SARS: 1918 Revisited? The Urgent Need for Global Collaboration in Public Health
Identifieur interne : 000A52 ( Pmc/Corpus ); précédent : 000A51; suivant : 000A53SARS: 1918 Revisited? The Urgent Need for Global Collaboration in Public Health
Auteurs : Dennis G. MakiSource :
- Mayo Clinic Proceedings [ 0025-6196 ] ; 2003.
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DOI: 10.4065/78.7.813
PubMed: 12839074
PubMed Central: 7126729
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">SARS: 1918 Revisited? The Urgent Need for Global Collaboration in Public Health</title><author><name sortKey="Maki, Dennis G" sort="Maki, Dennis G" uniqKey="Maki D" first="Dennis G." last="Maki">Dennis G. Maki</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">12839074</idno><idno type="pmc">7126729</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7126729</idno><idno type="RBID">PMC:7126729</idno><idno type="doi">10.4065/78.7.813</idno><date when="2003">2003</date><idno type="wicri:Area/Pmc/Corpus">000A52</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000A52</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">SARS: 1918 Revisited? The Urgent Need for Global Collaboration in Public Health</title><author><name sortKey="Maki, Dennis G" sort="Maki, Dennis G" uniqKey="Maki D" first="Dennis G." last="Maki">Dennis G. Maki</name></author></analytic><series><title level="j">Mayo Clinic Proceedings</title><idno type="ISSN">0025-6196</idno><idno type="eISSN">1942-5546</idno><imprint><date when="2003">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gottfried, Rs" uniqKey="Gottfried R">RS Gottfried</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pyle, Gf" uniqKey="Pyle G">GF Pyle</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Crosby, Aw" uniqKey="Crosby A">AW Crosby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peiris, Jsm" uniqKey="Peiris J">JSM Peiris</name></author><author><name sortKey="Lai, St" uniqKey="Lai S">ST Lai</name></author><author><name sortKey="Poon, Ll" uniqKey="Poon L">LL Poon</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Mayo Clin Proc</journal-id><journal-id journal-id-type="iso-abbrev">Mayo Clin. Proc</journal-id><journal-title-group><journal-title>Mayo Clinic Proceedings</journal-title></journal-title-group><issn pub-type="ppub">0025-6196</issn><issn pub-type="epub">1942-5546</issn><publisher><publisher-name>Mayo Foundation for Medical Education and Research. Published by Elsevier Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">12839074</article-id><article-id pub-id-type="pmc">7126729</article-id><article-id pub-id-type="publisher-id">S0025-6196(11)62678-5</article-id><article-id pub-id-type="doi">10.4065/78.7.813</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>SARS: 1918 Revisited? The Urgent Need for Global Collaboration in Public Health</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Maki</surname><given-names>Dennis G.</given-names></name><degrees>MD</degrees><email>dgmaki@medicine.wisc.edu</email><xref rid="cor1" ref-type="corresp">*</xref></contrib></contrib-group><aff>Department of Medicine Infection Control Department Center for Trauma and Life Support University of Wisconsin Hospital and Clinics University of Wisconsin-Madison</aff><author-notes><corresp id="cor1"><label>*</label>Address reprint requests and correspondence to Dennis G. Maki, MD, Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Clinical Sciences Center, H4/574-5158, 600 Highland Ave, Madison, WI 53792 <email>dgmaki@medicine.wisc.edu</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>20</day><month>10</month><year>2011</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>7</month><year>2003</year></pub-date><pub-date pub-type="epub"><day>20</day><month>10</month><year>2011</year></pub-date><volume>78</volume><issue>7</issue><fpage>813</fpage><lpage>816</lpage><permissions><copyright-statement>Copyright © 2003 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.</copyright-statement><copyright-year>2003</copyright-year><copyright-holder>Mayo Foundation for Medical Education and Research</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><related-article related-article-type="commentary-article" id="d32e385" ext-link-type="doi" xlink:href="10.4065/78.7.882"></related-article></article-meta></front><body><p id="para10"><italic>Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever.</italic></p><p id="para20">Sir William Osler</p><p id="para30">Humanity has been profoundly affected by plagues since the dawn of recorded history. The mother of all plagues, the Black Death, killed more than one third of the population of Europe in the 14th century.<xref rid="bib1" ref-type="bibr"><sup>1</sup></xref> In more recent times, the great influenza epidemic of 1918, which had an inexplicably devastating mortality in persons between the ages of 20 and 40 years,<xref rid="bib2" ref-type="bibr"><sup>2</sup></xref> claimed the lives of 4 times as many soldiers as died on the battlefields of France at the height of World War I, and 25 to 50 million persons worldwide died of H1N1 influenza A.<xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref></p><p id="para40">The world now faces a new apocalyptic horseman, severe acute respiratory syndrome (SARS), caused by a new human coronavirus (SARS-CoV). Genetic evidence suggests that SARS-CoV is a human-animal recombinant<xref rid="bib4" ref-type="bibr">4</xref>, <xref rid="bib5" ref-type="bibr">5</xref>, <xref rid="bib6" ref-type="bibr">6</xref>, <xref rid="bib7" ref-type="bibr">7</xref> that made the leap, possibly from a civet or other smaller mammal, to humans in Guangdong Province, southern China.