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Last Updated: Thursday, 24 April, 2003, 13:04 GMT 14:04 UK
Sars: Is global panic justified?
Beijing masked
Concern over Sars is growing in Beijing
Concern is mounting over the continuing spread of the deadly Sars virus.

Some experts say it could have a similar impact to the 1918 flu epidemic that killed 50 million - or the current world HIV crisis.

However, the World Health Organization believes that, in many countries, including Hong Kong, the worst may already be over.

BBC News Online looks at the actual risks faced by people around the world - and how they could change if the virus carries on spreading.

Sars can still be brought under control - and perhaps even eradicated - says the World Health Organization.

On Monday, it announced that it felt the outbreak had peaked in every country in south east Asia except China.

They know this because the number of new cases is falling away - although, in Hong Kong in particular, many people are still dying from the illness.

In Vietnam, the WHO is even more confident of success - there have been no fresh cases reported in 20 days - indicating that the outbreak is under control.

The strategy of the WHO has been to clamp down hard on Sars, issuing its first global health alert for years, and later, its tough travel advice on Toronto

This is even though its impact of Sars has been miniscule in comparison with established diseases such as malaria and AIDS

This is because experts believe they have to attempt to take up a once-only opportunity to eradicate Sars completely in many areas before it becomes established - freeing mankind of that burden forever.

And the good news from the Far East suggests that strategy is having a positive effect.

Future worry

There are some scientists, however, who do not share that level of optimism.

They believe that the illness, should it become established in countries with poor health systems, could kill millions worldwide.

Even in countries with no Sars cases, these predictions are likely to fuel growing panic.

At moment, even in areas where Sars cases are in the hundreds, there is little to justify this - and experts say there is certainly no reason to panic in countries with only a handful of cases.

The risk to an individual is tiny - for example, in Toronto, a city of millions, there have just over 300 cases - and authorities are hopeful that the number of new cases is drying up.

Hard to catch

Scientists say that, at the moment, the illness is relatively hard to catch.

It appears to be far less "transmissable" than influenza, and in many cases has required repeated close contact with an infected person, perhaps in a medical setting or within a family group.

However, overall there is still relatively little known about Sars - scientists do not fully understand how the virus is passed from person to person, or at what point a Sars carrier becomes contagious.

Many are trying to leave Beijing
It appears as though droplets released by a cough, and, in some cases, contact with contaminated sewage may be able to spread Sars.

Statements from the World Health Organization on Thursday were a mixture of upbeat prediction and more worrying news.

WHO spokesman Dick Thompson said that Sars cases were now being reported in western provinces of China - which he described as "low resource" areas.

Large numbers of people are said to be fleeing Beijing - perhaps unknowingly spreading Sars throughout the country.

However, the WHO spokesman said: "We are still confident that this is a disease which can be contained and eradicated."

Clamping down

Professor Peter Harvey, an infectious disease expert from the University of Birmingham, has just returned from a trip to Hong Kong and Southern China, said that efforts to eradicate the illness in Beijing and the southern province of Guangdong were bearing fruit.

However, he said that if Sars became established in rural areas, that would produce a far more difficult situation.

"Guangdong province has some of the best medical facilities in China.

"If the disease became endemic in rural areas with poor health provision, you could end up with a constant low-level problem - with outbreaks occurring again and again."

In my view, we are not going to get a global pandemic of Sars.
Professor Peter Harvey, University of Birmingham
And he said that the limited medical facilities in rural areas would increase the death rate.

This kind of endemic Sars in China would also increase the risk that Sars could eventually become established in other countries, such as India or in Africa.

He said: "It's possible that the health systems in these countries are in an even worse position to cope."

The WHO fears that smaller hospitals covering poorer, rural areas would be knocked out of action by even a handful of Sars cases.

The need to quarantine a hospital on which a large area depends not only means that Sars patients are threatened, but also patients needing treatment for a wide variety of other illnesses who need urgent access to hospital.

No doom

Dr Harvey, however, stopped well short of the apocalyptic vision offered by some scientists.

He said: "In my view, we are not going to get a global pandemic of Sars.

"I believe that it will behave a bit like Lassa Fever - with outbreaks every now and again that kill people. But Lassa fever never threatened to wipe out the world."

Comparisons with HIV are misjudged, he suggests.

"They are two completely different diseases - you just can't compare the two."

Future threat

However, there are warnings from scientists that the virus may outwit all efforts to contain it.

While Sars in its current form may not be as destructive as feared, other scientists do foresee situations in which it could become a more major threat.

Dr Adrian Mockett, who has studied coronavirus in animals, says that because this strain is relatively new to humans, genetic mutations which improve its ability to survive in our cells are possible.

He said: "You only get one chance to eradicate something like this - once it's established, you've got a real problem."

If future genetic mutations make Sars more transmissable, the WHO, and the world, would have a far bigger problem.


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