As a Deadly Mystery Virus Races around the Globe, Expert in Infectious Disease Asks, Will Man or Microbes Win?

News Editors/Health/Medical Writers

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The following is an opinion editorial provided by John Sinnott - MD, FACP, Cullison Professor and Director, Division of Infectious Diseases, Dept. of Internal Medicine, USF and Amber Degryse, BS ,third year medical student, USF College of Medicine:

Around the world people are distressed to hear of an unidentified emerging pathogen causing Sudden Acute Respiratory Syndrome (SARS). As an attending physician and medical student, so are we. With war in the Middle East brewing, our anxiety has been concentrated on a terrorist attack using biological weapons... forgotten was Mother Nature's power to unleash deadly outbreaks. Emerging infections are serious threats that must not be underestimated. Deaths from infectious diseases have risen 60% over the past 20 years and physicians have difficulty with the alarming number of new and resistant pathogens. New infectious diseases obviously create a time lag before identifying a cause and treatment. From West Nile Fever to resistant staph germs, and now a deadly new strain of pneumonia, we must increase our vigilance to the threat emerging pathogens pose for public health and safety.

This new threat exploded in November in China when cases of a severe pneumonia began to be reported. Amid little publicity, the illness peaked in February, and it appeared the numbers of cases were diminishing. Unfortunately; however, the numbers are on the rise again... and in countries much closer to home. There have now been over 400 cases and at least nine deaths from this mysterious SARS. The incubation period for this disease appears to be between two and seven days. Signs and symptoms include the sudden onset of fever over 101.4, cough, shortness of breath, bloody sputum, and difficulty breathing. Sufferers may also experience sore throat, muscle aches, and headache. Those who have recently traveled to Asia or have been in contact with an Asian traveler should carefully watch for signs of illness.

Multitudes of scientists from five different continents have been working diligently to uncover the cause of this illness. Only this week has a clue emerged. Scientists in Germany and Hong Kong believe that they have isolated particles of a virus belonging to the Paramyxovirus family as the culprit. The Paramyxovirus family contains other virulent pathogens such as measles and mumps as well as two recently recognized viruses, Hendra virus and Nipah virus. It must be stressed that these are very preliminary results and other laboratories have failed to demonstrate any known virus or bacteria from the victims. This illness may very well be a novel pathogen. In addition, there is no consensus on treatment.

With great concern, the disease is making a rapid sweep of the globe. At least ten countries have reported cases of SARS. There are eleven suspected cases in the United States according to the World Health Organization. In the modern times of the intercontinental jet, the spread of pathogens across thousands of miles can occur in hours. No Homeland security agent can stop this disease-causing entity from entering our borders. A disease on the other side of the world is no longer "their problem." We must act as a global community collaborating to combat the new pathogens.

And action is indeed being taken. The CDC activated its emergency operations center and has issued a health alert to hospitals across the United States. Health alert cards, the first issued in modern memory, are being given to international travelers. These describe the symptoms to be aware of and urge those with these complaints to seek prompt medical attention. Eight of our CDC scientists have been deployed to assist the World Health Organization in this multi-national investigation in search of a cause and a cure.

Emerging infections are serious threats that must be respected. In our age of high-tech diagnostic tests and powerful antibiotics it seems impossible that there is a disease sweeping the globe about which we know very little. Living in a modern society it is often easy to forget that there are areas of the world that make fertile grounds for the emergence of new and resistant infectious diseases. Overpopulation, overuse of antibiotics, new food processing techniques, intrusion into new ecosystems, travel, and finally medical advances all play an interconnected role in the genesis of new diseases.

AIDS, Ebola, Mad Cow Disease, and West Nile Fever are only a few examples of the multitudes of new diseases for which there is no cure. This new paradigm of connectivity is perhaps the best example of the struggle between nature's processes and man's struggle for survival. We create new pharmaceuticals but nature responds with new resistant bacteria. Obviously our defense has to be on an individual level. Vaccinations must become a personal priority. Check with your doctor, avoid the overuse of antibiotics, and above all, read and educate yourself on these vital topics. Our only hope to combat these emerging infectious diseases is to continue research, education, and support of public health efforts.