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AUTHOR:
TerrorismCentral Editorial Staff

TITLE:
TerrorismCentral Newsletter - March 30, 2003

SOURCE:
TerrorismCentral, March 30, 2003

TEXT:

The weekly News Highlights review international developments from Azerbaijan to Zimbabwe. The Feature Article discusses an issue of increasing international importance, "Emerging Infectious Diseases". It uses Severe Acute Respiratory Syndrome (SARS) to ask whether public health systems and international reporting and communications are up to the challenges of disease transmission in a global economy, especially one facing the risk of agents deliberately introduced, as would be the case in a bioterrorist incident.
 

CONTENTS:

NEWS HIGHLIGHTS OF THE WEEK:

1. World
2. Africa
3. Americas
4. Asia Pacific
5. Europe
6. Middle East
7. South Asia
8. Cyberterrorism and Information Warfare
9. Finance
10 Human Rights
11. Law and Legal Issues
12. Narco-terrorism
13. Transportation
14. Weapons of Mass Destruction
15. Recently Published

FEATURE ARTICLE:
Emerging Infectious Diseases


NEWS HIGHLIGHTS OF THE WEEK


1. World

While military operations in Iraq continue, a number of broader issues of long-term interest have emerged:
1. Iraqi use of guerilla tactics, widely reported as unexpected in early military war planning, has had an impact on supply chain management and staffing levels. Of immediate impact, the suicide attack required changes in tactics. This and other use of civilians will have a significant impact on the number of civilian casualties and on the military tactics the US-led forces will need to adopt in response.
2. Media coverage of this war is broader than ever. The use of "embedded" reporters, the drastic differences in coverage around the world, human rights issues, and even the health impacts of 24x7 coverage are all of interest.
3. The scale of antiwar demonstrations even before military action began is unprecedented. Worth particular attention is the number of countries in which public opinion and public policy differ. The way that governments who have heavily regulated public demonstrations in the past respond to this trend, as well as reports of foreign nationals volunteering in defense of Iraq, is worth watching.
4. Economic impacts of the war have been broadly negative. The initial bill sent to the US Congress was for $75 billion -- the total cost is unknown. A broadening boycott of US goods is worth watching. Note Richard Tomkins thorough article, including statistical analysis, "As hostility towards America grows, will the world lose its appetite for CocaCola, McDonald's and Nike?" Financial Times, March 27, 2003
5. The aftermath of the war continues to generate controversy, both internationally and internally in the US. The role of the UN, the way reconstruction will be undertaken, how contracts are awarded, and what overall policies will govern these decisions are very important.

The UN Security Council unanimously approved the resumption of the oil-for-food program, with control of the distributions under the control of Kofi Annan, the UN General Secretary. Security hazards and logistical problems have hindered humanitarian aid.

Meanwhile, the fighting in the Gulf seems to have given the other two members of the "Axis of Evil" -- Iran and North Korea -- incentive to proceed at full speed to develop a nuclear program of sufficient strength to provide deterrence against a similar attack. Other hotspots that have seen increased following the US-led military actions in Iraq include the Israeli-Palestinian conflict and other areas in the Middle East; India and Pakistan; and Russia, particularly the disruption of arms control negotiations scheduled with the US. Details for each region follow.

2. Africa

Algerian rebels, possibly of the Armed Islamic Group (GIA), attacked a group of travelers, killing nine civilians.

In Burundi, rebels of the Forces for the Defense of Democracy (FDD) attacked a military checkpoint located near a school, killing ten soldiers, two students, and two teachers. In other heavy fighting near the capital, the army reports 68 rebels killed, but casualty numbers have not been confirmed.

A week after the coup in the Central African Republic, General Bozize has taken on the role of President and will announce a new government soon.

The Ivory Coast's fragile government of national unity may not survive continued violence, including rebel attacks and incursions from neighboring countries.

Liberian rebels of the Liberians United for Reconciliation and Democracy (LURD) have advanced to the capital, Monrovia, and are engaged in a fierce battle against the government, attempting to oust President Charles Taylor. President Taylor alleges that the US has funded LURD and has acknowledged his government is importing weapons despite a UN embargo.

