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Where is SARS now?
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  1. P J M Openshaw
  1. Department of Respiratory Medicine, St Mary’s Campus, National Heart and Lung Division, Imperial College, London, UK; p.openshaw@ic.ac.uk

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The WHO and respective governments must be praised for their incisive and energetic leadership which has greatly limited the impact of SARS, but we can only guess what will happen next winter.

In February 2003 the World Health Organisation (WHO) received alarming news of antibiotic resistant community acquired pneumonia in Vietnam, Hong Kong, and Singapore of apparent viral origin. It named the disease “severe acute respiratory syndrome” (SARS) and issued urgent advice directed at reducing transmission and spread (http://www.who.int/csr/media/sars_wha.pdf). With unprecedented speed, the probable cause was identified as a novel coronavirus, now named SARS CoV. The imposition of draconian public health measures appears to have brought the disease under control, but there is still concern that, with over 8000 suspected or confirmed cases and contact networks reaching millions, there is every prospect that the disease will become endemic in China or spread to areas of the world in which it cannot be contained.

Although co-infection with SARS CoV and another agent has not been ruled out as the cause of SARS (particularly in “superspreaders” causing numerous secondary cases), SARS CoV alone seems likely to be the cause of most cases of SARS and can reproduce the disease in non-human primates.1,2 Coronaviruses have the distinction of containing the largest genome of all known RNA viruses. They are widespread throughout …

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