<xref rid="bib7" ref-type="bibr"><sup>7</sup></xref> Between November 2002 and June 5, 2003, 8402 persons worldwide have acquired SARS, the vast majority in China (5329 infected; 334 deaths), Taiwan (678; 81), Hong Kong (1748; 283), Singapore (206; 31), Vietnam (63; 5), or Toronto, Canada (216; 31).<xref rid="bib8" ref-type="bibr"><sup>8</sup></xref> In keeping with its infamous historical predecessors, SARS has resulted in the deaths of 12% of patients with this disease,<xref rid="bib8" ref-type="bibr"><sup>8</sup></xref> many in some of the most advanced hospitals in the world.<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref> Mortality in persons older than 60 years has exceeded 40%.<xref rid="bib13" ref-type="bibr"><sup>13</sup></xref></p><p id="para50">SARS, which produces an unusually severe form of atypical pneumonia, is only the latest in a growing list of emerging infectious diseases detected and characterized since 1977, including legionnaires' disease; <italic>Clostridium difficile</italic> antibiotic-associated colitis; toxic shock syndrome caused by unique strains of <italic>Staphylococcus aureus</italic> or <italic>Streptococcus pyogenes</italic>; hemolytic uremic syndrome and thrombotic thrombocytopenic purpura deriving from food-borne infection caused by <italic>Escherichia coli</italic> O157:H7; human immunodeficiency virus infection and acquired immunodeficiency syndrome (AIDS); the blurring spectrum of human and animal prion diseases-Creutzfeld-Jakob disease, bovine spongiform encephalopathy, and chronic wasting disease of cervids; and in North America, <italic>Hantavirus</italic> pneumonitis and West Nile encephalitis.</p><p id="para60">It has become clear that a large and highly developed country such as the United States not only has a powerful self-interest but also a moral obligation to invest in a world-class communicable disease center, such as the Centers for Disease Control and Prevention, to be able to detect and characterize new infectious diseases and contain their spread. The importance and impact of nationally funded organizations of excellence, staffed by the best and brightest and working in global concert with other like-minded organizations, also cannot be overstated. SARS was recognized as a distinct new infectious disease syndrome by Dr Carlo Urbani on February 28, 2003; the viral causation was identified and confirmed by scientists around the world within a month.<xref rid="bib4" ref-type="bibr">4</xref>, <xref rid="bib5" ref-type="bibr">5</xref>, <xref rid="bib6" ref-type="bibr">6</xref> International scientific collaboration, championed by epidemiologists and virologists at the World Health Organization, the US Centers for Disease Control and Prevention, and centers in Singapore, Hong Kong, Canada, and Germany, has been unprecedented<xref rid="bib14" ref-type="bibr">14</xref>, <xref rid="bib15" ref-type="bibr">15</xref> and has led to containment of SARS in most of the affected countries, particularly Vietnam, Singapore, and Hong Kong, at the time this editorial was written.<xref rid="bib8" ref-type="bibr">8</xref>, <xref rid="bib16" ref-type="bibr">16</xref></p><p id="para70">SARS is unique among the numerous types of community-acquired pneumonia: (1) it has a prohibitive mortality, considerably higher than most other viral or bacterial community-acquired pneumonias, with the exception of pneumonitis caused by <italic>Legionella pneumophila</italic> or <italic>Hantavirus</italic>; (2) mortality has been high in adults, especially those older than 60 years, but clinical disease has been uncommon and mild in children<xref rid="bib17" ref-type="bibr"><sup>17</sup></xref>; (3) early microbiologic confirmation of SARS has been difficult because the virus is hard to culture in vitro, conventional DNA/RNA detection techniques such as reverse-transcriptase polymerase chain reaction have been relatively insensitive in the early phase of infection,<xref rid="bib4" ref-type="bibr">4</xref>, <xref rid="bib5" ref-type="bibr">5</xref>, <xref rid="bib6" ref-type="bibr">6</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref> and seroconversion, which ultimately occurs in nearly all infected individuals, takes up to 20 days<xref rid="bib11" ref-type="bibr"><sup>11</sup></xref>; (4) SARS can be extraordinarily contagious,<xref rid="bib18" ref-type="bibr">18</xref>, <xref rid="bib19" ref-type="bibr">19</xref> with more than one half of the early cases involving health care workers<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref>; (5) the incubation period of SARS (mean, 6.4 days<xref rid="bib13" ref-type="bibr"><sup>13</sup></xref>) is much longer than that for other respiratory viruses, and it appears that infected persons are not contagious until they become symptomatic; and (6) most cases probably become infected by droplet spread<xref rid="bib20" ref-type="bibr"><sup>20</sup></xref> (<10μM respiratory particles inhaled within 2 m of the source), but SARS-CoV can survive for hours on environmental surfaces,<xref rid="bib21" ref-type="bibr"><sup>21</sup></xref> and, at least in theory, there appears to be potential for contact transmission and even fecal-oral spread.