Two weeks of ethnic violence in Nigeria have led to a number of national and international oil installations closing down, causing turmoil to Nigeria's economy and to the global oil markets. President Obasanjo has ordered the fighting Ijaw and Itsekiri militias be arrested. A possible ceasefire is in the works. In election-related violence, police killed seven members of a banned separatist movement.

The International Organization for Migration has reported that South Africa is the center of an international sex trafficking ring. Meanwhile, the South African health minister continues to be confronted by AIDS activists. On a positive note, the indigenous San people will receive payments for medical use of a plant used in their traditional practices.

Sudan rebels in Darfur attacked a government office, killing a customs officer and wounding several others.

In Uganda, discussions are under way regarding creating a multi-party political system. Rebels in the north from the Lord's Resistance Army that had called for peace talks have shot dead a government spokesman who was attempting to meet to begin discussions. Human Rights Watch also reports that some 5,000 children have been kidnapped by LRA since last June.

Zimbabwe's government is using widespread political violence to crack down on its political opponents, including imprisonment, severe beatings, and sexual assault. Some of the violence is related to voting for two seats held by the opposition Movement for Democratic Change (MDC).


3. Americas

Brazil's organized crime industry and their close relations to drug traffickers, have been responsible for widespread violence, most recently the assassination of Judge Alexandre Martins de Castro Filho.

In Colombia, eleven soldiers were killed by in a minefield set by leftist rebels, possibly of the Revolutionary Armed Forces of Colombia (FARC).

Cuba has arrested more than 80 accused political dissidents, claiming they are conspiring with the US.

In the US, inadequate resources for homeland security at the local level (states and cities) continue to raise concerns over the ability to respond to increased threats and federally mandated initiatives. A number of proposed security projects have faced criticism over civil liberties issues, oversight, and technical feasibility. These include passenger screening, tracking of foreign students, and other database systems.

Even while concerns over accuracy and security are becoming more vocal, the Justice Department has withdrawn a requirement that the FBI's National Crime Information Center ensure that information is timely and accurate before it is added to the database. This is even more complicated now that the FBI has so greatly increased surveillance. The FBI also plans to open additional offices overseas.

After Venezuelan President Hugo Chavez weathered the long general strike, the opposition has been greatly weakened. Strike leader Carlos Ortega has gone into exile in Costa Rica.


4. Asia Pacific

Australia has banned militant Islamic group Ansar al-Islam, based in Kurdish-held northern Iraq.

In Burma, a bomb, probably from dissident elements within the military, exploded in front of the state telecommunications office, killing one and injuring three.

In Indonesia, the government and separatist rebels of the Free Aceh Movement (GAM) are expected to exchange demilitarization plans in a week or so.

Japan launched two spy satellites and is investigating adding an offensive capability to their existing defensive military force, in response to the potential threat from North Korea.

Tensions between North and South Korea and elsewhere in the region are high. Joint US/South Korean military exercises have ended, but in protest against the exercises North Korea broke off its military liaison contact at the border, its only regular contact for any discussions with the US. Scheduled reconciliation talks with the South have been cancelled.

In the southern Philippines, guerillas from the Moro Islamic Liberation Front (MILF) attacked a town with a military detachment, killing five civilians, including a child. Soldiers killed five rebels. The MILF and government negotiators are expected to issue a statement regarding progress in the peace talks.

Thailand's drug crackdown, now nearly two months old, has killed nearly two thousand people and more than 42,000 suspects have been arrested.


5. Europe

Azerbaijan is concerned about possible refugees from Iraq including Kurdish terrorist organizations who may be attracted to the area of Karabakh that is not under state control.

Scientists in Bosnia Herzegovina have uncovered the largest mass grave in Bosnia, containing as many as 600 people who are likely victims of the Srebrenica massacre of 1995.

France has altered its terror alert system to indicate threats with a 4-color gauge.

Germany is trying six men who took over the Iraqi diplomatic mission in Berlin last year. They are accused of taking hostages, causing bodily injury, and trespassing. They have defended themselves as freedom fighters, only trying to do what US-led forces are attempting in Iraq now.

