Steve Quayle News Alerts

May 21, 2003
By LUKE SHOCKMAN

Donald Henderson knows history, and he is worried.

The doctor who led the international effort to eradicate smallpox said he's worried about history repeating itself, only on a much deadlier scale this time around.

In 1918, for reasons still unclear today, a new strain of flu - sometimes referred to as the Spanish flu - swept across the world, killing 20 million people.

Eighty-five years later, another virus is on the attack. SARS - severe acute respiratory syndrome - surfaced last fall in China, and so far has infected more than 7,800 people worldwide and killed more than 600.

That's a low death toll compared to the Spanish flu. But Henderson, who headed a team of international doctors who snuffed smallpox by the early 1980s, said it is not the death toll itself that concerns him with SARS - it is the percentage of people who die after contracting the virus.

The Spanish flu "had a death rate of about 1 or 2 percent, and SARS appears to be considerably higher," he said.

Much higher, in fact. Henderson and others caution that it is too early to say exactly what the death rate is because there are so many unknowns, but so far SARS appears to kill at least 5 percent to 15 percent of people it infects. If SARS somehow races through large populations similar to what the Spanish flu did ...

"We all consider this to be very, very worrisome," Henderson said. "There are those who've said we don't have many cases, or that we have more cases of AIDS. Well, true. But this has the potential for spread like HIV doesn't."

Now a professor at Johns Hopkins Bloomberg School of Public Health, as well as an adviser to U.S. Secretary of Health Tommy Thompson, Henderson doubts authorities will be able to eradicate SARS like he did with smallpox.

"If you get sick with smallpox, you are really sick and not inclined to fly. With SARS, you get a fever and a cough, but people with the disease, many of them are mobile, so the likelihood of transmission is much higher," he said.

Other public health authorities are more optimistic.

"We think we have a window of opportunity to get rid of this disease and put it back in the box," said Maria Cheng, a spokesman for the World Health Organization, based in Geneva.

Cheng said a vaccine might be developed in a year or two; others say it could take much longer. Even without a vaccine for SARS, she said, the disease can be contained. What happens with China, she said, is the big unknown.

China has been hit hard by SARS, with almost 300 killed and more than 5,200 infected. Authorities there initially covered up news of the disease, allowing the disease to spread rapidly. Even now, after improving its efforts, Cheng said China is still not providing enough information about SARS to international experts.

Last week, China's Supreme Court threatened execution of people who knowingly spread the disease by violating SARS quarantine laws. If China fails to contain SARS, Cheng agreed that chances for containing the virus dim for the very reasons Henderson pointed out.

Fortunately, SARS has not spread as quickly as the Spanish flu - yet - and the disease appears to have had little impact in the United States. Nationwide, there have been 350 suspected and probable cases, but no deaths.

Some public health experts have complained that SARS is getting too much attention, and the media are needlessly panicking the public.

Dr. David Baltimore, a Nobel Prize-winning vaccine research at the California Institute of Technology, wrote a guest editorial last month in The Wall Street Journal complaining of what he perceived as overreaction by the media and public toward SARS.

Dr. Jeffrey Koplan, who was director of the Centers for Disease Control and Prevention in Atlanta from 1998 until last year, disagreed.

"I don't think SARS has been overemphasized," he said. "Let him (Baltimore) see a room full of people on respirators."

While Koplan said he thinks all the attention SARS has been getting is appropriate, he said some of what's been reported is either inaccurate or misses the point.

Take the question of a vaccine, for example. While many experts, including those at the World Health Organization, suggest a vaccine might be developed within a year or two, Koplan scoffs at that.

"Forget it. If you have a vaccine in 10 years, consider yourself lucky," he said.

Current CDC officials say much the same thing.

What health officials need to focus on is a diagnostic test for SARS, Koplan said. For now, he said, authorities are trying to define SARS cases based on some rather shaky criteria, including whether you visited a country where SARS is present. But a definitive, cheap, quick test is needed soon, he said, so quarantine measures can be more efficient.

http://www.timesrecordnews.com/trn/nw_national/article/0,1891,TRN_5703_1978181,00.html