The first global consultation on the epidemiology of severe
acute respiratory syndrome (SARS) took place in Geneva on 16 and 17 May (
http://www.who.int/csr/sars/archive/2003_05_17/en/).
The purpose of the meeting was to ensure that the World Health Organization
(WHO) recommendations are based on the best available scientific evidence
and to review the available epidemiological information in the context of
its relevance to effective public health practice. Sixteen countries, including
all those most affected by SARS, were represented either in person, by video
link, or by telephone. A number of experts in the mathematical modelling of
infectious diseases were also present.
The group reviewed data on the incubation period, infectious period, case
fatality ratio, routes of transmission, subclinical infection, and the reproduction
number. The group concluded that the available data supports the control
measures currently recommended by WHO. In particular, participants from
the main outbreak sites noted the effectiveness of control measures aimed
at rapidly identifying and isolating new cases. The group also reported
that using ten days after last contact with a case as the period during
which contacts should be monitored for symptoms has been effective. There
remains no evidence that people without symptoms can transmit SARS. The
experts also reiterated the importance of the WHO recommendation that people
from SARS affected areas who have a febrile respiratory illness should not
travel. A number of areas requiring further research and collaboration were
identified including the susceptibility of children and pregnant women to
infection, the rate of asymptomatic infection, the duration of infectivity,
and the presence of animal reservoirs. The full conclusions of the meeting
will be published shortly as a consensus document.