In Greece, there have been two arson attacks against Citibank, with only property damage. Responsibility is unknown but is thought to be opposition to the war in Iraq.

Ireland's Aer Lingus has removed Irish republican songs from the in-flight entertainment repertoire.

Security in Macedonia is now in the hands of the European Union that has taken over from NATO.

Russia angrily denied US charges that it had supplied weapons to Iraq and said that such allegations could only damage relations between the two countries. Russia has asked for a UN investigation into the legality of the US-led war in Iraq.

In Chechnya, a referendum has been held in which a large majority of voters approved the new constitution, maintaining Chechnya as part of the Russian federation. The vote was held without a ceasefire in place, raising questions of conducting the poll under such conditions.

Serbian authorities continue to investigate those responsible for the murder of Prime Minister Zoran Djindjic. Zvezdan Jovanovic, a Special Operations officer, has been arrested for the assassination and his commander; Dusan Maricic is also under arrest for his links to the Zemun clan blamed for the murder. The Special Operations Unit has ties to organized crime and is likely to be disbanded. Two other suspects were killed during police raids.

Zoran Zivkovic has been named the new Prime Minister of Serbia. The remains of former Serbian president Ivan Stambolic have been found in a quicklime pit. Marjana Markovic, (the wife of former Yugoslav President Slobodan Milosevic on trial for war crimes), is being sought for information.

In Spain, Catalonian nationalists have submitted a proposal to turn the region into a sovereign state with an association to Madrid.

Four former Turkish members of parliament who have spent the last nine years in jail for using the Kurdish language and alleged links to the Kurdistan Workers Party (PKK) will receive a new trial as part of Turkey's continuing effort to meet EU criteria for human rights required for admission.

In discussions between the UK and Ireland regarding the Northern Ireland peace process, both sides agree that the ground has been laid for the next initiatives to be announced next month.

The UK plans to extent police powers to take fingerprints and DNA from anyone arrested, whether charged or not.

In raids in Derby, eight men were detained under the Terrorism Act but all have been released without charge.


6. Middle East

Around the Middle East security is high as fears of terrorism and political violence rise. This is both the result of increased risks associated with the war in Iraq but also with fears of the continuation of existing regimes and the aftermath of the war. See Roula Khalaf, "Middle East: 'The general sense is that the war is a major defeat in a long series of Arab defeats'" Financial Times, March 25, 2003.

Egyptian authorities have detained and possibly tortured hundreds of demonstrators and anti-war activists.

In the occupied Gaza Strip, an Israeli military operation killed two Palestinian security officers and injured six people.

Israeli resort town Netanya was subject to a suicide bomb that injured 30, six seriously. This is the first such attack since March 5.

Israel demolished an illegal settlement in the West Bank after an order by the High Court. A security fence is under construction. The UN characterized it as an illegal annexation.

In Lebanon, a small bomb exploded at the British embassy, causing minor damage and no casualties. At a British-linked bank, an anti-war protester held customers and staff hostage and threatened to detonate explosives. The siege ended peacefully and the protester was arrested.

Syria has joined Russia in angrily denying sending prohibited military equipment to Iraq. The foreign ministry suggested such claims were unfounded, and made only to justify the US failures.

In the occupied West Bank, an Israeli tank killed a 14-year old and wounded a 12-year old; two boys who had climbed onto an armored vehicle to steal a machine gun (or were possibly just throwing stones). During an undercover military operation, Israeli troops shot dead a 10-year old Palestinian girl and wounded her parents and sister. Three men, civilians, were also killed apparently because their car was mistaken for a similar one containing wanted militants. In another clash, a 17-year-old stone thrower was shot dead.


7. South Asia

Afghanistan is the site of renewed military activities as US forces attempt to thwart the resurgence of extremist activity. Fighting against warlord Khan Zadran, a US supporter, killed at least 10 of his associates. A Red Cross worker was pulled from a caravan and murdered by Taliban supporters. Senior Taliban commander Mullah Dadullah has told the BBC the Taliban wants to regain power with popular support. See Rahimullah Yusufzai "Taleban 'aims to regain power'" BBC News March 28 http://news.bbc.co.uk/2/hi/south_asia/2897137.stm

18 Afghan men, not associated with terrorism, were released from detention at the US base at Guantanamo Bay and returned to Afghanistan, where they have been freed. They described the conditions under which they had been held, including repeated interrogations, occasional beatings and humiliation, small cages and other issues, but said conditions at Guantanamo were better than those at the time of their arrest.

