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SARS Epidemic: A Global Challenge. Bong-Min Yang, PhD & Sung-il Cho, MD, PhD of School of Public Health Seoul National University. Why significant global issue?. Multi-country outbreaks Spread through air travel and human migration Causative agent still unknown Severity of illness

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sars epidemic a global challenge

SARS Epidemic: A Global Challenge

Bong-Min Yang, PhD

& Sung-il Cho, MD, PhD


School of Public Health

Seoul National University

why significant global issue
Why significant global issue?
  • Multi-country outbreaks
  • Spread through air travel and human migration
  • Causative agent still unknown
  • Severity of illness
  • Impacts on clinical and public health services
David P. Fidler (2004)
  • “SARS was a crisis, but victory was achieved”
political impact
Political Impact
  • Multinational organizations, particularly WHO, become to have increasing influence on global governance
    • After successful control, much credit given WHO for initiation and coordination of surveillance, research and control measures
  • WHO Initiated
    • Global Alert (12 March, 2003)
    • Travel Advisory (15 March, 2003)
    • Enhanced global surveillance
    • Global Outbreak Alert and Response Network (GOARN)
    • Specific Global Networks (Lab, Case management, Epidemiology)
political impact 2
Political Impact 2
  • Importance of global cooperation to an outbreak of infectious disease is fully realized
    • It validated the value of global public health networking
  • Weakness of China’s public health infrastructure was revealed
    • China first downplayed the extent and the risk of the infection, then joined the international network to control
  • Afterward, Chinese public health infrastructure was strengthened a lot
    • Case reporting structure established
    • Strengthened emergency response system
    • Provide funding for prevention of SARS
economic impact
Economic Impact
  • Direct costs
    • Medical treatment costs, and costs of some equipment and supplies for prevention
  • Indirect costs
    • Travel/airline
    • Tourism
    • Trade/investment
    • Shrunk consumer confidence
  • Global indirect costs estimated to be around US$80 billion (McKibbin, 2003)

Estimation of the impact of SARS on selected Asian Economies

Source: ERD of ADB using OEF model, staff estimates

lessons drawn
Lessons Drawn
  • Importance of
    • early detection
    • quarantine and surveillance
    • informing the public in time, and correctly
    • Supporting basic and specific research
    • Increasing public health capacity: manpower and facility
    • Promoting international cooperation and collaboration
sars situation in korea
SARS Situation in Korea
  • No death related with SARS
    • 3 probable cases
    • 17 suspected cases
  • Mostly those who visited China
  • Overall 65 reports for assessment
korean strategies for sars prevention
Korean Strategies for SARS Prevention
  • Early detection of imported cases
    • Quarantine
    • Surveillance
  • Prevention of secondary infection
    • Medical facilities
    • Protection of health care personnel (mask, etc.)
    • Isolation of patients
  • Information and education
    • Hand washing
  • Laboratory capability
    • Support laboratory diagnosis

SARS Management System


Chair: Minister of Health

Communicable Disease Task force

Chair: NIH director

SARS Control Team

Emergency Response Team

Chair : Municipal/Provincial vice mayor

Municipal/Provincial health director

Local SARS Control Team

Local Emergency Response Team

Chair: Vice district chair

District health officer



(fever etc)

Isolation room

Patient care

Special investigation




Suspected Cases


  • Identify passengers from high risk areas
  • Collaborate with immigration office
  • Examine air crews
  • For travelers
  • For visitors and immigrants
  • Media
  • Travel agencies
quarantine activities
Quarantine Activities
  • Check body temperature for travellers from China (5,000/day)
  • Examine aircrafts (45 planes and 7,000 persons/day)
  • 20,000 passengers/day screened, using infrared automatic body temperature thermometer
patient surveillence
Patient Surveillence
  • Case report network
  • Education of health care workers
  • Monitor emergency rooms
  • Networking of infection specialists

Public Information and Education

tasks underway after sars epidemic
Tasks Underway after SARS Epidemic
  • Establish infrastructure for communicable disease control
    • New establishment of CDC
    • Strengthen public health care sector
    • Networking of quarantine office and CDC
  • Strengthening response capacity for emerging disease
    • Global monitoring
    • Laboratory capacity and research
    • Emergency response preparedness