Severe acute respiratory syndrome revisited

Coronavirus may be responsible, but new information arrives every day

See also Papers p 850

Severe acute respiratory syndrome is an infectious disease in humans that was first recognised in south east Asia in late February 2003.1 Given the disturbing features associated with the disease—which include poorly defined pathogenesis, absence of laboratory diagnostic testing, and failure of known antimicrobial treatments—its emergence prompted the World Health Organization to issue the first global health alert for over a decade. An insidious and non-specific onset and incubation of up to 10-11 days are ingredients that favour community transmission—indeed, early epidemiology indicates spread along international air routes. However, a high proportion of illness has occurred in close contacts of affected individuals, which indicates spread through body fluids and secretions rather than aerosol routes. Despite rigorous procedures for infection control, transmission has continued in Hong Kong, Singapore, and Canada. This has resulted in yet more rigorous quarantine procedures, which have started to affect the economic life of those areas by reducing travel and trade and by inducing serious concerns in the population.

What …