Journal Mobile

CM Chu, KWT Tsang
Journal Issue: 
Volume 36: Issue 3: 2006




Two  newly  emerged  respiratory  viruses, SARS-CoV  and  the  highly pathogenic  avian  influenza  A  H5N1  virus, have  arisen  in  Asia  at  the  turn  of  the millennium. They both have the potential to cause global pandemics, facilitated by modern  high-speed  international  transportation.  Molecular  studies  suggest  that SARS-CoV  could  be  transmitted  to  humans  from  civet  cats  and  other  game animals consumed as a culinary delicacy. The H5N1 virus appears to be endemic in  bird  and  poultry  populations  in  Asia, with  sporadic  transmission  to  humans. Both  SARS-CoV  and  H5N1  begin  with  a  non-specific  influenza-like  illness, progressing rapidly to severe pneumonia and ARDS. Although various antiviral and immunomodulatory agents have been tried, or postulated to be useful, none has been proven effective by RCTs. Treatment remains supportive and the mortalities are  high  for  both  conditions.   No  vaccine  has  yet  been  approved  for  either infection, although infection control measures have been found to be effective in hospital  settings.  While  all  known  chains  of  person-to-person  transmission  of SARS  were  broken  in  July  2003, a  few  small  pockets  of  outbreak  have  occurred since, related to laboratory accidents and contact with game animals. The World Health  Organisation  has  consistently  warned  of  a  H5N1  pandemic,  and  the medical  community  needs  to  stay  vigilant.    Minimising  human  contact  with potentially infected animals, sound infection control measures in hospitals, farms, and  markets,  and  prompt  isolation  of  suspected  cases  are  the  mainstays  in preventing large-scale outbreaks for SARS and H5N1.