New SARS outbreak possible

Experts have suggested that the deadly SARS virus may return this winter, although it is unlikely to be on the same scale as the outbreak earlier this year. Earlier this month the World Health Organisation declared the SARS outbreak over.

In an article for the Journal of Epidemiology and Community Health, nine experts were questioned over the likelihood of a recurrence of the SARS outbreak. Among the nine experts, two believed SARS would not recur, three felt it would, and four were uncertain.

However, all agreed that doctors and public health officials could not afford to be complacent, as viral respiratory infections such as SARS are more likely to occur in cooler months. They also called for proactive targeted measures to reduce the chance of a new outbreak.

 (c) 1998-2003 DeHavilland Information Services plc. All rights reserved

 British Medical Journal

 Press Release: Thursday, 17th July (British Medical Journals)


SARS could very well return this autumn, leading experts predict

[Will the SARS epidemic recur? Commentaries from nine leading
international public health experts. Publication ahead of October print issue; 2003]

SARS could return this autumn, predict some leading public health
experts, but it is unlikely to be on the scale of an epidemic.

An international panel of nine experts were asked by the editors of the
Journal of Epidemiology and Community Health to give their views on the
likelihood of a recurrence of severe acute respiratory syndrome (SARS).
The views of Journal readers are also being canvassed on the journal's

Among the nine experts, two felt that SARS would not recur, three felt
that it would; and four were uncertain. But the overall consensus was that
doctors and public health officials simply cannot afford to be
complacent, because there are several reasons why SARS could re-surface this

Seasonality is a common aspect of viral respiratory infections,
particularly the coronavirus family to which SARS belongs: influenza
and respiratory syncitial virus are two cases in point. This is supported
by the decline of reported cases of the infection in warmer months, the
last of which was in Taiwan on June 15.

Another important factor is that the source of SARS has as yet not been
identified, although it is thought to be have been transmitted from an
animal, with the current contenders civet cats and racoon dogs in

While it is unlikely that the virus will have adapted itself to produce
a 'sub clinical infection,' thereby creating a potential human reservoir
of infection, there may very well be an animal reservoir, so facilitating
the same route of animal transmission. Because the infection in humans is
so recent, no immunity will have been built up, added to which it is not
known if the infection has been completely eradicated in people.

Several of the experts point out the importance of public health
measures to respond quickly to infectious disease and contain its spread. The
validity of some of these measures, such as home quarantine, face
masks, and restricting public events, is unproven; what really seems to count
are effective isolation procedures and early detection of the disease, this
last being hampered by the relatively poor sensitivity of diagnostic

The experts note that there is cause for optimism, as many of those
countries affected by the previous outbreak have adopted heightened
surveillance and detection methods, but this is not always possible in
countries with less developed health care systems and resources, they