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Volume 10, Number 11—November 2004
ICEID Session Summaries

SARS, the First Pandemic of the 21st Century1

James W. LeDuc*Comments to Author  and M. Anita Barry†
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Boston Public Health Commission, Boston, Massachusetts, USA

Suggested citation for this article

The 2003 outbreak of severe acute respiratory syndrome (SARS) shocked the world as it spread swiftly from continent to continent, resulting in >8,000 infections, with approximately 10% mortality, and a devastating effect on local and regional economies. Three laboratories—one each in Hong Kong, Germany, and the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, USA—nearly simultaneously isolated an apparently new coronavirus as the cause of SARS. Through traditional virus isolation and molecular techniques, CDC's team recovered the virus from specimens and characterized it as a novel coronavirus. Specific nucleotide sequences of the new virus were identified in specimens from SARS patients, and an immune response to the agent was demonstrated in patients' sera.

The potential for global spread of SARS was quickly recognized by the World Health Organization (WHO). The Global Outbreak Alert and Response Network was activated to help identify and deploy volunteers from around the world to assist the most severely affected nations, and WHO rapidly issued several recommendations to help nations control outbreaks and prevent spread.

Hong Kong was among the first cities affected by SARS, and its healthcare community suffered greatly from the disease. Some lessons from their experiences included recognition of the value of real-time information in a rapidly progressing epidemic with a large number of cases and the need for frequent patient updates, challenges of national efforts to maintain entry and exit health screening among international travelers, and implementation of home quarantine as an effective tool to interrupt SARS transmission.

In Toronto, Ontario, Canada, the public health department had responsibility for SARS surveillance and case reporting, investigation and management of possible cases, identification and quarantine of contacts, health risk assessment, and communications, and they were a liaison with hospitals regarding infection control. These were massive responsibilities. Serious practical and legal challenges were encountered as the department successfully implemented quarantine measures for the first time in more than half a century. Daunting challenges were also overcome in disease surveillance and reporting; meeting the needs for accurate, timely information and guidance; and implementing effective infection control practices in healthcare facilities. One of the most important lessons was an awareness of the psychosocial problems among healthcare workers directly involved in facing SARS.


Suggested citation for this article: LeDuc JW, Barry MA. SARS, the first pandemic of the 21st century. Emerg Infect Dis [serial on the Internet]. 2004 Nov [date cited].

DOI: 10.3201/eid1011.040797_02

1Presented at the International Conference on Emerging Infectious Diseases, Atlanta, Georgia, February 29 – March 3, 2004, by William Bellini, Centers for Disease Control and Prevention; Guenael Rodier, World Health Organization; Thomas Tsang, Department of Health, Hong Kong, China; and Barbara Yaffe, Toronto Public Health.

Table of Contents – Volume 10, Number 11—November 2004

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Please use the form below to submit correspondence to the authors or contact them at the following address:

James W. LeDuc, Director, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop A31, 1600 Clifton Road NE, Atlanta, GA 30333, USA; fax: 404-639-3163

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Page created: April 17, 2012
Page updated: April 17, 2012
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