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New Yorkers Can Work Together to Reduce Respiratory Illness

By Antonia C. Novello, M.D., M.P.H., Dr.P.H.
New York State Health Commissioner

This year's flu season dramatically demonstrated the power of a respiratory virus to produce illness and alarm among thousands of people across the United States. Despite our familiarity with influenza, and the certainty of its arrival every year, an earlier start to the 2003-2004 flu season coupled with a new strain of virus resulted in record numbers of people seeking vaccination against influenza. Throughout the nation, people came to understand that influenza can be a serious illness, and limiting its transmission is an urgent health priority.

Unfortunately, there is no vaccine to protect us against another serious respiratory illness — Sudden Acute Respiratory Syndrome (often called SARS). That is why health officials in New York State, and across the nation and world, are working together to prepare for a possible global resurgence of SARS.

While we hope SARS will not return to the United States, we cannot afford complacency. We need to better understand the nature of this disease and its implications. Like influenza, it appears that SARS is a seasonal infection that wanes during the summer only to re-emerge in cold weather. It is entirely conceivable that the disease could reemerge as a global threat in the coming months as people continue to travel around the world in unprecedented numbers and speed. This assessment is based on basic science, coupled with historical experience.

This past spring, despite its stepped-up efforts to control the outbreak, Taiwan reported 35 new SARS cases in a 24-hour period and a total of 52 SARS deaths. Worldwide, SARS has infected over 8,000 people and killed 774, according to the most recent data from the World Health Organization.

It only takes one highly infectious person to set off a SARS cascade. During a Congressional hearing, Bush administration officials said the United States had been fortunate to get a few days warning before the first SARS case showed up here. Other cities such as Toronto and Hanoi became infected before doctors even knew the disease existed.

It is precisely for that reason that Governor Pataki has directed us to do everything possible to prepare for SARS, should it re-emerge this winter season.

In collaboration with county health departments and hospitals, the State Health Department has developed a SARS preparedness and response plan which includes specific guidance about SARS surveillance and reporting, isolation and quarantine of possibly infected persons, laboratory testing, infection control and SARS education for members of the public and health care providers. In addition, we are collaborating with federal, state and local health departments and healthcare organizations to plan for rapid case identification and response.

What can you do to assist with this effort?

When you go to a doctor's office or the hospital emergency department, always notify the reception area immediately if you have any flu-like symptoms (cough, fever, difficulty breathing, and/or muscle aches). If you do have a respiratory infection — especially if SARS is a possibility — your doctor may suggest that you wear a surgical mask to cover your nose and mouth and keep germs from spreading.

And, while it sounds too simple to be true, frequent hand-washing can reduce the spread of viruses that cause colds, flu and even SARS. Respiratory viruses can stay alive for many hours on surfaces like doorknobs, elevator buttons and railings. When you touch the surface, germs get on your hands. If you rub your eyes or nose afterward, the germs can get into your body and make you sick. To reduce illness, carry a waterless hand gel and use it often. Be sure to wash your hands with soap and water every time you go to the bathroom. And of course, when you cough or sneeze, always cover your mouth and nose with a tissue, and then dispose of it properly.

If you develop influenza-like symptoms, stay home from work or school until you start feeling better. That will both limit transmission of respiratory viruses and help you get the rest you need to recover as quickly as possible.

New York was fortunate to have minimal impact from SARS last year, but we will not rely on luck. With hard work, and a truly cooperative effort, we will be prepared for SARS and able to respond quickly and appropriately should the threat become reality.