Cold-and-flu seasonal spread suggests new burst of SARS

Vigilance is today's watchword -- whether for emerging infections or obesity and smoking. Integration of the exam room and public health has never been so important.

By Victoria Stagg Elliott, AMNews staff. July 7, 2003.

Chicago -- Severe acute respiratory syndrome, the dreaded atypical pneumonia that sickened thousands and killed hundreds, may return in the months ahead.

"Although the epidemic appears to be coming under containment now, we have no idea what to expect in the fall," said Centers for Disease Control and Prevention Director Julie Gerberding, MD, MPH. "It would not be surprising if we had a re-emergence."

Dr. Gerberding spoke during the American Medical Association's Annual Meeting last month and underscored to physicians that the SARS experience is still unfolding. Seasonal coughs and colds that come with cooler weather may foreshadow new complications.

The syndrome could reappear in autumn much like other respiratory illnesses, including influenza, and it may be spread by people who don't even know they are infected. There is increasing evidence that some who contract SARS have mild versions or experience no symptoms at all. And still unknown is whether the virus can be transmitted by those who are asymptomatic.

Thus, there's absolutely no way to predict what the future holds.

"We may have an easier ride because we know what's going on and can act more quickly. On the other hand, it may have the pattern of pandemic flu where the first year out there was a small blip in cases, and the second year we have a crisis," she said.

Her bottom line: "We have to be very, very vigilant."

Overall, vigilance has become an even greater necessity because of what Dr. Gerberding and other health officials refer to as "the new normal." The SARS experience is just one scenario that illustrates its implications.