Fear Factor
By ANDRÉ PICARD
From Saturday's Globe and Mail
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Severe acute respiratory syndrome is an international bug of mystery. By hitching a ride with travellers, it has caused thousands of cases around the world ― so many, in fact, that it has been dubbed the most significant outbreak ever spread through air travel.
Thus far, seven Canadians have died and more than 100 may be infected. But the tally doesn't really seem all that high, considering the elevated level of concern. As the top disease specialists here and abroad struggled to find the cause, many questions remain unanswered. For the average Canadian, the main one is: how serious a threat is SARS?
A few things to remember when trying to come up with an answer.
The cause
The leading candidate is a previously unknown coronavirus, a sort of "super-cold" that has jumped to humans from cattle or poultry. But many samples from sufferers contain metapneumovirus, a common cause of respiratory ailments among children that may have mutated.
Another theory is that the two relatively harmless bugs have somehow joined forces. Scientists also concede that it is possible these two bugs may not be related to the illness, and that they have no idea what is causing SARS.
What is almost certain is that the disease sprung up last November in China's Guangdong province.
How SARS travels
Like the common cold, it seems to be spread by droplets. If someone infected coughs or sneezes, anyone within about a metre is vulnerable. The bug also can linger, so if an infected person touches a door knob or elevator button, anyone who does the same soon after is at risk.
There is also some evidence that the bug may be airborne, but clearly some carriers are "super-infectors" and far more infectious than others.
The death rate
So far, about four per cent of people worldwide who contracted SARS have died. In Canada, it's 10 per cent. That is far higher than influenza, but still about half the death rate of West Nile virus.
Influenza, however, is such a common infection that it is a much bigger killer over all. More than 5,000 people a year in Canada die of the flu, even though there is an effective vaccine. But we don't shut down hospitals and run around in masks during the flu season, which lasts about five months a year.
The signs
The illness usually begins with a high fever (higher than 100.4¨F or 38¨C), a dry cough and a general feeling of malaise. In other words, the symptoms are identical to a host of respiratory illnesses.
Until there is a test, the only distinguishing factor is contact with someone known to have SARS. If not, you don't have it.
The risk factor
So far, all cases in Canada can be traced directly to contact with an original SARS carrier; public health officials insist there has been no community spread. If it does gain a foothold, it could become a part of the infectious-disease landscape, like influenza.
Evasion strategy
It's boring and low-tech but washing your hands guards against a host of diseases, including SARS, and it's never a good idea to hang around someone with a hacking cough or to put your fingers in your mouth.
Should you wear a mask?
No, it will just make you seem paranoid. You'd be far better off tying your hands behind your back.
Travel advisory
It's not a good idea to visit areas where SARS has spread within the community, such as China, Hong Kong and Singapore. But there are all kinds of things you can pick up on the road, and in terms of danger, SARS isn't that bad. It's not that common and fairly easy to avoid.
Travelling to Toronto poses no danger, unless you plan to sneak into one of the hospitals' isolation wards. As for Chinatown, SARS is no more common there than anywhere else in the city. Public health officials have done no racial profiling of sufferers, but there is no evidence that people of Asian origin are disproportionately affected.
In fact, more than two-thirds of the people infected with SARS are healthcare workers, so it's hospitals you should really avoid, not Chinese restaurants.
Treating the disease
The vast majority of cases clear up on their own, although Tylenol can be used to reduce fever. When respiratory symptoms become serious, and sufferers get pneumonia, they are given a combination of Ribivarin (a powerful antimicrobial) and steroids. But there is no real proof that treatment works. Because SARS is likely caused by a virus (not a bacteria), antibiotics don't help.
The final buzzer
An outbreak like this is officially over when two incubation periods have passed after the last new infection: In this case, 20 days. Practically speaking, that means you expect SARS to be around for at least another month. More likely, it's here to stay.
By ANDRÉ PICARD
From Saturday's Globe and Mail
E-mail this Article
Print this Article
Severe acute respiratory syndrome is an international bug of mystery. By hitching a ride with travellers, it has caused thousands of cases around the world ― so many, in fact, that it has been dubbed the most significant outbreak ever spread through air travel.
Thus far, seven Canadians have died and more than 100 may be infected. But the tally doesn't really seem all that high, considering the elevated level of concern. As the top disease specialists here and abroad struggled to find the cause, many questions remain unanswered. For the average Canadian, the main one is: how serious a threat is SARS?
A few things to remember when trying to come up with an answer.
The cause
The leading candidate is a previously unknown coronavirus, a sort of "super-cold" that has jumped to humans from cattle or poultry. But many samples from sufferers contain metapneumovirus, a common cause of respiratory ailments among children that may have mutated.
Another theory is that the two relatively harmless bugs have somehow joined forces. Scientists also concede that it is possible these two bugs may not be related to the illness, and that they have no idea what is causing SARS.
What is almost certain is that the disease sprung up last November in China's Guangdong province.
How SARS travels
Like the common cold, it seems to be spread by droplets. If someone infected coughs or sneezes, anyone within about a metre is vulnerable. The bug also can linger, so if an infected person touches a door knob or elevator button, anyone who does the same soon after is at risk.
There is also some evidence that the bug may be airborne, but clearly some carriers are "super-infectors" and far more infectious than others.
The death rate
So far, about four per cent of people worldwide who contracted SARS have died. In Canada, it's 10 per cent. That is far higher than influenza, but still about half the death rate of West Nile virus.
Influenza, however, is such a common infection that it is a much bigger killer over all. More than 5,000 people a year in Canada die of the flu, even though there is an effective vaccine. But we don't shut down hospitals and run around in masks during the flu season, which lasts about five months a year.
The signs
The illness usually begins with a high fever (higher than 100.4¨F or 38¨C), a dry cough and a general feeling of malaise. In other words, the symptoms are identical to a host of respiratory illnesses.
Until there is a test, the only distinguishing factor is contact with someone known to have SARS. If not, you don't have it.
The risk factor
So far, all cases in Canada can be traced directly to contact with an original SARS carrier; public health officials insist there has been no community spread. If it does gain a foothold, it could become a part of the infectious-disease landscape, like influenza.
Evasion strategy
It's boring and low-tech but washing your hands guards against a host of diseases, including SARS, and it's never a good idea to hang around someone with a hacking cough or to put your fingers in your mouth.
Should you wear a mask?
No, it will just make you seem paranoid. You'd be far better off tying your hands behind your back.
Travel advisory
It's not a good idea to visit areas where SARS has spread within the community, such as China, Hong Kong and Singapore. But there are all kinds of things you can pick up on the road, and in terms of danger, SARS isn't that bad. It's not that common and fairly easy to avoid.
Travelling to Toronto poses no danger, unless you plan to sneak into one of the hospitals' isolation wards. As for Chinatown, SARS is no more common there than anywhere else in the city. Public health officials have done no racial profiling of sufferers, but there is no evidence that people of Asian origin are disproportionately affected.
In fact, more than two-thirds of the people infected with SARS are healthcare workers, so it's hospitals you should really avoid, not Chinese restaurants.
Treating the disease
The vast majority of cases clear up on their own, although Tylenol can be used to reduce fever. When respiratory symptoms become serious, and sufferers get pneumonia, they are given a combination of Ribivarin (a powerful antimicrobial) and steroids. But there is no real proof that treatment works. Because SARS is likely caused by a virus (not a bacteria), antibiotics don't help.
The final buzzer
An outbreak like this is officially over when two incubation periods have passed after the last new infection: In this case, 20 days. Practically speaking, that means you expect SARS to be around for at least another month. More likely, it's here to stay.