In the Indian state of Andhra Pradesh, left wing rebels of the People's War Group have attacked Coca Cola and Pepsi shops and warehouses, with property damage only, in protest against the war in Iraq. In Gujarat former minister Haren Pandya was assassinated. He had been in charge of security during the deadly Gujarat riots last year. Responsibility is unknown.

Indian-administered Kashmir was the site of a massacre in which at least 24 Hindus, more than half women and children, were killed. The attack took place in a small village where it is reported that Islamic militants went door-to-door, pulling people from their homes, and shooting them dead. Days later, a bomb placed inside a fuel tanker exploded, killing one and injuring six. Kashmiri militant Abdul Majeed Dar of Hezbul Mujahedeen, who had tried to open discussions with India, was assassinated. The week ended with an incident in which six civilians were mutilated by having their noses sliced off because they were accused of being informers. No one has claimed responsibility for these incidents, but Islamic separatist militants are suspected.

India and Pakistan have carried out additional missile tests of short-range missiles capable of carrying a nuclear weapon. This and the violent incidents during the week signal another increase in violence and have greatly increased tension between the two countries.

Nepal has lifted the ban against the pro-Maoist newspaper Janadesh. The government has suggested beginning initial peace talks next week.


8. Cyberterrorism and Information Warfare

There have been a number of hacking attacks related to pro- and anti- Iraqi war protests, including sites from Al Jazeera, Oak Ridge National Labs, Spain's ruling Popular Party site, the US Court of Appeals 4th circuit, US Veterans of Foreign Wars and many others. The US Department of Homeland Security has announced Operation Liberty Shield, in which businesses and the general public send cybersecurity incident reports to the National Infrastructure Protection Center or Federal Bureau of Investigation. For examples of attacks linked to this operation, see http://www.ds-osac.org/view.cfm?key=774755474B&type=3D13151D011112

A Tower Group report "Identity Theft: Lenders Are Victims, Too" suggests that losses in US financial services lenders cost at least a billion dollars last year.


9. Finance

Australian banks are looking into anti-money-laundering systems. See Kelly Mills, "Banks target terror funds", March 25, http://news.com.au/common/printpage/0,6093,6181247,00.html

For links between Saudi intelligence chief Prince Turki al-Saisal and al Qaeda funding, see "Saudi envoy in UK linked to 9/11" by Paul Harris and Martin Bright, The Observer march 2, http://www.guardian.co.uk/Print/0,3858,4616412,00.html

The Organization for Economic Cooperation and Development (OECD) is considering new rules on ship registration to make it more difficult for terrorists to own or operate large vessels. ("Ship laundering" uses tactics similar to those of money launderers to disguise ownership.)


10. Human Rights

If confirmed, Argentine lawyer Luis Moreno Ocampo will be the first chief prosecutor of the International Criminal Court.

Belgium's law providing universal jurisdiction for war crimes, crimes against humanity and genocide, is being reviewed after  more than 30 current and former heads of state and other political leaders face possible legal action.

UN human rights envoy to Burma, Paulo Sergio Pinheiro, criticized the continued detention of more than 1.200 political prisoners as unjustifiable and absurd. He cut his visit short after finding a hidden bugging device where he was interviewing prisoners.

In south-western China, 28 baby girls, between a few days and three months of age, were found packed into suitcases, travelling by bus. Twenty suspects have been arrested.

Saudi Arabia has freed leading reformist cleric Sheikh Saeed bin Zuair, who had been imprisoned without trial for eight years.


11. Law and Legal Issues

Suleiman Abdalla (a/k/a Ngaka, a/k/a Chuck Norris) has been extradited from Kenya to the US in connection with the 1998 embassy bombings.

