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Mystery bug is 'rehearsal for next 'flu pandemic' 

A University of Leicester medical scientist and world authority on respiratory illnesses claims that the mystery condition known as Severe Acute Respiratory Syndrome (Sars) is a ‘rehearsal for the next influenza pandemic’.

Writing in the British Medical Journal, Professor Karl Nicholson, Professor of Infectious Disease at the University of Leicester, and Maria Zambon, deputy director of  the Enteric Respiratory and Neurological Virus Laboratory, Public Health laboratory Service said that Plagues are as certain as death and taxes.

Professor Nicholson, who is also a doctor at the Leicester Royal Infirmary,  has just returned from Hanoi where he was called to as short notice by the World Health Organsiation. WHO has advised tourists and business people not to travel to Hong Kong or parts of China because of the outbreak of the deadly, pneumonia-like virus which has infected more than 2000 people worldwide.

Chief Medical Officer Sir Liam Donaldson - a former student and senior lecturer at the University of Leicester - has also issued warning over travelling to certain areas.

Professor Nicholson and Dr Zambon also highlight the availability of new communications technology as an ally in combating the new virus.

The authors said: “Over the past few decades several important human viruses have emerged. These include HIV, hepatitis F, Ebola, Hantaan, and Nipah, metapneumovirus which is associated with respiratory illness in young children.

“Against this background, the emergence of new human infectious diseases or viruses is unsurprising. Severe acute respiratory syndrome was first recognised at the end of February in Hanoi, Vietnam. It is highly infectious, with attack rates of over 50% among healthcare workers caring for patients with the syndrome.

“The most common early systemic symptoms in Hong Kong and Hanoi include fever, malaise, myalgia, headache, and dizziness. Sore throat and rhinorrhoea occur early in fewer than 25% of cases, and cough occurred early in only 39% of cases. Because of its non-specific early manifestation, sudden acute respiratory syndrome will be overlooked unless clinicians have a high index of suspicion and seek a history of travel or contact with the syndrome.

“After 3-7 days of fever the lower respiratory phase begins, with a non-productive cough, which may be accompanied by dyspnoea and chest pain. Breathlessness requiring oxygen occurred in many cases after about five days and progressed people requiring ventilatory support in some cases.”

Professor Nicholson, who was among a handful of experts analysing the condition, said the outbreak raises several important clinical issues.

The authors said: “The speed of travel favours intercontinental spread of disease. The rapid dissemination of sudden acute respiratory syndrome around the world should be considered a rehearsal for the next pandemic of influenza, as it shows what will happen with a new human virus spread by the respiratory route, with no vaccines and antivirals in limited supply.”

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Last updated: 7 April 2003 15:00
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