Tue, May 20, 2003 - Page 8 News List

Lessons for fighting other epidemics

By Chou Cheng-kung 周成功

The SARS epidemic is having an unprecedented impact on Tai-wanese society. From the initial lack of concern to the later fear-induced paralysis, we have over and over again been able to see the lack of preparation for an outbreak of an unknown epidemic in our society.

Effective isolation of the source of infection is crucial to controlling the epidemic. Even though quarantine and disease inspection will be a great inconvenience to the public that may lead to economic losses, it is still the only efficient method for controlling such an epidemic.

The fact that students under house quarantine still attend evening school and taxi drivers work to the day they die shows that we still seem to lack a mechanisms to effectively guarantee the implementation of quarantine policies.

From dengue fever and enteroviruses in the past to the current SARS, we could say with almost absolute certainty that SARS will not be the last contagious disease to hit Taiwan.

Whether we will be able to learn something from the SARS epidemic is relevant to the question of whether we will be able to safely come through a similar situation in future.

Detection and control of global epidemics is still dependent on concerted international efforts and cooperation. The World Health Organization (WHO) could be said to have set a new standard in this global fight against SARS.

When the WHO discovered that one of its experts on infectious diseases had died as a result of being infected by the virus in Vietnam, while receiving continuous information on similar symptoms in Hong Kong and China, it decisively issued a global alert on March 22. It was the first time since its founding that the WHO issued such a warning.

Two days later, the US Centers for Disease Control (USCDC) started up its Emergency Operation Center. It also set up an international network for cooperative research under the WHO umbrella. The network brings together more than 10 laboratories around the world in a joint effort to find the possible source of SARS.

The first SARS infection in Taiwan was reported on March 17. On April 10, less than a month later, two papers, from Germany and the USCDC respectively, appeared in the same issue of the New England Journal of Medicine. These two papers both point out that SARS may be caused by a new strain of coronavirus.

Three weeks later, the US magazine Science published the complete gene sequence of the SARS virus, completed separately by US and Canadian laboratories.

The complete gene sequencing of the SARS virus overturned some past assumptions about its origins. In the past, it was believed that SARS might be the result of a new virus produced by a mutation in an already known coronavirus in domestic birds or animals.

An analysis of the gene sequence tells us that the SARS virus never has existed in a person, and that it may be a coronavirus from an unknown animal. A gene mutation enabled it to infect and create pathological changes in human cells. Finding the natural SARS host would facilitate the prevention of similar epidemics from occurring.

In modern internationalized societies, the rapid flow of people and goods ensures that the outbreak of an epidemic no longer is accidental. Correctly predicting the spread or control of an epidemic is posing an extremely hard challenge. The failed predictions of the plague outbreak in India in 1994, or the swine influenza in the US in 1976 led to those two countries suffering massive economic losses.

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