<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib19" ref-type="bibr">19</xref>, <xref rid="bib22" ref-type="bibr">22</xref></p><p id="para80">In this issue of the <italic>Mayo Clinic Proceedings</italic>, Sampathkumar et al<xref rid="bib23" ref-type="bibr"><sup>23</sup></xref> provide a succinct review of SARS and a valuable primer for clinicians and infection control practitioners. Although clinical features of SARS are nonspecific, with near-ubiquitous fever and cough, it must be emphasized that coryza and sore throat, which are common with most other human respiratory virus infections, are uncommon in SARS, and the cough is characteristically nonproductive.<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref> In contrast, gastrointestinal symptoms such as diarrhea are common and in some cases may predominate without respiratory symptoms.<xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib19" ref-type="bibr">19</xref> Notably, several laboratory findings, rarely seen with other types of community-acquired pneumonia, may prove to be of considerable value as surrogate markers of early SARS: lymphopenia (<1000/μL); mild thrombocytopenia (<150,000/μL); evidence of disseminated intravascular coagulation with elevated D-dimer levels; low-grade rhabdomyolysis with elevated creatine phosphokinase levels; and especially an elevated lactic dehydrogenase level; 1 or more of these abnormalities are seen in up to 90% of patients, particularly in sicker patients.<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref> Until a sensitive, specific, and rapid confirmatory diagnostic test becomes available, for any febrile patient with cough, especially with radiological evidence of pneumonia or acute respiratory distress syndrome (ARDS), who has recently returned from a country where community transmission of SARS is occurring or has occurred or who has had recent close contact with another person suspected of having SARS, an immediate algorithmic approach must be initiated to prevent nosocomial spread. Specific measures include segregating patients with suspected SARS from other patients, ideally in a negative-pressure isolation room; masking the patient; and requiring all health care workers attending to the patient to wear a fit-tested N-95 respirator mask (or powered air-purifying system), a full-length long-sleeved gown and nonsterile gloves, and eye protection with goggles or a face shield.<xref rid="bib24" ref-type="bibr">24</xref>, <xref rid="bib25" ref-type="bibr">25</xref> Suspicion of SARS must be recorded on all specimens sent to the diagnostic laboratory. As Sampathkumar et al point out, all health care workers attending to the patient must be noted and monitored closely for fever, the earliest sign of occupationally acquired infection.</p><p id="para90">The importance of measures to prevent droplet airborne spread cannot be overemphasized. In a novel analysis of a large cohort of health care workers who had had extensive contact with patients with SARS in 5 Hong Kong hospitals, Seto et al<xref rid="bib20" ref-type="bibr"><sup>20</sup></xref> found that no health care worker who consistently used a mask, either an N-95 respirator mask or a high-quality surgical mask, became infected (<italic>P</italic><.01), even if he or she did not always wear gloves. Hand washing and wearing a gown also appeared to be important in protection against occupationally acquired infection.</p><p id="para100">To prevent spread of SARS in the community, public health authorities must strive to identify <italic>every</italic> contact of the presumed case, especially health care workers exposed without the benefit of barrier precautions, and place them on home quarantine.<xref rid="bib24" ref-type="bibr">24</xref>, <xref rid="bib25" ref-type="bibr">25</xref> The epidemiological feature of SARS that gives greatest hope for containing spread is the prolonged incubation period, which allows case-contact investigation and quarantine to be instituted before contacts destined to become ill can spread SARS-CoV to others. Whereas quarantine was ineffective in preventing spread of influenza during the great epidemic of 1918<xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref> because of its extremely brief incubation period, isolation of actively infected patients and stringent quarantine of those exposed have been the linchpin of control of SARS in Vietnam, Hong Kong, Singapore, Canada, and perhaps even China.<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref>, <xref rid="bib12" ref-type="bibr">12</xref>, <xref rid="bib13" ref-type="bibr">13</xref>, <xref rid="bib16" ref-type="bibr">16</xref></p><p id="para110">Beyond ruling out other treatable causes of community-acquired pneumonia and cutting-edge supportive care for critical illness,<xref rid="bib26" ref-type="bibr"><sup>26</sup></xref> including lung-protective low-tidal-volume mechanical ventilatory support,<xref rid="bib27" ref-type="bibr"><sup>27</sup></xref> stringent glycemic control,<xref rid="bib28" ref-type="bibr"><sup>28</sup></xref> restrictive use of packed red blood cell transfusions,<xref rid="bib29" ref-type="bibr"><sup>29</sup></xref> and uncompromising adherence to basic infection control precautions,<xref rid="bib26" ref-type="bibr"><sup>26</sup></xref> it is still uncertain whether corticosteroids or antivirals, such as ribavirin, both recommended anecdotally by Hong Kong physician-investigators who have treated large numbers of patients,<xref