1. SARS Severe Acute Respiratory Syndrome 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 What’s New and What’s Relevant in 2005-2006?

2. 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.”

3. 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

4. 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)

5. 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)

6. Questions