May 5, 2003

ATLANTA (AP) -- Despite only a few months' experience with SARS, global disease fighters sense an opportunity to stop the disease and prevent it from becoming a regular part of 21st century life.

It's important, health officials say, because once a virus is established -- like AIDS, for example - it becomes more of a health and economic challenge.

"We do believe this disease can be totally contained and can be eradicated but ... we need to take this opportunity right now," Dr. Mike Ryan, coordinator of the World Health Organization's global alert network, said recently.

Newly emerging infectious diseases have been difficult to eliminate. Officials say the Ebola virus in the 1970s was the last time a potential global threat was contained.

But the WHO's broader experience of corralling 900 outbreaks of various diseases in recent years has given officials a sense about when a disease can be contained.

The control of SARS in Hanoi, Vietnam, has shown that even basic techniques in a country with limited health resources can control an outbreak, said WHO spokesman Dick Thompson.

"There's nothing biological that says it can't be done," Thompson said. "Given what happened in Hanoi, it makes us believe nothing stands in our way except a whole lot of work."

But other health officials have said it's too early to tell what will happen with SARS.

Dr. Jeffrey Koplan, former director of the Centers for Disease Control and Prevention, has said it is "very unrealistic" to expect health officials to "magically" stop its spread. Current director Dr. Julie Gerberding has said "it's too soon to predict where it's going to go."

In the past, officials have only been successful in eradicating a few emerging veterinary diseases, said Dr. Donald Hopkins, associate executive director of the Carter Center in Atlanta and a former CDC deputy director. The Carter Center promotes human rights and seeks to eliminate human suffering, in part by improving global health conditions.

But health officials have no choice but to try to eliminate SARS as a threat to humans, said Hopkins, who leads the fight to eradicate Guinea worm disease. Although not contagious, Guinea worm disease, is viewed as one of the next diseases, along with polio, likely to be stamped out. It is caused by microscopic worm larvae in contaminated water and now is found only in Africa.

"Right now (SARS) is relatively new in the human population," Hopkins said. "If this thing comes to be endemic in China, it would be a great tragedy."

The dilemma health officials face is to "pay the economic price now" by risking public fear over SARS or to "pay a much stronger economic price later" if the disease becomes commonplace in some countries, Hopkins said.

Other observers agreed.

"Now we have a chance to actually eradicate SARS," said Lynn Caporale, a biochemist and author of the 2002 book "Darwin and the Genome," which examines infectious diseases. "But once this virus gets itself established, then our options are more challenging -- we still don't have a vaccine for HIV, after all these years."

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