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By Malorye Branca
Senior Informatics Editor

June 15, 2003 | With 3,000 children in Africa dying of malaria each day, and tuberculosis and AIDS inflicting similar damage, no wonder some people are asking: "What is all the fuss about SARS?"

The stories that capture the public's attention, however, are often predictable. "Many quick deaths and a lot of economic damage are a concoction for high public interest," according to Rashid Chotani, an assistant professor and director of the Global Infectious Disease Surveillance & Alert System Program for Humanitarian Assistance at Johns Hopkins Schools of Medicine & Public Health.

SARS has both of those characteristics in abundance. "The fatality rate is about 6.4 percent now, and we can't yet even start calculating how much SARS is going to cost in the long run," Chotani says.

Easy transmission and large numbers of exposed people also pique public interest. An outbreak of plague in Malawi (which occurred in 2002) is deemed less threatening, partly because it is easier to contain than a hardy, respiratory virus rooted in well-traveled cities such as Hong Kong and Toronto.

Always at the back of health officials' minds is the Spanish influenza pandemic of 1918 to 1919, which killed an estimated 20 million people worldwide. At least two subsequent flu epidemics killed more than a million people, including tens of thousands in the United States.

So, why did HIV, a highly lethal disease, at least before the advent of cocktail inhibitors, not raise panic as soon as the first cases were identified in 1981? According to Chotani, the virus' insidious progress is one of the things that masked its potential for devastation.

The anxiety people feel in the face of diseases like SARS, West Nile virus, avian influenza, and anthrax also reflects their recognition that, even with top-notch medical care, these diseases kill frequently, almost randomly, making interest in a vaccine all that much greater.

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