SARS Timeline. Nov 16 ‘02 Feb 11 ‘03 Feb 28 March 11 March 12 March 19 March 27 April 5 April 9 April 14 April 17 April 28 First cases Hong Kong WHO Sequence
Nov 16 ‘02Feb 11 ‘03Feb 28March 11March 12March 19March 27April 5April 9April 14April 17April 28
First cases Hong Kong WHO Sequence
retrospectively and Vietnam issues of suspected
Recognized, report out- travel agent, a
Guangdong, breaks in advisories coronavirus,
China hospital established
Acute coverup India
respiratory WHO admitted;
reported in issues SARS SARSGuangdong global made top
by China alert priority Vietnam
Reported First ing virus
First in U.S. and SARS in (WHO)
SARS Europe Africa
Case Distribution of SARS Worldwide
ERSI, May 2003
ERSI, May 2003
Guangdong Province, China
11 close contacts
Hotel MHong Kong
Hong Kong SAR
>100 close contacts
21 close contacts
37 close contacts
Effect of Travel and Missed Cases on the SARS Epidemic
Spread from Hotel M, Hong Kong
# Probable Cases# Deaths
Hong Kong1728 269
Taiwan 596 76
Singapore 206 31
Canada 148 26
United States 65 0
Vietnam 63 5
Philippines 12 2
Other Countries 62 4
Number of SARS Cases Reported over Time (China)
Incidence Difference across Different Age Groups (China)
Fatality Rates of Different Age Groups
SARS DiagnosticsKey Messages
Peiris: personal communication
Prevention of SARS
A collective action for the common good predicated on aiding individuals infected or exposed to infectious agents while protecting others from the dangers of inadvertent exposure
Meeting needs of individuals infected and exposed is paramount
Origin of SARS – animal reservoirs?
Is coronavirus the etiologic agent?
What proportion of exposed persons
develop clinical disease and death?
Are there asymptomatic carriers?
What causes “super shedders”?
Is pathology caused by the virus or the
response to the virus?
Will SARS reappear in the fall?