Mystery disease: scientists race to contain worldwide SARS outbreak.

GUANGDONG PROVINCE, China--Last November in the southern Chinese city of Foshan, a businessman checked into a hospital. He had a high fever and a dry cough, and he had difficulty breathing. Doctors suspected he had a type of pneumonia, which usually isn't highly contagious. However, the doctors couldn't identify the germ that had made him sick. The man eventually recovered, but four of the healthcare workers who treated him became gravely ill with the disease.

Within a few months, hundreds of people in Guangdong province were hospitalized with the mysterious illness, and many died. In late February, Liu Jianlun, a 64-year-old doctor who had treated some of the patients, boarded a bus to Hong Kong to attend a wedding at the swanky Metropole Hotel. Unwittingly, he took the infection with him. After a coughing fit, the doctor left the hotel and walked to a nearby hospital, where he said, "Lock me up. Do not touch me. I have a very virulent disease."

Doctors didn't follow his advice fast enough. By the time they put Liu in isolation, 70 hospital workers and 17 students were ill. The doctor had also infected seven hotel guests. Within days, the doctor and two of the hotel guests were dead. Unaware of any danger, the the rest of the infected guests helped spread the killer bug around the world.

On March 15, the World Health Organization (WHO) issued a global health alert and launched a worldwide campaign to contain the fast-spreading disease, which is now known as SARS (severe acute respiratory syndrome).

"We had to let other countries know that this was coming. And we had to let passengers know what the disease was as well, so that if they got it they could tell their doctors and get themselves isolated," said Dr. David Heymann of WHO.

At the time CE went to press, there were almost 3,000 reported cases of SARS with more than 100 deaths in 20 countries. At press time, the United States reported 125 cases and no related deaths.

FEAR OF THE UNKNOWN

Scientists know very little about SARS, and that worries them. They don't know how the first person contracted the disease, and they don't know how it spreads. They don't know why some people catch it and others don't and why some people recover and others die. Doctors do not yet know how to treat it and ultimately how to prevent it.

"It's looking like it's going to be a long, long drawn-out battle. One of the major stresses is not knowing where it is going to go," said Dr. Gavin Joynt, a doctor at a Hong Kong hospital plagued by the disease.

Scientists believe that SARS is caused by a mutant form of a corona virus, the same kind of virus that often causes the common cold. Scientists initially suspected that the disease spread through the air by close contact, since most of the affected people were healthcare workers treating SARS patients or patients' family members.

That theory came into question in April after hundreds of tenants in a Hong Kong apartment complex developed the disease. Those cases baffled healthcare workers because many of those patients had no direct exposure to a person with SARS. The outbreak led researchers to believe that the disease could also be spread via water, sewage, or pest feces.

"It could even [be spread by] such a thing as a door handle, where someone with SARS has coughed and left droplets containing the virus, and then the next person gets these droplets on [his] fingers, touches [his] eyes or mouth, and becomes infected," said Dr. Maria Zambon, a British doctor who is developing a test to determine whether a person has SARS.

The news isn't all bad, however. "Most people tend to get better," said Heymann. "About 10 percent [of SARS victims] have a stormy course, and 4 percent die," he said.

RACE FOR THE CURE

Affected nations are doing whatever they can to contain the spread of SARS. Some Asian governments are quarantining, or isolating, patients. Malaysia stopped issuing visas for Chinese travelers. Indonesia banned spitting in public places. The Roman Catholic Church of Singapore even banned priests from hearing confessions.

In the meantime, scientists around the world are scrambling to find answers to the many questions raised by SARS.

At a recent press conference, Dr. Julie Gerberding, director of the U.S. Centers for Disease Control in Atlanta, praised the scientific community for its handling of the SARS outbreak. "Speed of scientific discovery and communication are hallmarks of the response to SARS and reflect amazing achievements in science, technology, and international collaboration," she said. Then she asked a tough question about SARS: "Despite these advances, a very sobering question remains, Are we fast enough?"

CONSIDER THIS ... Do you think SARS could become an epidemic like Spanish flu? Why or why not?