rid="bib9" ref-type="bibr">9</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref> will improve outcome in terms of reducing mortality and length of hospitalization. The exuberant, proliferative inflammatory response with alveolar membrane formation seen histopatho-logically<xref rid="bib5" ref-type="bibr">5</xref>, <xref rid="bib10" ref-type="bibr">10</xref>, <xref rid="bib11" ref-type="bibr">11</xref> is extremely similar to that seen in gardenvariety ARDS but also not unlike desquamative interstitial pneumonitis or organizing pneumonia,<xref rid="bib30" ref-type="bibr"><sup>30</sup></xref> with or without bronchiolitis obliterans,<xref rid="bib31" ref-type="bibr"><sup>31</sup></xref> conditions that usually respond favorably to corticosteroids. Evidence that moderate doses of corticosteroids may be of benefit in refractory late-phase severe ARDS<xref rid="bib32" ref-type="bibr"><sup>32</sup></xref> and unequivocally improve survival in patients with AIDS and severe <italic>Pneumocystis carinii</italic> pneumonia<xref rid="bib33" ref-type="bibr"><sup>33</sup></xref> further suggests that, in patients with SARS <italic>and</italic> progressive hypoxemic respiratory failure, early treatment with prednisone at a dose of 1 to 2 mg/kg per day may improve survival. In contrast, the efficacy of antivirals such as ribavirin, which has substantial toxicity,<xref rid="bib12" ref-type="bibr"><sup>12</sup></xref> is far less clear, and no antiviral drug or drugs can be recommended at this time. Prospective multicenter randomized trials are urgently needed to determine conclusively the therapeutic role of early use of corticosteroids as well as ribavirin and other candidate antiviral drugs.</p><p id="para120">However, the burning question remains: Will SARS continue to spread? Might it even explode on the world in the coming fall and winter months in the Northern Hemisphere (<xref rid="tbl1" ref-type="table">Table 1</xref>)? The huge negative economic impact of SARS in Asia and Canada to date has been sobering,<xref rid="bib38" ref-type="bibr"><sup>38</sup></xref> but the very real potential for uncontained global spread is even more sobering. Accelerated efforts to develop a vaccine, with trials in animal models under way, are encouraging. We can take heart that SARS has been successfully contained in most affected countries,<xref rid="bib8" ref-type="bibr">8</xref>, <xref rid="bib16" ref-type="bibr">16</xref> at least for now, but most importantly, SARS may have launched a new era of international cooperation in communicable disease control and public health in general.<xref rid="bib14" ref-type="bibr">14</xref>, <xref rid="bib15" ref-type="bibr">15</xref> It is no longer acceptable for countries to conceal their outbreaks or other health care problems.<xref rid="bib39" ref-type="bibr"><sup>39</sup></xref> Realizing that each day hundreds of thousands of people from every corner of the globe fly transcontinentally, the world is a rapidly shrinking global village in regard to infectious diseases. It is in every country's selfinterest to be forthcoming and work collaboratively toward a common goal-the prevention of communicable diseases and improvement of the health of every citizen of the world.<table-wrap position="float" id="tbl1"><label>Table 1</label><caption><p>Parallels Between 1918 Influenza and SARS<xref rid="tbl1fn1" ref-type="table-fn">*</xref></p></caption><table frame="hsides" rules="groups"><tbody><tr><td align="left">Like more recent strains of the influenza A virus,<xref rid="bib34" ref-type="bibr"><sup>34</sup></xref> the 1918 (H1N1) strain was almost certainly a human-animal recombinant that originated in southern China <xref rid="bib35" ref-type="bibr">35</xref>, <xref rid="bib36" ref-type="bibr">36</xref></td><td align="left">In all likelihood, so is the SARS coronavirus (SARS-CoV)<xref rid="bib4" ref-type="bibr">4</xref>, <xref rid="bib5" ref-type="bibr">5</xref>, <xref rid="bib6" ref-type="bibr">6</xref>, <xref rid="bib7" ref-type="bibr">7</xref></td></tr><tr><td align="left">H1N1 influenza was extraordinarily contagious presumably because there was so little natural immunity in the general population worldwide<xref rid="bib36" ref-type="bibr"><sup>36</sup></xref></td><td align="left">Serologic surveys by the CDC using specimens from US serum banks show no persons with preexisting antibodies to the new SARS virus<xref rid="bib5" ref-type="bibr"><sup>5</sup></xref></td></tr><tr><td align="left">H1N1 influenza A had high mortality among young and healthy individuals<xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref></td><td align="left">SARS has also had a prohibitive mortality<xref rid="bib8" ref-type="bibr"><sup>8</sup></xref> and has killed previously well health care workers, including the discoverer of SARS, Dr Carlo Urbani<xref rid="bib37" ref-type="bibr"><sup>37</sup></xref></td></tr><tr><td align="left">Influenza A classically spreads in the late fall and winter months and is rarely seen during the late spring and summer months<xref rid="bib34" ref-type="bibr"><sup>34</sup></xref>; in 1918, influenza continued to occur, inexplicably, all summer<xref rid="bib3" ref-type="bibr"><sup>3</sup></xref></td><td align="left">SARS has caused epidemic disease all spring and will likely continue to spread slowly throughout the summer months</td></tr><tr><td align="left">In 1918, pandemic influenza surged worldwide in late August and the fall<xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref></td><td align="left">With SARS, we do not know what will occur, but we must be prepared for the worst; countries, regional and municipal health departments, hospitals, and individual practitioners must be informed and prepared</td></tr></tbody></table><table-wrap-foot><fn id="tbl1fn1"><label>*</label><p>CDC = Centers for Disease Control and Prevention; SARS = severe acute respiratory syndrome.