SARS Spreads from Southern China to the World

In November 2002, an unfamiliar respiratory illness emerged in Foshan, located in the southern Chinese province of Guangdong. The first known case occurred there on 16 November, and by January 2003 the pathogen was spreading to health care workers and to the families of patients. Gaps in investigative capacity and reporting transparency in southern China delayed notification to the World Health Organization by about three months, and a visiting WHO team was not allowed to investigate in Guangdong until early April. In February 2003, Guangdong health officials reported 305 cases and five deaths, but in late March China revised the province's count for the period through the end of February to 792 cases and 31 deaths.

The contagion expanded internationally through regional transit networks centered in Hong Kong. On 21 February 2003, a 64-year-old medical doctor from Zhongshan University in Guangzhou, already experiencing respiratory symptoms, arrived in Hong Kong and stayed on the ninth floor of the Metropole Hotel. About twenty SARS cases were ultimately linked to that floor, and infected guests carried the virus to destinations across Asia and North America. Among those infected was a Chinese-American businessman who traveled to Hanoi and fell severely ill. Carlo Urbani, an infectious disease specialist with the World Health Organization stationed in Vietnam, attended the businessman and recognized that the hospital was contending with a novel, dangerously contagious disease. Urbani raised alarms before dying of the infection on 29 March.