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While severe acute respiratory syndrome has not threatened the U.S. military community in Europe, medical professionals at Landstuhl Regional Medical Center remain watchful and are prepared to handle suspected cases that may arise.

Preparations for a smallpox outbreak, plus a recent case that initially appeared like SARS, have given U.S. military doctors valuable practice, said Air Force Lt. Col. George Christopher, chief of Landstuhl’s infectious disease control program.

“We are always open to the idea of emerging diseases,” Christopher said. “We always have to be ready for something new.”

Christopher, 50, of McLean, Va., watched news reports in February discussing an emerging epidemic of atypical pneumonia in China. While military health agencies offer guidance through e-mail, Christopher also follows daily Internet updates on the home pages for the Centers for Disease Control and Prevention and the World Health Organization.

Like many in his field, Christopher first thought SARS might be a new strain of influenza, or a new paramyxo virus, a distances cousin of measles often circulated among animals. Now scientists lean toward SARS being a new coronavirus, a virus similar to the common cold named for its crownlike shape, Christopher said.

Over the past two years, doctors at Landstuhl have prepared to handle an outbreak of smallpox, a disease far more lethal, Christopher said. That training will help should they encounter SARS or any other infectious disease, Christopher said.

Recently, the hospital’s plans were put to the test when a servicemember returned from the States with a fever and a cough. The troop was at a West Coast airport when passengers from Hong Kong arrived in the terminal, Christopher said.

“He didn’t recall anyone coughing or sneezing on him, and he hadn’t been to Asia or had close contact with anyone,” Christopher said.

Still, doctors isolated the man in a specially ventilated room normally used to quarantine patients with diseases such as tuberculosis. Then, they swabbed his nose and throat for test samples.

Any suspected SARS specimens must be sent to the CDC in Atlanta, Christopher said. While Landstuhl’s top-notch microbiology lab cannot test for SARS, they can rule SARS out by identifying other viruses, Christopher said. In this case, the lab identified that the servicemember had the flu.

By Thursday, 4,439 people had come down with SARS worldwide, with the majority of the cases from China and Hong Kong, according to the World Health Organization. In the United States, 37 people have been identified with SARS.

Since the outbreak, at least 276 SARS patients have died worldwide.

While those numbers may be startling, as SARS is newly identified, it hardly compares with influenza. According to the CDC, about 36,000 people in the United States die each year from the flu. About 114,000 flu patients are admitted to U.S. hospitals each year.

In Europe, the number of SARS cases are far less than Asia. Germany has seven cases, Italy and the United Kingdom have six each and France has four, Christopher said. Bulgaria reported its first case Thursday.

To avoid exposure to SARS, avoid travel to places like China, Singapore, Vietnam and Toronto, Christopher said, citing WHO recommendations.

“We are at low risk,” Christopher said, of troops stationed in Europe. “To catch SARS you have to go to one of those areas or come into very close contact with a SARS case.”

— More information on SARS can be found at the following Web sites: Center For Disease Control and Prevention at, and World Health Organization at

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