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SARS Severe Acute Respiratory Syndrome What’s New and What’s Relevant in 2005-2006? Jeffrey S. Duchin, M.D. Chief, Communicable Disease Control, Epidemiology and Immunization Section, Public Health - Seattle & King County Division of Allergy and Infectious Diseases, University of Washington SARS: October 2004 Quotes from World Health Organization (WHO) “…the world is in an inter-epidemic period for SARS.” “At this time, the most probable sources of infection with SARS-CoV are exposure in laboratories where the virus is used or stored for diagnostic and research purposes, or from animal reservoirs of SARS-CoV-like viruses. It remains very difficult to predict when or whether SARS will reemerge in epidemic form.” SARS: What’s New? Most recent human cases of SARS-CoV infection – China, April 2004: outbreak from laboratory-acquired infections Currently no known SARS transmission anywhere in the world Bats: Natural Reservoirs of SARS-Like Coronaviruses Bats are reservoir hosts of several zoonotic viruses – e.g., Hendra and Nipah viruses Bats may be persistently infected with many viruses but rarely display clinical symptoms 408 bats tested from four locations in China – Three species from the genus Rhinolophus (horseshoe bats) demonstrated a high SARS-CoV antibody prevalence*: 13/46 bats (28%) in R. pearsoni from Guangxi 2/6 bats (33%) in R. pussilus from Guangxi 5/ 7 bats (71%) in R. macrotis from Hubei *Li, et al (Science 2005; 310:676-679) SARS: What’s Relevant in 2005-06? Components of SARS Response Capacity* Command and control: Incident management Surveillance Case and contact investigation and management Preparedness & response in healthcare facilities Community containment measures including isolation and quarantine Managing travel-associated risk Laboratory diagnosis Communication * Based on CDC’s Public Health Guidance for Community Level Preparedness and Response to SARS (version 2) Questions