Michael Dickson was arrested in the Czech Republic on an international warrant and will be extradited to the UK on charges he was involved in an IRA mortar attack against a British post in Lower Saxony.

The trial of Abdel Ilah el-Mardoudi, Farouk ali-Haimoud, Ahmed Hannan and Karim Koubriti has begun in Detroit, Michigan, US, for allegedly conspiring to attack targets in the US.

Alberto Fujimori, former President of Peru, will not be extradited by Japan despite a request from Interpol and Peruvian authorities regarding kidnapping, murder and fraud charges. He remains on Interpol's "Most Wanted" list.

Yaha Goba has pleaded guilty in Buffalo, New York, to charges of assisting al Qaeda. He is one of six men who had been arrested in this regard and is the third to plead guilty in a plea arrangement.

Suleiman Abdalla Salim Hemed, arrested in Kenya on suspicion of involvement in the 1998 embassy bombings, has been extradited to US officials.

Mustafa al-Hisawai is on bail in Pakistan and will face charges in connection with financing of al Qaeda. He was arrested with al Qaeda leader Khalid Sheikh Mohammed.

Zvezdan Jovanovic has been arrested in Serbia in connection with the assassination of Prime Minister Zoran Djindjic. Many others are under arrest as well.

Mullah Krekar, leader of Ansar al Islam, has been arrested in Norway following threats of attacks and allegations of links to al Qaeda.

Amina Lawal's appeal against her conviction for adultery and a sentence to death by stoning was postponed in Nigeria when the judges did not appear in court. This may have been delayed to avoid further possible incitements to violence.

Vladimiro Montesinos, former head of Peru's intelligence service, has been sentenced to five years prison for corruption. This is added to an existing sentence, and he faces trials on more than 50 other charges.

Luis de la Barreda Moreno, head of the secret police during the "dirty war" in Mexico has been indicted for three murders

General Mirko Norac, formerly of the Croation army, has been sentenced in Croatia to 12 years prison for killing some 50 Serbians in 1991. Two other defendants in the case were jailed and one acquitted.

Ahmed Abdul Qadus is in custody in Pakistan while charges are being determined in connection with his alleged housing of al Qaeda leader Khalid Sheikh Mohammed.

Vojislav Seselj, accused in The Hague of crimes against humanity and war crimes, has pleaded not guilty to murdering and torturing non-Serbs in 1991-93.

Shadi Sukeya, wanted militant of the Islamic Jihad in the West Bank, was arrested by Israeli Defense Forces. He had been hiding in the Red Cross offices.


12. Narco-terrorism

Thailand's drug crackdown, now nearly two months old, has killed nearly two thousand people and more than 42,000 suspects have been arrested.


13. Transportation

Maritime security is on high alert and some ships under escort. There have been a number of attacks against ships carrying hazardous cargoes, although no materials were seized. See, for example, Keith Bradsher "Attacks on Chemical Ships in Southeast Asia Seem to Be Piracy, Not Terror" The New York Times, March 27. The Organization for Economic Cooperation and Development (OECD) is considering new rules on ship registration to make it more difficult for terrorists to own or operate large vessels.

A domestic Turkish flight was hijacked and forced to fly to Greece. The hijacker said a bundle of candles was plastics explosives. The motive was apparently domestic. There were no casualties.


14. Weapons of Mass Destruction

Russia has denied US claims that it sold banned equipment to Iraq. However, both the US and Russia have been large suppliers in the past. See Alexander Koliandre's "Russia's race to export arms" BBC News March 28 http://news.bbc.co.uk/2/hi/business/2888003.stm. Syria has also denied sending prohibited weapons to Iraq.

Pakistan and India have each tested short range missiles capable of carrying nuclear weapons. Russia tested an intercontinental ballistic missile.

Smallpox vaccinations are under scrutiny in the US following two fatal heart attacks and five others with severe problems. Less than 22,000 of the targeted 500,000 health care workers have been inoculated so far. The Centers for Disease Control ordered that no one with heart disease be vaccinated.


