Making Sense of SARS

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Toronto Mayor Mel Lastman reacts to the World Health Organization's warning to travellers to avoid Toronto

With its flu-like symptoms now affecting citizens in at least 26 countries, SARS (or Severe Acute Respiratory Syndrome) has much of the world on edge. As of April 25th, the World Health Organization (WHO) reports 4649 SARS cases, 2422 of those in China, where the government has now instituted widespread quarantines. Worldwide, 274 deaths are now linked to the disease, 115 in Hong Kong alone.

While SARS initially appeared to be centered in Asia, concern is growing on the other side of the world. In Toronto, where 140 SARS cases and 15 deaths have been reported, health officials fear the virus may have spread beyond the walls of the city's hospitals, where it was originally contained. As a result, Toronto has been added to the WHO's travel advisory bulletin. In Beijing, where 750 cases have been confirmed, anxious residents are storming supermarkets to stock up on food and water, and lining up at train stations loaded down with luggage, hoping to escape to more rural areas less affected by the disease.

Despite its current high profile, relatively little is known about SARS, but health officials are working on isolating the virus and identifying possible treatments. In the meantime, here is what we do know about SARS, and what you can do to protect yourself.

What is SARS? According to WHO, SARS is a virus that affects the respiratory tract (lungs), causing a dry cough, shortness of breath, stiffness, fever, loss of appetite and malaise. The symptoms are very similar to those associated with the flu, except that SARS can appear as pneumonia in chest x-rays.

Where did SARS come from?The outbreak seems to center around China's Guangdong Province, near Hong Kong. From an epidemiological standpoint, no one knows where SARS comes from, where it began, or how its first victim became infected.

Is SARS spreading through Canada? According to WHO officials, the threat of SARS in Canada, and particularly Toronto, appears to be growing, given that some suspected new cases have appeared in Canadians who, unlike everyone previously diagnosed with SARS, have not traveled to Asia. The global health group has issued a travel advisory, urging " persons planning to travel [to Toronto] to consider postponing all but essential travel." Meanwhile, Toronto city officials are furious with the announcement, claiming the WHO's decree is premature, and arguing the resultant decline in tourist and business traffic could send the city into a financial tailspin. The mayor has asked the WHO to repeal the advisory.

Is SARS an agent of bioterror? Health officials say there is no reason to believe the outbreak of SARS is the result of bioterrorism.

Who is at risk? Theoretically, anyone who is within coughing or sneezing distance of someone infected with SARS can come down with the virus. (SARS is spread through bodily secretions, i.e. saliva, which is why so many people in Asian cities are now wearing surgical masks). Those who live or work in close quarters, like housing projects or hospitals appear to be most at risk. People diagnosed with SARS are generally isolated from the general public, and health care workers who treat these patients are at significant risk for the disease, and should wear filter masks, goggles, aprons, head covers, and gloves when in contact with SARS patients. That said, the virus does not seem to be as contagious as the flu.

How can I protect myself from SARS? If you live in a country (i.e. the U.S.) where no concentrated outbreak has been documented, you don't need to worry too much about contracting SARS. People who live in hard-hit areas like Hong Kong, which is adjacent to Guangdong, should follow local health officials' instructions and keep their distance from people known to be infected. Travelers should note that WHO now recommends that travel to Hong Kong or the Guangdong Province, as well as Beijing and Shanxi Province, China, and Toronto be postponed, unless the travel is "essential."

How is SARS treated? At the moment, the only treatment is isolation, observation and "supportive care," or rest and liquids. While some hospitals have administered antibiotics to affected patients, the drugs do not appear to help.

Should I be worried about SARS? Probably not. While the disease has the potential to spread relatively easily, it is hardly a global health crisis. At this point, SARS is certainly more exotic, but far less dangerous, than the flu, which kills 20,000 people a year in the U.S. alone.

It's always frightening to watch an outbreak spread. But it's also important to keep it in perspective. If you're anxious about SARS, keep up with the news and contact local health authorities if you fear you may have come in contact with SARS. In this situation, as in so many, information is the best defense.