The SARS Epidemic in Perspective

Medical Author: Frederick Hecht, MD
Medical Editor: Barbara K. Hecht, PhD and Leslie J. Schoenfield, MD, PhD

June 6, 2003 --The epidemic that has captured far and away the most media attention in 2003 is clearly SARS: severe acute respiratory syndrome. The SARS epidemic is justifiably frightening. But, to put such matters in a public health perspective, where would SARS be on an epidemic scorecard? .

A scorecard, based on data from the World Health Organization in 2003, might read as follows:

• Tuberculosis: 8 million new cases and 2 million deaths a year. A third of the world population has TB. Drug-resistant incurable strains on the rise.
  
  
• Malaria: 300-500 million new cases and a million deaths a year. Drug-resistant forms are increasing.
  
  
• Hepatitis B: 10-30 million new cases and a million deaths a year from hepatitis B, a leading cause of cirrhosis, liver cancer, and liver failure.
  
  
• Diarrheal diseases: 2.7 billion new cases and 1.9 million deaths, mainly of children, per year from cholera, shigella, typhoid, E. coli, and other agents of diarrhea.
  
  
• HIV/AIDS: 5.5 million new cases of HIV infection and 3.1 million deaths a year from AIDS.
  
  
• Measles: 30 million new cases and nearly 900,000 deaths a year. Measles (also called rubeola) is entirely preventable with a vaccine that costs 26 cents and has been available since 1963.
  
  
• Dengue fever: 20 million new cases and 24,000 deaths a year from this mosquito-borne disease.
  
  
• Influenza: 3-5 million new cases and 250,000 deaths a year.
  
  
• Yellow fever: 200,000 new cases and 30,000 deaths a year.
  
  
• SARS: About 8,000 cases and perhaps 800 deaths from SARS to date this year.

We might conclude that the SARS epidemic, fortunately, has not reached anywhere near the proportions of the TB, malaria, and some other more established epidemics. This is not to downgrade the potential threat posed by SARS. But if SARS is frightening, should we not be truly terrified by the likes of TB and malaria? It is just a matter of perspective - a perspective on SARS and other epidemics of infectious diseases.