</p></fn></table-wrap-foot></table-wrap></p></body><back><ref-list id="bibl10"><title>REFERENCES</title><ref id="bib1"><label>1</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Gottfried</surname><given-names>RS</given-names></name></person-group><source>The Black Death: Natural and Unnatural Human Disaster in Medieval Europe</source><year>1983</year><publisher-name>Free Press</publisher-name><publisher-loc>New York, NY</publisher-loc></element-citation></ref><ref id="bib2"><label>2</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Pyle</surname><given-names>GF</given-names></name></person-group><source>The Diffusion of Influenza: Patterns and Paradigms</source><year>1986</year><publisher-name>Rowman & Littlefield</publisher-name><publisher-loc>Totowa, NJ</publisher-loc></element-citation></ref><ref id="bib3"><label>3</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Crosby</surname><given-names>AW</given-names></name></person-group><source>America's Forgotten Pandemic: The Influenza of 1918</source><year>1989</year><publisher-name>Cambridge University Press</publisher-name><publisher-loc>Cambridge, England</publisher-loc></element-citation></ref><ref id="bib4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Peiris</surname><given-names>JSM</given-names></name><name><surname>Lai</surname><given-names>ST</given-names></name><name><surname>Poon</surname><given-names>LL</given-names></name><name><surname>SARS study group</surname></name></person-group><article-title>Coronavirus as a possible cause of severe acute respiratory syndrome</article-title><source>Lancet</source><volume>361</volume><year>2003</year><fpage>1319</fpage><lpage>1325</lpage><pub-id pub-id-type="pmid">12711465</pub-id></element-citation></ref><ref id="bib5"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ksiazek</surname><given-names>TG</given-names></name><name><surname>Erdman</surname><given-names>D</given-names></name><name><surname>Goldsmith</surname><given-names>CS</given-names></name><name><surname>SARS Working Group</surname></name></person-group><article-title>A novel coronavirus associated with severe acute respiratory syndrome</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>1953</fpage><lpage>1966</lpage><pub-id pub-id-type="pmid">12690092</pub-id></element-citation></ref><ref id="bib6"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Drosten</surname><given-names>C</given-names></name><name><surname>Günther</surname><given-names>S</given-names></name><name><surname>Preiser</surname><given-names>W</given-names></name></person-group><article-title>Identification of a novel coronavirus in patients with severe acute respiratory syndrome</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>1967</fpage><lpage>1976</lpage><pub-id pub-id-type="pmid">12690091</pub-id></element-citation></ref><ref id="bib7"><label>7</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Ruan</surname><given-names>Y</given-names></name><name><surname>Wei</surname><given-names>CL</given-names></name><name><surname>Ling</surname><given-names>AE</given-names></name></person-group><article-title>Comparative full-length genome sequence analysis of 14 SARS coronavirus isolates and common mutations associated with putative origins of infection. <italic>Lancet</italic> [serial online]</article-title><ext-link ext-link-type="uri" xlink:href="http://image.thelancet.com/extras/03art4454web.pdf">Available at: http://image.thelancet.com/extras/03art4454web.pdf</ext-link><year>May 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib8"><label>8</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>World Health Organization</surname></name></person-group><article-title>Cumulative number of reported probable cases of SARS</article-title><ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/sars/country/2003_06_04/en/print.html">Available at: www.who.int/csr/sars/country/2003_06_04/en/print.html</ext-link><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib9"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>N</given-names></name><name><surname>Hui</surname><given-names>D</given-names></name><name><surname>Wu</surname><given-names>A</given-names></name></person-group><article-title>A major outbreak of severe acute respiratory syndrome in Hong Kong</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>1986</fpage><lpage>1994</lpage><ext-link ext-link-type="uri" xlink:href="http://www.nejm.org">Available at: www.nejm.org</ext-link><comment>Accessibility verified June 5, 2003.</comment><pub-id pub-id-type="pmid">12682352</pub-id></element-citation></ref><ref id="bib10"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsang</surname><given-names>KW</given-names></name><name><surname>Ho</surname><given-names>PL</given-names></name><name><surname>Ooi</surname><given-names>GC</given-names></name></person-group><article-title>A cluster of cases of severe acute respiratory syndrome in Hong Kong</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>1977</fpage><lpage>1985</lpage><ext-link ext-link-type="uri" xlink:href="http://www.nejm.org">Available at: www.nejm.org</ext-link><comment>Accessibility verified June 5, 2003.