15. Recently Published

Ira Berlin, "Generations of Captivity: A History of African-American Slaves" Belknap Press/Harvard University Press

Paul Berman "Al Qaeda's Philosopher" New York Times Magazine, March 23, 2003sd

Francois Bizot, "The Gate" (about Khmer Rouge) Knopf

Joseph Braude, "The New Iraq: Rebuilding the Country for Its People, the Middle East, and the World" basic Books

Richard English, "Armed Struggle: The History of the IRA", MacMillan

Seymour M. Hersh, "Who Lied to Whom" Why did the Administration endorse a forgery about Iraq's nuclear program?" The New Yorker, March 31, 2003

Gilles Kepel, Bad Moon Rising: A Chronicle of the Middle East Today, Saqi Books

Bernard Lewis, "The Crisis of Islam: Holy War and Unholy Terror" Random House/Modern Library

Susan Sontag, "Regarding the Pain of Others" Farrar, Straus and Giroux

Elsa Walsh, "The Prince: How the Saudi Ambassador became Washington's indispensable operator" The New Yorker, March 24, 2003

Fareed Zakaria, "The Future of Freedom: Illiberal Democracy at Home and Abroad" Norton


FEATURE ARTICLE: Emerging Infectious Diseases 

In the past thirty years, some three dozen new infectious diseases have appeared, more than two dozen believed defeated have emerged as major health issues, and a number of infectious agents that once readily responded to treatment have developed increasing resistance to antimicrobial drugs. These diseases whose incidence in humans has increased or will increase in the near future, are referred to as "emerging infections".

Diseases or agents that have re-emerged as public health risks include viral rabies, dengue fever, yellow fever, schistosomiasis, neurocysticercosis, acanthamebiasis, visceral leishmaniasis, malaria, toxoplasmosis, giardiasis, echinococcosis, group A streptococcus, trench fever, plague, diphtheria, tuberculosis, pertussis, salmonella, pneumococcus and cholera.

New diseases include
* Diseases that attack the immune system such as the variant forms of HIV/AIDS
* Hemorrhagic fevers such as Ebola, (with a death rate as high as ninety percent), Guanarito virus that causes Venezuelan hemorrhagic fever, Sabia virus that causes Brazilian hemorrhagic fever and Hantavirus that causes serious respiratory disease
* Rotavirus and the parasite Cryptosporidium parvum, Cyclospora cayatanensis and Enterocytozoon bieneusi that cause diarrhea
* Legionnaires' disease
* Staphylococcus aureus that leads to toxic shock syndrome
* Viruses: Parvovirus Bl9, Human herpesvirus-6 (HHV-6), Hepatitis E, Hepatitis C
* Bacteria: Campylobacter jejuni, Escherichia coli, Borrelia burgdorferi, Ehrlichia chafeensis, Vibrio cholerae, Bartonella henselae
* The Helicobacter pylori bacteria that causes peptic ulcers
* Parasites such as Encephalitozzon hellem, Babesia, Encephalitozoon cuniculi

Social, economic, technological and political changes can each contribute to the emergence or re-emergence of disease. For example:
* Changes in land use can introduce new vectors by altering the environment to be more favorable to infectious agents or by breaking down environmental barriers that had helped separate humans from the new vectors
* Environmental changes brought on by dam construction, irrigation, or other ecological changes can alter the types of species contained in the area or alter the relationship between vector and host. Changes in water purity and processing techniques or in sewage treatment have massive public health implications.
* Urbanization creates denser population growth that can help spread infections rapidly. Other changes that involve close proximity, such as increased use of child day care centers, have a similar impact in making it easier to spread infection through personal contact.
* Technological changes can have unintended consequences, such as the introduction of soft contact lenses creating a favorable environment for acanthamebiasis or water cooling systems becoming breading grounds for Legionnaires' disease. Contemporary food processing and shipping practices make it possible to quickly distribute disease to a broad geography from which it is difficult to track the source.
* Vast increases in the number of immunocompromised human hosts can let diseases take hold that used to be easily kept in check
* Vaccination programs may be interrupted or refused. For instance, some people believe that vaccines against measles or pertussis may be unsafe. In a similar vein, some countries have denied a linkage between HIV infection and AIDS, in turn limiting access to life-saving drugs and making educational programs difficult or ineffective.
* The rapid growth of antibiotic resistant bacteria, largely through misuse and overuse of antibiotics, creates new strains of microbe and makes treatment difficult
* Modern transportation systems, particularly flight, can quickly spread infections around the globe.
* Microbes adapt faster than humans do.

