Jack Siglin
In late 2002, doctors in the Guangdong Province in southern China began noticing a spike in the number of cases of atypical pneumonia. Quick lab workups showed that the disease didn’t seem to be caused by any of the usual pathogenic suspects. By December 2003, more than 8,000 cases of what turned out to be a new disease had cropped up in 29 countries. Nearly 800 people died, including the World Health Organization scientist who recognized the disease was “something novel.” The mystery disease was SARS: severe acute respiratory syndrome.
The SARS outbreak was principally the first time a zoonotic transmission — that is to say, a pathogen jumping between species — wound up on the front page of newspapers worldwide. Humans, viruses and bacteria have long coexisted in what is, the vast majority of the time, a peaceful relationship. Every now and then, however, one of the tiny microorganisms experiences pathogenesis: It becomes a hazard to human health.
The SARS virus existed for an innumerable period as a harmless 80-nanometer particle carried around on bats. For scale, I am 6 feet, 3 inches. One would need to stack 24 million SARS viruses vertically to make a stack my height. In 2002, it made the jump to civet cats (a small ferret-like feline commonly eaten in parts of China). In the markets in Guangdong, the virus mutated and began infecting humans. By the time the outbreak was stopped— via the epidemiology equivalent of brute-force methods (quarantine)— the deed was done. Many were dead, governments and health services were at a loss, and people were afraid.
Following the outbreak, governments from all over the world participated in a joint effort to revamp global health policy. Points of emphasis include preparedness training for health employees, enhanced disease surveillance and a focus on limiting infection spread. The results have been a mixed bag. Last summer, the protocols got a major test.
A close relative of SARS, the MERS virus is thought to be transmitted from camels to humans. The name itself stands for Middle East Respiratory Syndrome, owing to its primary localization in the Arabian Peninsula. However, last May, a South Korean businessman unknowingly carried the virus from the Middle East back to Korea. Nine days after he initially sought medical attention, he was diagnosed with MERS. By that point, the infection had already spread. By the time it had run its course, almost 200 people had contracted MERS.
The ability of one single case to spread an infection to hundreds of people almost exclusively within medical centers speaks very poorly of the implementation of post-SARS policies. The Ebola outbreak in the summer of 2014 showed a similar outcome: Namely, global health policy is still not prepared to deal with sudden outcrops of dangerous diseases. The solution is not clear. Advances in monitoring technology offer glimpses of hope. Modeling algorithms have unprecedented predictive power. International cooperation, as is always the case, is a tough but necessary endeavor.
SARS. Swine flu. Ebola. MERS. Each of these cropped up out of the blue, scared everyone stiff and faded back into the ether. Unquestionably, they’re still lurking, with many of their kin yet to be identified . The threats are real, and we must be prepared next time. We have little choice.