</comment><pub-id pub-id-type="pmid">12671062</pub-id></element-citation></ref><ref id="bib11"><label>11</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Peiris</surname><given-names>JSM</given-names></name><name><surname>Chu</surname><given-names>CM</given-names></name><name><surname>Cheng</surname><given-names>VCC</given-names></name></person-group><article-title>Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. <italic>Lancet</italic> [serial online]</article-title><ext-link ext-link-type="uri" xlink:href="http://image.thelancet.com/extras/03art4432web.pdf">Available at: http://image.thelancet.com/extras/03art4432web.pdf</ext-link><year>May 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib12"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Booth</surname><given-names>CM</given-names></name><name><surname>Matukas</surname><given-names>LM</given-names></name><name><surname>Tomlinson</surname><given-names>GA</given-names></name></person-group><article-title>Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area</article-title><source>JAMA</source><volume>289</volume><year>2003</year><fpage>2801</fpage><lpage>2809</lpage><ext-link ext-link-type="uri" xlink:href="http://jama.ama-assn.org/cgi/search?fulltext=greater+toronto+area">Available at: http://jama.ama-assn.org/cgi/search?fulltext=greater+toronto+area</ext-link><comment>Accessibility verified June 4, 2003.</comment><pub-id pub-id-type="pmid">12734147</pub-id></element-citation></ref><ref id="bib13"><label>13</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Donnelly</surname><given-names>CA</given-names></name><name><surname>Ghani</surname><given-names>AC</given-names></name><name><surname>Leung</surname><given-names>GM</given-names></name></person-group><article-title>Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. <italic>Lancet</italic> [serial online]</article-title><ext-link ext-link-type="uri" xlink:href="http://image.thelancet.com/extras/03art4453web.pdf">Available at: http://image.thelancet.com/extras/03art4453web.pdf</ext-link><year>May 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib14"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>World Health Organization</surname></name></person-group><article-title>A multicentre collaboration to investigate the cause of severe acute respiratory syndrome</article-title><source>Lancet</source><volume>361</volume><year>2003</year><fpage>1730</fpage><lpage>1733</lpage><pub-id pub-id-type="pmid">12767752</pub-id></element-citation></ref><ref id="bib15"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gerberding</surname><given-names>JL</given-names></name></person-group><article-title>Faster…but fast enough? responding to the epidemic of severe acute respiratory syndrome [editorial]</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>2030</fpage><lpage>2031</lpage><pub-id pub-id-type="pmid">12672880</pub-id></element-citation></ref><ref id="bib16"><label>16</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>World Health Organization</surname></name></person-group><article-title>Update 73 - No new deaths, but vigilance needed for imported cases</article-title><ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/don/2003_06_04/en/print.html">Available at: www.who.int/csr/don/2003_06_04/en/print.html</ext-link><year>June 4, 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib17"><label>17</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Hon</surname><given-names>KLE</given-names></name><name><surname>Leung</surname><given-names>CW</given-names></name><name><surname>Cheng</surname><given-names>WTF</given-names></name></person-group><article-title>Clinical presentations and outcome of severe acute respiratory syndrome in children. <italic>Lancet</italic> [serial online]</article-title><ext-link ext-link-type="uri" xlink:href="http://image.thelancet.com/extras/03let4127web.pdf">Available at: http://image.thelancet.com/extras/03let4127web.pdf</ext-link><year>April 2003</year><comment>Accessibility verified June 4, 2003.</comment></element-citation></ref><ref id="bib18"><label>18</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Centers for Disease Control and Prevention</surname></name></person-group><article-title>Severe acute respiratory syndrome—Singapore, 2003</article-title><source>MMWR Morb Mortal Wkly Rep</source><volume>52</volume><year>2003</year><fpage>405</fpage><lpage>411</lpage><pub-id pub-id-type="pmid">12807088</pub-id></element-citation></ref><ref id="bib19"><label>19</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Centers for Disease Control and Prevention</surname></name></person-group><article-title>Severe acute respiratory syndrome—Taiwan, 2003</article-title><source>MMWR Morb Mortal Wkly Rep</source><volume>52</volume><year>2003</year><fpage>461</fpage><lpage>466</lpage><pub-id pub-id-type="pmid">12807078</pub-id></element-citation></ref><ref id="bib20"><label>20</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Seto</surname><given-names>WH</given-names></name><name><surname>Tsang</surname><given-names>D</given-names></name><name><surname>Yung</surname><given-names>RW</given-names></name><name><surname>Expert SARS Group of Hospital Authority</surname></name></person-group><article-title>Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS)</article-title><source>Lancet</source><volume>361</volume><year>2003</year><fpage>1519</fpage><lpage>1520</lpage><pub-id pub-id-type="pmid">12737864</pub-id></element-citation></ref><ref id="bib21"><label>21</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>World Health Organization</surname></name></person-group><article-title>First data on stability and resistance of SARS coronavirus compiled by members of WHO laboratory network</article-title><ext-link ext-link-type="uri" xlink:href="http://www.who.int/csr/sars/survival_2003_05_04/en">Available at: www.who.int/csr/sars/survival_2003_05_04/en</ext-link><comment>Accessibility verified June 4, 2003.