This paper describes from a Canadian perspective a landmark event in history which affected countries worldwide, namely the global outbreak of the newly emerged infectious disease, Severe Acute Respiratory Syndrome (SARS). The rapidity with which this paper was written and with which the journal editors reviewed the paper allowed for its early online release as one of the first peer-reviewed papers on the topic of SARS. The timing of this release coincided with the early stage of the worldwide SARS outbreak during a time when the full extent of the outbreak was still being learned and when very little was known about the disease with regard to clinical and laboratory features, course of the illness, and modes of transmission. The timeliness of this publication, its free dissemination online, and the extremely large baseline readership of the New England Journal of Medicine, all enabled this paper to reach a very large captive audience in a very short period of time. Indeed, this paper was downloaded by more than 50,000 readers within only the first two days of publication. In addition, it was translated into Chinese and published in the China Medical Tribune, which is distributed to more than 170,000 physicians in China. The target audience of this paper includes persons from a wide range of disciplines due to the paper’s inclusion of a wide range of data regarding the identification of SARS in Canada relevant to fields of epidemiology, clinical medicine, microbiology, and pathology. The target audience of this paper continues to remain large given concerns regarding the speed with which SARS spread worldwide when it was first introduced and the uncertainty as to where and when its potential re-emergence may occur.

Yes. This paper describes a landmark event, specifically the identification of SARS in Canada. It describes the initial understanding of this newly discovered syndrome, enabling others to learn from the experience of the paper’s authors.

This paper describes the identification of SARS in Canada from the epidemiologic, clinical, microbiologic, and pathologic points of view and was published in a timely manner enabling others to learn from the experience of the paper’s authors in an accelerated fashion while the SARS outbreak was indeed evolving. Its initial description of the clinical syndrome and associated pathology of SARS, the possible underlying cause(s) of SARS, and the associated incubation period and likely mode of transmission of SARS have since been corroborated by additional studies.

Microbiologists, infectious disease physicians, public health physicians, and infection control practitioners are inherently called to be on the front lines against emerging infectious diseases. As such, many of the authors have had prominent roles working together during past outbreaks. When chance brought SARS to Canada, it was a fortuitous opportunity for us to build on previous collaborative relationships to work together to understand and to share our understanding of SARS from the Canadian perspective.