Meeting

The recent global response to the SARS epidemic has demonstrated both understood and unexpected strengths and weaknesses in national and international capacities to address infectious disease challenges. SARS has served as the most recent bellwether of the considerable consequences suffered at many levels --public health, economic, psychological, and political -- when unanticipated epidemics arise in a highly connected and interdependent world.

At the same time, the speed of scientific discovery and the speed of communications have been hallmarks of the response to SARS and reflect amazing achievements in science, technology, and international collaboration. However, despite these advances, very sobering questions remain: will SARS reemerge, and with greater virulence? Can we contain greater and more rapid spread? Will we have preventative or therapeutic countermeasures? Can the necessary global cooperation for containment be sustained? If not SARS, are we prepared for the next unknown? Are our public health and research investments (human, technical, and financial) flexible enough to respond to the ever-changing profile of microbial threats?

The Forum on Microbial Threats (previously the Forum on Emerging Infections) conducted a workshop to discuss and illuminate the issues surrounding the global SARS outbreak. Through invited presentations and roundtable discussion, the following areas will be considered in the context of what lessons can be learned to better prepare for the reemergence of SARS or another, inevitable infectious disease outbreak:

• Evaluation of the experiences in major sites of the outbreak (Hong Kong/China, Taiwan, Vietnam, Toronto
• Epidemiological tracking of the earliest cases (to include role of animal contact)
• The natural history of infection and evidence for episodes of hyper-transmission
• Understanding of the virus (comparative sequencing, immuno-pathologic response, evolutionary potential, etc.) and the subsequent research agenda (should we consider a comprehensive microbial genome project)
• Diagnostic, anti-viral, and vaccine development (progress and process) and research
• Effectiveness of strategies used to deal with affected populations: isolation, quarantine; other hospital infection control and decontamination practices (the why & how it worked; can these measures be universally applied?)
• The role of population screening to assess the extent of disease spread
• Clinical management strategies (steroids, ribavirin, etc.)/ current and potential
• Effectiveness of surveillance and laboratory capacity for early detection and characterization of new pathogens (technical and policy aspects)
• Effectiveness, capabilities, and coordination of reporting and communication tools (particularly IT solutions) for the public health and research communities
• Public communication and education strategies (include role of media and the education of decisionmakers)
• Economic impacts (measurement tools and strategies for mitigating negative consequences; diversion of limited public health and research funding from other critical areas)
• Political/legal impacts (cooperation, instability, role of leadership, sufficiency of international PH law)
• Effectiveness of interagency and international coordination and collaboration (identifying the multi-disciplinary, multi-sector players and obstacles to efficiency)
• Application of modeling for prediction and response strategies