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27 April 2003

Vigilance, Early Detection Can Contain SARS, U.S. Officials Say

(Despite spread, most people need not worry about catching SARS) (801)
By Howard Cincotta

Washington File Special Correspondent

The United States is putting strong emphasis on early detection and
containment within the healthcare system to combat the further spread
of severe acute respiratory syndrome, or SARS, say U.S. officials who
spoke on several Sunday news programs April 27.

"We need to stay vigilant here," said Dr. Julie Gerberding, director
of the Centers for Disease Control and Prevention (CDC), appearing on
Fox News Sunday with Tony Snow. "We haven't had the kind of long
chains of transmission that we've seen in some other countries, but
there's no reason why that couldn't happen here. So we are putting a
high emphasis on early detection."

On CBS Face the Nation, Gerberding stressed the need to be vigilant
but not overreact to the threat of SARS. "This isn't like influenza.
If it was influenza, we would have it everywhere by now. We can
contain this, but we've got to remain vigilant. And I think where we
need to be concentrating our efforts is in the healthcare facilities
and in the traveling arena, not generically not throughout the general

Gerberding said screening people at international points of departure
is one method of ensuring that someone who is actually ill doesn't
board a plane. The problem, however, is that most people who have been
exposed to SARS are not actually sick at the time they travel, she
pointed out, and will acquire the infection a week to 10 days later.

"That's why we have this health-alerting process," Gerberding said on
Fox News Sunday, "where we advise incoming travelers from these
regions to contact their health official if they have any symptom
within 10 days of their arrival."

Gerberding said that the possibility of a situation in which it would
be necessary to deny entry to passengers from another country was
highly unlikely.

Appearing on ABC's This Week with George Stephanopoulos, Dr. Anthony
Fauci, Director of the National Institute of Allergy and Infectious
Disease, said that the future spread of SARS is unpredictable. "I
think that we would have to assume that we're going to have to be
living with this, hopefully not in an escalating fashion," he

If there is any good news about SARS, Fauci said, it is that the virus
grows well in laboratory tissue cultures, which means scientists can
immediately begin testing it with drugs that already exist. "We could
get lucky in that," Fauci said. "If we do, wonderful. If not, then you
have to target your drug development, which would take much longer."

The U.S. has been fortunate in having advance warning of the SARS
outbreak, Fauci noted, which, together with effective public health
measures, have meant no reported SARS deaths to date.

On CBS Face the Nation, Gerberding stressed that the CDC is
coordinating efforts to find potential SARS cases as early as
possible, to the point of including people who probably don't have
SARS. "But we're erring on the side of identifying them and isolating
that so there's not transmission," she said.

Both Gerberding and Fauci said that they felt travel to Toronto and
Canada was safe, as the CDC has stated, provided travelers take
normal, sensible precautions.

"We should not prevent people from going to Toronto," Fauci said.
"Just tell them, stay heads up, monitor your health. Avoid places like
hospitals where we know there's a greater chance of getting infected.
So, obviously, I agree with the CDC's recommendation."

Gerberding noted that she planned to travel to Toronto next week. "The
issue is not so much traveling to Canada, it's recognizing exposure
and then not traveling if you've been exposed -- leaving the country."

She said the media have not exaggerated the SARS threat, but pointed
out that some people were taking steps, such as wearing masks on the
street, that are not an effective means of preventing the spread of
the disease.

Asked how communicable the SARS virus is, Gerberding said on Fox News
Sunday, "On average, it's not as communicable as, say, influenza, but
we do see these situations where a particular person is especially
efficient at transmitting it, and the combination of a person like
that and unprotected health care workers can really initiate a cascade
of spread."

Gerberding said on CBS Face the Nation that, even though SARS will
continue to spread in some areas, most people don't have to worry
about catching or transmitting SARS. "They should pay attention to the
travel advisories and not go places that there's advice to suggest
that you shouldn't go unless it's essential," she said. "They also
should pay attention if they know anyone who has SARS."

(The Washington File is a product of the Office of International
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