</comment></element-citation></ref><ref id="bib22"><label>22</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Hong Kong Department of Health Report</surname></name></person-group><article-title>Main findings of an investigation into the outbreak of severe acute respiratory syndrome at Amoy Gardens</article-title><ext-link ext-link-type="uri" xlink:href="http://www.info.gov.hk/dh/ap.htm">Available at: www.info.gov.hk/dh/ap.htm</ext-link><comment>Accessed June 3, 2003.</comment></element-citation></ref><ref id="bib23"><label>23</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sampathkumar</surname><given-names>P</given-names></name><name><surname>Temesgen</surname><given-names>Z</given-names></name><name><surname>Smith</surname><given-names>TF</given-names></name><name><surname>Thompson</surname><given-names>RL</given-names></name></person-group><article-title>SARS: epidemiology, clinical presentation, management, and infection control measures</article-title><source>Mayo Clin Proc</source><volume>78</volume><year>2003</year><fpage>882</fpage><lpage>890</lpage><pub-id pub-id-type="pmid">12839084</pub-id></element-citation></ref><ref id="bib24"><label>24</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Centers for Disease Control and Prevention</surname></name></person-group><article-title>Interim guidance on infection control precautions for patients with suspected severe acute respiratory syndrome (SARS) and close contacts in house-holds</article-title><ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/ncidod/sars/ic-closecontacts.htm">Available at: www.cdc.gov/ncidod/sars/ic-closecontacts.htm</ext-link><year>April 29, 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib25"><label>25</label><element-citation publication-type="other"><person-group person-group-type="author"><name><surname>Centers for Disease Control and Prevention</surname></name></person-group><article-title>Updated interim domestic infection control guidance in the health-care and community setting for patients with suspected SARS</article-title><ext-link ext-link-type="uri" xlink:href="http://www.cdc.gov/ncidod/sars/infectioncontrol.htm">Available at: www.cdc.gov/ncidod/sars/infectioncontrol.htm</ext-link><year>May 1, 2003</year><comment>Accessibility verified June 5, 2003.</comment></element-citation></ref><ref id="bib26"><label>26</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Maki</surname><given-names>DG</given-names></name></person-group><chapter-title>Management of life-threatening infection in the ICU</chapter-title><person-group person-group-type="editor"><name><surname>Murray</surname><given-names>MJ</given-names></name><name><surname>Coursin</surname><given-names>DB</given-names></name><name><surname>Pearl</surname><given-names>RG</given-names></name><name><surname>Prough</surname><given-names>DS</given-names></name></person-group><source>Critical Care Medicine: Perioperative Management</source><edition>2nd ed.</edition><year>2002</year><publisher-name>Lippincott Williams & Wilkins</publisher-name><publisher-loc>Philadelphia, Pa</publisher-loc><fpage>616</fpage><lpage>648</lpage></element-citation></ref><ref id="bib27"><label>27</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Acute Respiratory Distress Syndrome Network</surname></name></person-group><article-title>Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome</article-title><source>N Engl J Med</source><volume>342</volume><year>2000</year><fpage>1301</fpage><lpage>1308</lpage><pub-id pub-id-type="pmid">10793162</pub-id></element-citation></ref><ref id="bib28"><label>28</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>van den Berghe</surname><given-names>G</given-names></name><name><surname>Wouters</surname><given-names>P</given-names></name><name><surname>Weekers</surname><given-names>F</given-names></name></person-group><article-title>Intensive insulin therapy in critically ill patients</article-title><source>N Engl J Med</source><volume>345</volume><year>2001</year><fpage>1359</fpage><lpage>1367</lpage><pub-id pub-id-type="pmid">11794168</pub-id></element-citation></ref><ref id="bib29"><label>29</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hebert</surname><given-names>PC</given-names></name><name><surname>Wells</surname><given-names>G</given-names></name><name><surname>Blajchman</surname><given-names>MA</given-names></name><name><surname>Transfusion Requirements in Critical Care Investigators</surname></name><name><surname>Canadian Critical Care Trials Group</surname></name></person-group><article-title>A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care [published correction appears in <italic>N Engl J Med</italic>. 