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The SARS scare

INDIA HAD ESCAPED being afflicted by the SARS virus ever since it was first detected in Hong Kong last month. But with Goa having turned up the first case, the country joins a long list of 25 countries which have reported incidence of this atypical pneumonia virus, which has created one of the worst worldwide health scares in recent times. The patient in question, a marine engineer, had travelled recently to both Hong Kong and Singapore (both of which are SARS hotspots) and had tested positive after developing a mild fever. Surprisingly, however, the Government of Goa has now raised the possibility that this could be a false alarm by hinting that the test could be a "false positive" and sending the patient's blood and other samples for a second test, which will be conducted by New Delhi's National Institute of Communicable Diseases. The doubts that have been raised about whether this was really the first Indian case of SARS are based largely on the patient's atypical symptoms. He suffered only a mild fever, had a natural remission and showed no signs of severe cough and difficulty in breathing, thereby not displaying two of the three warning signs specified by the World Health Organisation (WHO) as customary symptoms of the disease.

However, facts such as these cannot be used to draw any firm conclusions and, at the end of the day, the existence or non-existence of the virus can be determined only by laboratory tests. Goa has reasons to be particularly worried by the incidence of SARS. Its economy is very much tied up with tourism, particularly tourists from abroad. Even though this is not peak season, charter flights continue to make their way in from around the world and thousands of foreign tourists arrive in the State from other metropolitan Indian cities. The flutter that the single positive test has caused in this tourism-dependant State is palpable. Although no flights have been cancelled yet, the last thing that Goa needs is travel advisories issued by other countries. This reported case of SARS has occurred well after the Government had introduced measures to prevent the spread of the virus, which included those to screen passengers arriving at international airports and seaports. It was always clear that such steps could, at best, provide an early detection system. Infectious diseases do not respect borders in a world where people are constantly on the move and there can be no foolproof measures to insulate a country from a virus that spreads in the manner that SARS does.

Meanwhile, the news from around the world about this killer disease is mixed. While some countries have revised the number of probable SARS cases downward, the number of people afflicted in South East Asia, particularly in places such as Hong Kong, continues to grow. Mainland China, where the disease was said to have originated, has now reported as many as 65 deaths, but the accuracy of this figure continues to be the subject of immense controversy with world health authorities accusing the country of suppressing information and massively under-reporting the incidence of SARS. Beijing has rejected the charge. But criticism that China's less-than-helpful attitude may have delayed global attempts to identify and overcome the virus may have had some impact, with the Government declaring that the war on SARS must be transparent and that all authorities must provide full cooperation to international agencies. The remarkable aspect of the battle against SARS, which has now been conclusively identified as a virus related to the one that causes the common cold, is the extent of international scientific cooperation that has gone into doing so. The secret about what till only recently was described as a mystery killer has been unravelled in a matter of days — something that has taken years for some other deadly diseases, including AIDS. If there are hopes that SARS can be overcome shortly, it is largely because of such cooperation.

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