The most recent emerging infectious disease is Severe Acute Respiratory Syndrome (SARS). The first cases emerged in mainland China and is most rapidly spreading in Hong Kong. Community transmission has also occurred in Vietnam and Singapore. There are cases in 13 countries, including Canada and the US.

As of March 29, there have been 1,550 cases and 54 deaths. http://www.who.int/csr/sarscountry/2003_03_29/en/

The Centers for Disease Control (CDC) provides this case definition for SARS:
"Respiratory illness of unknown etiology with onset since February 1, 2003, and the following criteria:
Measured temperature > 100.5°F (>38° C) AND
One or more clinical findings of respiratory illness (e.g. cough, shortness of breath, difficulty breathing, hypoxia, or radiographic findings of either pneumonia or acute respiratory distress syndrome) AND
Travel within 10 days of onset of symptoms to an area with documented or suspected community transmission of SARS (see list below; excludes areas with secondary cases limited to healthcare workers or direct household contacts)
OR
Close contact* within 10 days of onset of symptoms with either a person with a respiratory illness who traveled to a SARS area or a person known to be a suspect SARS case.
* Close contact is defined as having cared for, having lived with, or having direct contact with respiratory secretions and/or body fluids of a patient known to be suspect SARS case.

The cause of the disease has not yet been identified. In two cases, CDC identified a new coronavirus. Coronaviruses are highly contagious and include respiratory illnesses like the common cold. Other researchers have detected a paramyxovirus (these cause diseases including mumps and measles).

There is no cure for SARS and treatment is primarily palliative, to relieve symptoms. Therapy has also included antibiotics and antiviral agents and investigation is ongoing to find the most effective treatments. While the origin of the disease remains unknown, patients are isolated and standard measures taken to prevent transmission.

Of broader interest is the response to this new disease of unknown origin:
* The outbreak started in southern China in November last year. Within three months, it had spread to 13 countries.
* About 1,500 have been quarantined in Singapore and Canada has ordered selective quarantines.
* Chinese authorities have ordered a blackout of news of the disease and have refused permission for the World Health Organization to visit the site of the first cases.
* Airlines are on alert for screening travelers. Passengers leaving Hong Kong, Taiwan, Hanoi, Singapore, Toronto and Guangdong China are being screened against possible transmission.
* Demand for face masks has gone up among populations in areas that have had infections
* Economists have calculated that the economic impact of the virus could be worst for Asian economies than the war in Iraq (http://news.bbc.co.uk/2/hi/business/2895427.stm and David Barboza, "Fears of War and Illness Hurt Tourism in Asia" The New York Times, March 28)

SARS shows a pattern of transmission similar to comparable diseases and is not related to terrorism. However, the lessons it offers for public health policy, international cooperation, and public response are valuable and can help to inform the public debate regarding future bioterrorist attacks and the crucial role of the public health sector in national and international security. A global early warning system for disease recognition and notification is urgently needed. To be effective countries must be willing to openly communicate. Secrecy, whether for fear of public disorder or economic disruption, is not a plausible option in the interconnected global economy today.

Additional Reading:
Bruce Jay Plotkin and Ann Marie Kimball, " Designing an International Policy and Legal Framework for the Control of Emerging Infectious Diseases: First Steps" in Emerging Infectious Diseases, Jan-Mar 1997
Centers for Disease Control SARS information http://www.cdc.gov/ncidod/sars/ includes links to international sites
National Institute of Allergy and Infectious Diseases, Emerging Infectious Diseases, http://www.niaid.nih.gov/publications/eid.htm
Matt Pottinger and Rebecca Buckman, "A Mystery Illness Spreads in Asia, and So Does Fear", The Wall Street Journal, March 28, 2003
World Health Organization, Disease Outbreak News, http://www.who.int/csr/don/en/

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