1999;340:1056]</article-title><source>N Engl J Med</source><volume>340</volume><year>1999</year><fpage>409</fpage><lpage>417</lpage><pub-id pub-id-type="pmid">9971864</pub-id></element-citation></ref><ref id="bib30"><label>30</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cordier</surname><given-names>JF</given-names></name></person-group><article-title>Organising pneumonia</article-title><source>Thorax</source><volume>55</volume><year>2000</year><fpage>318</fpage><lpage>328</lpage><pub-id pub-id-type="pmid">10722773</pub-id></element-citation></ref><ref id="bib31"><label>31</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Epler</surname><given-names>GR</given-names></name></person-group><article-title>Bronchiolitis obliterans organizing pneumonia</article-title><source>Arch Intern Med</source><volume>161</volume><year>2001</year><fpage>158</fpage><lpage>164</lpage><pub-id pub-id-type="pmid">11176728</pub-id></element-citation></ref><ref id="bib32"><label>32</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Meduri</surname><given-names>GU</given-names></name><name><surname>Headley</surname><given-names>AS</given-names></name><name><surname>Golden</surname><given-names>E</given-names></name></person-group><article-title>Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial</article-title><source>JAMA</source><volume>280</volume><year>1998</year><fpage>159</fpage><lpage>165</lpage><pub-id pub-id-type="pmid">9669790</pub-id></element-citation></ref><ref id="bib33"><label>33</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gagnon</surname><given-names>S</given-names></name><name><surname>Boota</surname><given-names>AM</given-names></name><name><surname>Fischl</surname><given-names>MA</given-names></name><name><surname>Baier</surname><given-names>H</given-names></name><name><surname>Kirksey</surname><given-names>OW</given-names></name><name><surname>La Voie</surname><given-names>L</given-names></name></person-group><article-title>Corticosteroids as adjunctive therapy for severe <italic>Pneumocystis carinii</italic> pneumonia in the acquired immunodeficiency syndrome: a double-blind, placebo-controlled trial</article-title><source>N Engl J Med</source><volume>323</volume><year>1990</year><fpage>1444</fpage><lpage>1450</lpage><pub-id pub-id-type="pmid">2233916</pub-id></element-citation></ref><ref id="bib34"><label>34</label><element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Treanor</surname><given-names>JT</given-names></name></person-group><chapter-title>Influenza virus</chapter-title><person-group person-group-type="editor"><name><surname>Mandell</surname><given-names>GL</given-names></name><name><surname>Bennett</surname><given-names>JE</given-names></name><name><surname>Dolin</surname><given-names>R</given-names></name></person-group><source>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</source><edition>5th ed.</edition><year>2000</year><publisher-name>Churchill Livingstone</publisher-name><publisher-loc>Philadelphia, Pa</publisher-loc><fpage>1823</fpage><lpage>1849</lpage></element-citation></ref><ref id="bib35"><label>35</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brownlee</surname><given-names>GG</given-names></name><name><surname>Fodor</surname><given-names>E</given-names></name></person-group><article-title>The predicted antigenicity of the haemagglutinin of the 1918 Spanish influenza pandemic suggests an avian origin</article-title><source>Philos Trans R Soc Lond B Biol Sci</source><volume>356</volume><year>2001</year><fpage>1871</fpage><lpage>1876</lpage><pub-id pub-id-type="pmid">11779386</pub-id></element-citation></ref><ref id="bib36"><label>36</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hilleman</surname><given-names>MR</given-names></name></person-group><article-title>Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control</article-title><source>Vaccine</source><volume>20</volume><year>2002</year><fpage>3068</fpage><lpage>3087</lpage><pub-id pub-id-type="pmid">12163258</pub-id></element-citation></ref><ref id="bib37"><label>37</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Reilley</surname><given-names>B</given-names></name><name><surname>Van Herp</surname><given-names>M</given-names></name><name><surname>Sermand</surname><given-names>D</given-names></name><name><surname>Dentico</surname><given-names>N</given-names></name></person-group><article-title>SARS and Carlo Urbani</article-title><source>N Engl J Med</source><volume>348</volume><year>2003</year><fpage>1951</fpage><lpage>1952</lpage><pub-id pub-id-type="pmid">12748315</pub-id></element-citation></ref><ref id="bib38"><label>38</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Simon</surname><given-names>B</given-names></name></person-group><article-title>The cost of a virus</article-title><source>New York Times</source><volume>Sect W</volume><year>May 23, 2003</year><fpage>1</fpage></element-citation></ref><ref id="bib39"><label>39</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Benitez</surname><given-names>MA</given-names></name></person-group><article-title>Beijing doctor alleges SARS cases cover-up in China</article-title><source>Lancet</source><volume>361</volume><year>2003</year><fpage>1357</fpage><pub-id pub-id-type="pmid">12711481</pub-id></element-citation></ref></ref-list><ack><title>Acknowledgments</title><p><italic>We must hang together or assuredly we shall all hang separately.</italic></p><p>Benjamin Franklin</p></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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