SARS: a local public health perspective.

The outbreak of Severe Acute Respiratory Syndrome (SARS) was an international incident that was unprecedented in scale and scope. It led to the first declaration of a health emergency by the Province of Ontario and required the mobilization of public health staff, infectious disease specialists and infection control practitioners from across Toronto, Ontario and the U.S. The overall response was a team effort that in many ways brought out the best in organizations and individuals. It has been said that SARS will do for febrile respiratory illnesses what HIV/AIDS did for bloodborne illnesses. SARS has been a tremendous wake-up call for stronger attention to hospital infection control, infectious disease surveillance, outbreak investigation and management, and surge capacity across the health sector. The SARS outbreak differed from outbreaks of previously known infectious diseases. There was no diagnostic test, no treatment, no vaccine, and rapidly changing information on its transmission and virulence. This was combined with rapid spread across the health care sector and across international boundaries. These factors required a concerted and coordinated response from local, provincial and federal health authorities, the health care sector, the community, and other agencies.