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This information resource was developed and is maintained by Stephen M. Apatow, Director of Research and Development (vitae), who is a specialist in strategic planning and project development of initiatives associated with human medicine, veterinary medicine and U.S. and international law. Questions or suggestions regarding the Biodefense Reference Library can be sent to: admin@humanitarian.net

In contrast to the spread of West Nile Virus (West Nile Virus - Biodefense and Epidemiological Tracking: from the initial index case in New York City throughout the North American Continent during the period from 1999-2003, Severe Acute Respiratory Syndrome (SARS) has crossed international boundries within a matter of weeks. 
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• SARS: A double epidemic model for the SARS propagation: BMC Infectious Diseases 2003,3 :19.
• Bird Flu a Disaster for Poultry Production, Threatens Global Food Security: Avian influenza has caused great damage to livestock production and threatened global food security, statistics released by FAO earlier February showed that more than 450 million birds had been culled in Asia excluding China, about some 0.7 percent of the region's total inventory.  Stephen M. Apatow, Humanitarian Resource Institute, 23 February 2004.
• SARS, flu tough to tell apart: It's mid-January and you've got a fever, a cough and an all-over achiness. Must be the flu, right?  Then again, could it be SARS? How are you -- or your doctor -- supposed to know? ``That's a very good question and one we have no answer for right now,'' said Dr. Marguerite Erme, the Akron Health Department's disease-control medical officer. National Flu Surveillance Network.
• Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults: Infectious Diseases Society of America, Clinical Infectious Diseases, 2003;37:1405-1433. See also: New guidelines give specifics for pneumonia care, American Medical Association News, Dec. 22/29, 2003.
• SARS coronavirus: a new challenge for prevention and therapy: The genes of SARS-CoV were compared with the corresponding genes of known coronaviruses of humans, pigs, cattle, dogs, cats, mice, rats, chickens, and turkeys. Each gene of SARS-CoV has only 70% or less identity with the corresponding gene of the known coronaviruses. Thus, SARS-CoV is only dis-tantly related to the known coronaviruses of humans and animals. Phylogenetic analysis suggests that SARS-CoV does not fit within any of the three groups that contain all other known coronaviruses. Holmes, J. Clin. Invest. 111:1605–1609 (2003). doi:10.1172/JCI200318819. For additional information, visit the: HRI Bioinformatics: Pathobiological Diagnostics Site.
• SARS Down But Still a Threat: National Intelligence Council, Intelligence Community Assessment, August 2003.
• International Law, Communicable Diseases and the Geopolitical Objective of Minimal Interference with World Trade and Travel: Stephen M. Apatow, Humanitarian Resource Institute Legal Resource Center, 5 May 2003. This articles focuses on the importance of current U.S. State Department Warnings. For additional information, visit the: HRI: SARS Legal Resource and Information Center.
• SARS scare reminiscent of 1918 crisis Death rate appears to eclipse that of Spanish flu  Donald Henderson knows history, and he is worried. The doctor who led the international effort to eradicate smallpox said he’s worried about history repeating itself, only on a much deadlier scale this time around. -- 19 May 2003, Toledo Blade

• SARS: Assessing the Threat - Why are so few "Probable" Cases Reported to the WHO
• SARS: Veterinary Public Health and Pandemic Disease
• SARS: Facing the Challenge of HIV/AIDS
• SARS - Facing a Phase II Pandemic and the Threat of Bioterrorism
• SARS: Lancet: Early online publication
• CDC: Preventing Spread of Severe Acute Respiratory Syndrome (SARS) 
• Triage of Patients which may have Severe Acute Respiratory Syndrome (SARS)

• Coronavirus -  Medline: Severe Acute Respiratory Syndrome, The National Library of Medicine and National Institutes of Health.
• Influenza - Medline: The National Library of Medicine and National Institutes of Health

Politics influences outbreak investigation. It is not unusual for health authorities in affected countries to refuse to cooperate with international disease investigations out of fear of bad publicity or adverse economic impacts such as trade embargoes or loss of  tourism. - Commentary, Biodefense Brief, March 27, 2003, Center for Civilian Biodefense Strategies Clinicians' Biodefense Network

World Health Organization
Global Outbreak Alert & Response Network
Severe Acute Respiratory Syndrome (SARS)
<http://www.who.int/csr/sars/en/>

Canadian SARS Update
<http://www.hc-sc.gc.ca/english/protection/warnings/sars/sars_numbers.html>

U.S. Centers for Disease Control
<http://www.cdc.gov/od/oc/media/sars.htm>
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[Additional reports and updates can be accessed through ProMED-mail <http://www.promedmail.org>. ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org>]

Related Information:

• Preparedness for Deliberate Epidemics:  In May 2002, the World Health Assembly passed a resolution, Global public health response to natural occurrence, accidental release or deliberate use of biological and chemical agents or radionuclear material that affect health. See resolution. The Secretariat provided a background paper, Deliberate use of biological and chemical agents to cause harm for consideration by the World Health Assembly. 
• Pandemics: How They Start, How They Spread, and Their Potential Impact: Centers for Disease Control and Prevention