Lacking the research and investigative capacity to control the SARS epidemic, WHO elicited public health service partners from countries such as the United States, the United Kingdom, Germany, and France. WHO’s international Global Alert and Response Network (GOARN) is a virtual network of 11 leading, well-equipped, and high biosecurity infectious disease labs in nine countries established primarily to address influenza outbreaks. GOARN was instrumental in spearheading laboratory efforts: these labs were connected by secure web sites and daily teleconferences to identify the causative agent of SARS, develop diagnostic tests, and collect and analyze clinical and epidemiological data on SARS. The U.S. CDC established other virtual teams in the United States, eliciting advice from medical experts, epidemiologists, and virologists, including both biomedical and veterinary coronavirus experts. Highly trained personnel from the CDC were dispatched to outbreak areas to assist in infection control, and numerous CDC employees were involved in all aspects of the response to SARS. To educate the public by countering rumors with reliable information, both WHO and the CDC provided factual information on SARS through updated web sites, satellite broadcasts, frequent presentations to the news media, and public response hotlines for clinicians and the general public.
These exceptional international laboratory efforts led to the rapid identification of a new coronavirus as the causative agent of SARS by April 16, 2003, only about 1 month after the initial WHO global alert (Drosten et al., 2003; Ksiazek et al., 2003; Peiris et al., 2003; Poutanen et al., 2003). Although vaccines or antivirals to prevent or control SARS infections were lacking, the SARS epidemic was countered by classical infection control and containment methods. These included screening of individuals for symptoms (fevers) with isolation, quarantine, and effective clinical management of symptomatic patients, followed by contact tracing and 10-day quarantine of known contacts. Implementation of effective surveillance measures, identification of the causative agent of SARS as a coronavirus, and containment of the SARS epidemic were attributed to this unparalleled level of global cooperation. Two features of the global SARS outbreaks include the following:
SARS had devastating social and economic global impacts disproportionate to the number of actual fatalities and affecting both global travel and trade.
International collaboration and communication among agencies and with scientists in established laboratory networks with prior working relationships and access to state-of-the-art equipment and the required biosecurity level were key elements for rapid and successful SARS diagnosis and control.