290 • The Great Plaguenessman was hospitalized. That case and others that followed went unre-
ported by the authorities for four months until February 2003 , when the
World Health Organization was first informed of a menacing outbreak
throughout the province. The rapid spread astonished epidemiologists. In
February one infected man traveled to seven countries before being hospital-
ized after returning to Hong Kong. By mid-March twenty countries listed
cases, and the World Health Organization issued temporary travel advisories
warning against visiting countries and cities as far from China as Toronto,
Canada. The spread of infection among hospital workers in Beijing and
other major Chinese centers was especially alarming, causing the quarantin-
ing of hospital wards that had a high level of infection among health practi-
tioners and the closing of two entire hospitals. Mortality among infected
persons rose from 3 percent initially to 10 percent within a few weeks and to
more than 50 percent among patients older than sixty-five years in places
such as Hong Kong.
As had been the case with plague in 1665 , the authorities in 2003 had to
rely on bodily signs and symptoms to identify SARS-infected individuals.
The Centers for Disease Control developed a diagnostic blood test, but it
could not detect the antibodies that the human genome forms against SARS
corona-type virus until three weeks after infection. In Beijing in 2003 , as in
London in 1665 , preservatives and cures appeared like magic in the medical
marketplace, with anti-SARS herbal brews and disinfectant bleaches selling
briskly on the word of government officials, popular newssheets, or neigh-
borhood gossip, even as vendors acknowledged that the public “knew” there
was no cure for SARS. Probably of greatest concern to medical professionals
at the outset of the epidemic was the possibility that the SARS coronavirus
would mutate, thereby hampering treatments. As of this writing, the silver
lining is that the first major study of the virus’s genome revealed little muta-
tion during its spread to different countries.^58
Some epidemics have originated in the heart of the most advanced na-
tions. In the United States infectious diseases are the third greatest cause of
death, following heart disease and cancer. In the world at large, infectious
diseases remain the leading cause of death.
There have been victories, to be sure. The first “conquest of infectious dis-
ease” came with the much-heralded eradication of smallpox twenty-five
years ago. Many epidemiologists hold out hope of eliminating measles by
2013. And some medical experts aim at eradicating yellow fever by the mid-
dle of the century.