Lessons from the Severe Acute Respiratory Syndrome Outbreaks
Severe acute respiratory syndrome (SARS) is now a global public health threat with many medical, ethical, social, economic, political, and legal implications. The nonspecific signs and symptoms of this disease, coupled with a relatively long incubation period and the initial absence of a reliable diagnostic test, limited the understanding of the magnitude of the outbreak. This paper outlines our experience with public health issues that have arisen during this outbreak of SARS in Hong Kong. We confirmed that case detection, reporting, clear and timely dissemination of information, and strict infection control measures are essential in handling such an infectious disease outbreak. The need for an outbreak response unit is crucial to combat any future outbreak.

Severe acute respiratory syndrome (SARS) originated in November 2002 in the Guangdong Province of China and, by February 2003, had spread to Hong Kong and subsequently to 32 other countries or regions, infecting approximately 8,459 patients and resulting in >800 deaths. The overall mortality rate is approximately 14% to 15%, ranging from <1% in persons <24 years of age to >50% in persons >65 years of age. The cause of SARS is not yet confirmed, but a novel coronavirus has been identified and resembles the virus found in civet cats. SARS is the latest in a series of new infectious diseases (e.g., HIV/AIDS, Ebola, Nipah, and Avian H5N1 influenza) that are adding additional stress to a healthcare system already dealing with the resurgence of established conditions (e.g., dengue, malaria, and tuberculosis). As global air travel is now commonplace and has facilitated the international spread of SARS, identifying and globally publicizing the lessons learned from the latest outbreak are important.