearly nothing for several days, though it has rebounded since the hoax was exposed, according to Robert Weber, a spokesman for the group Asian Americans for Equality. Weber adds that while tourists and visitors appeared to avoid Chinatown out of fear of SARS last week, leading to empty restaurants and deserted street markets, trade seems to be returning to the area now. "But, business-wise, Chinatown really didn't need a SARS scare. After September 11, that was like having a root canal after a heart attack," Weber says. "No one here is spreading SARS. People should come eat here and enjoy what we have to offer."
U.S. Senator Hilary Rodham Clinton, New York City Health Commissioner Thomas Frieden, and New York City Councilmember John Liu held a joint press conference to discuss how $16 million that Senator Clinton secured on behalf of the Centers for Disease Control to help combat SARS will be used. The conference attendees ate at a Chinatown restaurant.
What Is SARS?
The U.S. Centers for Disease Control has said the cause of the disease appears to be a new mutation of the coronavirus, a member of a virus family which also causes some forms of the common cold. Symptoms of the illness include a high fever (over 104 degrees Fahrenheit), cough, and shortness of breath.
There is no cure for SARS at this time, although the CDC is working on an antiviral agent, a vaccine, and a diagnostic test for the illness.
While the disease is clearly contagious, it is not clear exactly how it is spread -- whether it requires personal contact, or can be spread through the air, as through droplets from a sneeze. It is also not clear whether people can be carriers but not show signs of infection themselves.
"Most of what everyone is saying is based on sketchy data, so it's going to be a while before we know what's going on with this disease," says Arthur Rheingold, head of the Division of Epidemiology at U.C.-Berkeley's School of Public Health. "We don't know the primary routes of transmission yet. We don't understand whether people can be carriers without showing symptoms. Investigators are frantically trying to find these things out."
Jerry Hauer, acting assistant secretary for public health preparedness at the U.S. Department of Health and Human Services, told the Associated Press on April 7 that health officials are baffled as to why U.S. patients have become less sick than those in, say, neighboring Canada, where SARS has killed 10 people and forced thousands of people in Toronto to be quarantined.
"It might be that some of these folks in Canada just got more of the virus, were in closer contact," Hauer told the AP. "Any theory I give you at this point in time would just be a theory."
Hauer also said the spread of the illness may be slowing. ``I think we've started to stabilize in the number of cases. We're not seeing these large jumps every day,'' he said. But "[w]e don't know yet whether ... we're through act one of a two-act play or whether we're just four lines into a three-act play."
President Bush signed an executive order adding SARS to a short list of diseases requiring mandatory quarantine under the Public Health Service Act. But no one in the United States has been quarantined for the illness, and there are no plans to do so at this time, experts testified before a Senate committee on April 7. Although some experts warn that SARS could yet turn out to be a deadly global pandemic, Berkeley's Rheingold says he doubts it could have the kind of lethal potential as, say, the deadly Spanish flu epidemic of 1918, which killed tens of millions worldwide.
"We have better medical care these days, antibiotics for treating secondary infections, better public health systems in place," Rheingold says. "I would expect that even if we find we have an organism of comparable lethality on our hands, we would do much better, mortality-wise."
To avoid contracting SARS, he says, "Don't travel to Asia unless you have to." Otherwise, he says, take the same precautions as you would to avoid the common cold: "Wash your hands a lot." The average person, he believes, has a "vanishingly small risk of catching SARS on the street."Sue Wilson is a journalist who writes frequently on health and science topics for such outlets as the New York Times, WNET, and UNICEF.
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