New Disease Scary, but Not as Bad as Flu

WASHINGTON (Reuters) - It jumped from ducks to farmers in the densely populated southern provinces of China, spreading via jet to the whole world within a year and killing half a million people. SARS? No -- just ordinary influenza.

As world health officials scramble to identify and contain the outbreak of Severe Acute Respiratory Syndrome, they are drawing constant parallels with flu, a much more familiar -- and so far deadlier -- foe.

SARS has killed an estimated 78 people and made 2,151 ill, the World Health Organization (news - web sites) said in its latest update.

In contrast, influenza kills anywhere between 250,000 and 500,000 people every year around the world. In the United States, with a vaccine and modern medical care widely available, flu kills at least 36,000 people a year.

The "Spanish flu" pandemic of 1918 killed between 40 million and 50 million worldwide, most of them young, healthy adults. The "Asian flu" and "Hong Kong flu" pandemics of 1956-1957 and 1967-1968 killed a combined 4.5 million people.

The SARS outbreak is tiny in comparison, said Dr. Richard Duma, head of infectious diseases at the Halifax Medical Center in Daytona, Florida, and a member of the board of the National Foundation for Infectious Disease. "I think it is frightening a lot of people but I don't think it will produce the mortality that influenza will produce," Duma said.

In fact, when SARS cases were first reported in Guangdong early this year, experts assumed it was another outbreak of a deadly strain of influenza known as H5N1.

In 1997, Hong Kong authorities slaughtered more than a million chickens and ducks to stem the epidemic of "bird flu" that came to be known by its genetic nickname of H5N1. It killed six people and infected 18.

Richard Webby, an influenza virus expert at St. Jude Children's Research Hospital in Memphis, noted that three members of a Hong Kong family who visited Fujian Province in southern China became infected with H5N1 early this year and two of them died.

U.S. and WHO experts knew of a larger outbreak of respiratory disease in China's Guangdong province at the time and assumed it was more H5N1, which alarmed them.

The new outbreak has since been identified as SARS, which may be caused by a different virus, known as a coronavirus.

But the parallels with influenza are obvious. Both are respiratory diseases, both are highly infectious and both, apparently, have jumped from animals to people.

And both were born in China. Influenza begins as an infection of birds, one that does not make its avian hosts ill. A slight mutation allows it to move into people, sometimes via pigs as an intermediate host.

Once a person recovers from influenza, he or she has immunity to that strain. But every year a new strain jumps from the flocks of chickens, ducks and geese raised in China, forcing vaccine makers to come up with a new formula.

Something similar may have happened with SARS, said Mike Osterholm, an infectious disease expert at the University of Minnesota who has for years been warning about such emerging infections.

"You have the world's largest population in China. You have the world's largest population of pigs in China, the world's largest population of aquatic birds. You have close contacts and you have a lot of different species where these agents are floating around, and you are going to see a jump from animals to people," Osterholm said in a telephone interview.

Only SARS looks worse than ordinary flu. It kills between 3.5 percent and 4 percent of known victims -- a rate higher than the 1918 influenza epidemic, the worst epidemic in recorded history, in which 3 percent of patients died.

In an average year, influenza kills fewer than 1 percent of patients, experts said.

"Four percent mortality -- that is a lot of people if you multiply it by a few million," Webby said.

Did you notice the report that said coronavirus was not found among the patients in Guangdong?

No I didn't see that. Do you have a link?

That would be an interesting scenario. Maybe the virus did originate in Hong Kong, and the Guangdong sickness was something else? It just seems a little too coincidental...

Bi Shengli told the South China Morning Post that collaboration with health officials in Guangdong had revealed that the earliest SARS patients had been in close and continued contact with chickens, ducks, pigeons and owls.

The connection between SARS and fowl bolsters preliminary scientific data on the virus. Researchers have identified a coronavirus as the cause of SARS, but have yet to publish full details. However, early work suggests the virus is related to one that causes bronchitis in birds, including chickens.

"Coronaviruses can cause respiratory diseases in birds, so we might think they could do the same in people," notes Yvonne Cossart, a virologist at the University of Sydney, Australia

Bi said tests on 30 Guangdong patients did not find evidence of a coronavirus. But virologists contacted by New Scientist say coronaviruses are notoriously difficult to grow in culture, which is the main way scientists try to isolate them from patients.

link

Thanks for that.

coronaviruses are notoriously difficult to grow in culture

Unable to find the virus. I've been to Chinese hospitals and I can understand why. Their medical facilities are not nearly as modern as the US, however they do have a lot of imported equipment for x-rays, MRI, etc., etc. I've never seen a pathology lab though...

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