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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 l.jpg

SARS Epidemic: A Global Challenge

Bong-Min Yang, PhD

& Sung-il Cho, MD, PhD


School of Public Health

Seoul National University

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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

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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)

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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

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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)

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Estimation of the impact of SARS on selected Asian Economies

Source: ERD of ADB using OEF model, staff estimates

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Korea ’s exports have decreased, but not much

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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

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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

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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

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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

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(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

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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

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Patient Surveillence

  • Case report network

  • Education of health care workers

  • Monitor emergency rooms

  • Networking of infection specialists

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Public Information and Education

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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