title: Managing febrile respiratory illnesses during a hypothetical SARS outbreak.
abstract: Since the World Health Organization declared the global outbreak of severe acute respiratory syndrome (SARS) contained in July 2003, new cases have periodically reemerged in Asia. This situation has placed hospitals and health officials worldwide on heightened alert. In a future outbreak, rapidly and accurately distinguishing SARS from other common febrile respiratory illnesses (FRIs) could be difficult. We constructed a decision-analysis model to identify the most efficient strategies for managing undifferentiated FRIs within a hypothetical SARS outbreak in New York City during the season of respiratory infections. If establishing reliable epidemiologic links were not possible, societal costs would exceed 2.0 billion US dollars per month. SARS testing with existing polymerase chain reaction assays would have harmful public health and economic consequences if SARS made up <0.1% of circulating FRIs. Increasing influenza vaccination rates among the general population before the onset of respiratory season would save both money and lives.
authors.affiliation: Inner City Health Research Unit, St. Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada M5B 1W8. km.khan@utoronto.ca
authors.forename: Kamran
authors.initials: K
authors.lastname: Khan
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
authors.forename: Michael
authors.initials: M
authors.lastname: Gardam
authors.forename: Joshua Graff
authors.initials: JG
authors.lastname: Zivin
mesh_terms: D003140:Communicable Disease Control / Q000379:methods; D003658:Decision Making, Computer-Assisted; D004196:Disease Outbreaks; D006801:Humans; D008954:Models, Biological; D018803:Models, Economic; D009519:New York City / Q000453:epidemiology; D011634:Public Health; D012141:Respiratory Tract Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D045169:Severe Acute Respiratory Syndrome / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*