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Global SARS spread seen, economy could be affected

Global SARS spread seen, economy could be affected

Severe acute respiratory syndrome, or SARS, will continue to spread globally and could potentially have a dramatic effect on the economy, Nobel laureate scientists have said.

Their comments came during a panel discussion as part of the Massachusetts Biotechnology Council's annual meeting in Boston, last week. "I do think SARS will spread," said Walter Gilbert, who won the Nobel for Chemistry in 1980 and is the Carl M. Loeb university professor in the Department of Molecular and Cellular Biology at Harvard University. "It's an infectious disease, like influenza. It will spread around the world."

The outbreak is comparable to the influenza pandemic of 1918, said Eric Lander, director of the Whitehead Center for Genomic Research and a biology professor at the Massachusetts Institute of Technology (MIT).

Lander was the panel discussion moderator.

The 1918 global influenza pandemic killed between 20 million and 40 million people, spreading along trade routes and shipping lines and resulting in the worst epidemic in US history. It has been referred to as the most devastating outbreak of infectious disease in recorded world history. More people died in that single year than from the bubonic plague outbreak of 1347 to 1351.

But SARS seemed to spread more slowly than the flu and so scientists had more time to try to develop drugs to control it and health agencies could take steps to intervene, said Phillip Sharp, a Nobel laureate in physiology or medicine and an institute professor and founding director of the McGovern Institute for Brain Research at MIT. However, "if this spreads next year, it will have a major economic impact," he said.

The scientific community should react to SARS with "prudence" and "put an intense effort into trying to reduce mortality," Sharp said.

The World Health Organization (WHO) reported 4439 suspected cases with 263 deaths between November 1, 2002, and April 24, 2003.

SARS first occurred in the southern Guangdong province of China, before spreading to other Asian nations first. As of April 24, WHO was reporting probable SARS cases in 27 countries and Hong Kong.

WHO recommended that travelers consider postponing all but essential visits to Beijing, Shanxi Province and Guangdong in China, Hong Kong, Singapore, Vietnam and Toronto, which was the hardest hit city outside of Asia so far.

Symptoms generally begin with a fever of more than 100.4 degrees Fahrenheit (38 degrees Celsius) and may also include headache, overall feelings of discomfort and body aches, according to the US Centers for Disease Control (CDC), which has reported suspected SARS cases in 36 states as of April 23. Some people who contracted SARS also had mild respiratory symptoms and might develop a dry cough and difficulty breathing after two to seven days, the CDC said.

SARS appears to spread by close person-to-person contact and most cases have involved those who cared for or lived with a SARS patient or who had direct contact with infectious materials. The virus might be spread by touching the skin of those infected or objects that have been contaminated with infectious droplets, health officials said, but they also continued to caution that it was possible SARS could be spread more broadly through the air or in other ways not currently known.

Besides affecting business travel, SARS has also led to the in-home quarantine of about 200 HP workers in Toronto after two employees came down with symptoms of the disease. Concerns about the virus also have led companies to cancel trade shows and events and led to travel restrictions being imposed by companies and universities, including Harvard, which this week said that it was placing a moratorium on university-related or university-paid travel to locations in the WHO advisories. WHO is reassessing its advisories daily and providing information at its Web site, www.who.org/.

Some scientists who continue to study the 1918 influenza pandemic, known as the "Spanish flu," believe that it also originated in the Guangdong province. That theory was boosted by the DNA sequencing of the virus using archival lung tissue from two US soldiers who died in the pandemic and frozen lung tissue from an Inuit woman buried in Alaskan permafrost, according to the scientific journal, Nature.

Another pivotal difference between that pandemic and SARS is that scientists in Canada and the US decoded the DNA of the suspected SARS virus, which is believed to be a coronavirus, within weeks of its discovery. The virus was found to have 29,736 base pairs and the sequence can be downloaded at the Web site of the Genome Sciences Centre (GSC), which is part of the British Columbia Cancer Agency in Vancouver (http://www.bcgsc.bc.ca/). The GSC laid first claim to completing the sequencing, which is expected to lead to diagnostic tests for SARS, assuming that the coronavirus that was decoded actually is SARS. Coronavirus is one of the viruses that causes the common cold.

SARS came up as a topic at the Biotechnology Council panel discussion during a question-and-answer session with the audience. The panel was asked if it believed SARS would spread and as a follow-up question was queried about its views on how the Chinese government initially handled the outbreak.

WHO officials raised the issue that the government had lied about how serious the epidemic was and that numerous published media reports said that Chinese authorities ordered doctors to hide SARS patients from WHO officials.

The first cases of SARS are believed to have occurred in China last November and doctors in the Guangdong province reportedly knew that they were dealing with a new virus by the middle of December.

Officials in the province did little to deal with the disease until early in February, while those in Beijing did not take action until March, according to a timeline that eventually emerged as the disease outbreak unfolded.

But in an extraordinary move for Chinese leaders, the government last week said that there was a tenfold increase in SARS in Beijing and also announced that the minister of health and Beijing's mayor had been removed from their top-level posts in the Communist Party.

Chinese officials also ordered 4,000 Beijing residents to in-home quarantine on Friday, according to published reports.

Sharp noted at the panel discussion that China was just now becoming a more open society, while Gilbert said that he doubted that the Chinese could have controlled the outbreak any better.

"It's not like they were hiding 50,000 cases," he said. "They were hiding 2000 cases."

Now that WHO has stepped in and issued advisories and quarantines have occurred, there is some evidence that SARS can be controlled. "Vietnam and a few other countries show that if cases can be detected and isolated early enough, an outbreak can be brought under control," WHO said in a recent update about the disease in that nation.

A pharmaceutical company, GenVec, has announced that it signed an expansion of an existing agreement with the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health to begin work on a clinical grade vaccine for SARS.


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