*EPF510 09/05/2003
U.S., World Health Officials Brace for Possible Re-emergence of SARS
(Onset of flu season may bring another SARS surge) (760)

By Charlene Porter
Washington File Staff Writer

Washington -- The World Health Organization (WHO) is recommending broader influenza vaccination campaigns in order to better contain the common illness in the oncoming season and help prevent misdiagnoses of severe acute respiratory syndrome (SARS). The previously unknown, often deadly respiratory illness swept out of China last year and ultimately infected more than 8,400 people, causing 916 deaths.

"Influenza vaccination in high-risk groups and health workers caring for them will reduce the number of pneumonia cases which could be confused with SARS," WHO reported in a September 2 advisory about influenza vaccination in the context of SARS concerns.

WHO coordinated an international health investigation involving efforts of scientists and medical researchers in many of the 29 countries where SARS cases developed, an effort that was widely hailed as a positive public health development to emerge from the outbreak. In light of the SARS experience, the Geneva-based health agency now reports that "health authorities in some countries are giving higher priority to the vaccination of groups known to be at high risk of severe illness and mortality associated with influenza."

WHO estimates that only one-quarter of the 1,000 million people who belong to groups at high risk of death from influenza are vaccinated each year, so the agency welcomes increased vaccination efforts. Each flu season results in 3 to 5 million cases of the respiratory disease, and as many as 500,000 deaths, according to international health statistics.

WHO declared the SARS outbreak over in July when transmission of cases seemed to stop, but officials recognized that the possibility of resurgence during the flu season was great. Last May, when SARS was still spreading, U.S. Centers for Disease Control and Prevention (CDC) Director Julie Gerberding said at a briefing that SARS could behave like any respiratory illness -- more likely to spread in winter than summer.

"We need to be prepared for the possibility that we'll see a resurgence or even expansion of SARS next fall," said Gerberding, explaining that the U.S. health agency was already preparing for a possible resurgence during the flu season, typically ranging from November to March.

In an August 27 statement, CDC described preparations for another SARS outbreak. "CDC continues to work with state public health departments in the U.S. to ensure that clinicians and other health care professionals in this country are aware of appropriate infection control practices when managing cases of respiratory illness."

SARS caught world health specialists unawares when it began spreading from its origins in China in February and March, revealing itself to be highly infectious, rapid in development and sometimes fatal. Disease experts quickly recognized the need for rigid disease containment precautions in health care settings. They imposed screening methods to assess the health of traveling passengers who were likely carriers of the disease from one country to another. They identified the pathogen that was causing the flu-like disease as a coronavirus, related to others that cause upper respiratory illnesses. They didn't find a cure, however, and they didn't find the original source of the virus.

Researchers are investigating that mystery and though some clues have been found in recent days, there are still no breakthroughs. Scientists are looking in the animal kingdom for signs of the virus, and researchers from the Genome Institute of Singapore say they've confirmed that SARS is a disease that jumped from an animal species to humans. According to press reports, their finding is based on an analysis of virus found in the bloodstreams of slaughtered animals sold as meat in a Chinese marketplace.

A research effort backed by the U.N. Food and Agriculture Organization (FAO) and WHO has tested more than 600 domesticated farm animals and found no sign of the virus.

The hunt continues for what's known as a reservoir of the virus, the place of its natural habitat. It may be that an animal species carries the coronavirus that causes SARS in humans, even though the animal host never becomes sick. If scientists can find that reservoir, then that species would help serve as an early warning system when an outbreak in humans could be likely.

A September 1 FAO press release says the agency is working with WHO to conduct further testing on livestock animals in high-risk areas and to standardize methods for validating the presence of the SARS virus in animals.

(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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