10th anniversary of SARS outbreak: Shadow of SARS remains in an enduring nightmare

Shadow of SARS remains in an enduring nightmare

Mary Ann Benitez

Wednesday, March 13, 2013

Hong Kong may be prepared for new infections, but 10 years after SARS killed 299 people here – and was then overcome – some gaps remain in defenses.

The warning came yesterday from Thomas Tsang Ho-fai, a former controller of the Centre for Health Protection.

“Despite everything we did in pandemic preparedness, some unresolved challenges remain,” he said in marking the 10th anniversary of the emergence of Severe Acute Respiratory Syndrome.

One challenge is limited knowledge about the behavior of novel pathogens such as the SARS coronavirus.

Ten years on, no vaccine is available to see off SARS. In fact, experimental vaccines could stimulate lung diseases.

“A SARS vaccine is probably at least five years away,” Tsang said at the Chinese University of Hong Kong’s School of Public Health and Primary Care. “The sustainability of the health- care response will be a big challenge if an outbreak lasts for months or years.

And “community behavior is always unpredictable,” noted Tsang, who left government service in December. It can “change in the blink of an eye.”

Former secretary for food, health and welfare Yeoh Eng-kiong, who led the response to SARS and is now professor of public health at CUHK, said the crisis went beyond a health issue 10 years ago.

“Many countries saw it as a security issue,” he said. “Singapore did very well as it had the army to help tackle the problem. Eventually, China got SARS under control as it brought in the army.”

The chairman of CUHK’s department of microbiology, Paul Chan Kay- sheung, said that after much research into a possible animal reservoir of the SARS coronavirus no “persistent” host has been found, though early studies showed bats and civet cats were involved.

Chan said it is likely that recombination occurred in some animal species to create the SARS coronavirus but it could not survive for long in any one.

“If this theory is true, then it’s good news as there is no more persistent reservoir of SARS,” he said. Now, “we tend to believe SARS may not return because of a lack of a persistent reservoir.”

Leo Poon Lit-man, an associate professor at the University of Hong Kong’s School of Public Health, warned that if the SARS-like novel coronavirus that emerged in the Middle East last year continues to infect people it could adapt to cause another “disastrous pandemic.”

Although the novel coronavirus is different from the SARS coronavirus, he said, the bad news is that it already can infect multiple hosts such as pigs, monkeys, bats as well as humans.

Poon said it was “lucky” SARS did not replicate well in the first week of the onset of the disease, allowing for quarantine of patients and other measures.

“But if the novel coronavirus has a very robust replication early, we may have no such efficient mass measure to control the disease – just like flu.”