Why not Urbani virus?

19 May 2003 | News

Though it has been afflicting people in China since November 2002, the disease hit the global headline only in March when it infected people in Hong Kong. And for nearly two months, as the scientific world groped in the laboratories to identify the microbe that was believed to cause the disease, it was just called the Severe Acute Respiratory Syndrome or SARS.

There are still doubts about whether a new virus of the corona family, which is the real culprit behind the fast spreading global infection. Yet, for want of a better alternative, the world has accepted it as the cause. And it has been simply named the SARS virus.

However, there are many health experts who feel that the virus should be named after its most famous victim so far— Dr Carlo Urbani, 46, the deceased director of infectious diseases for the Western Pacific Region of the World Health Organization (WHO).

By all accounts he was the first to tell the world about this illness when a mysterious pneumonia hit many nurses in a Vietnam hospital. He alerted the world of the danger of the new disease and died on March 29, exactly a month after treating the first suspected SARS patient himself. Dr Urbani had apparently got the infection from Johnny Chen, an American businessman who entered Vietnam-France Hospital in Hanoi on 26 February with flu-like symptoms.

As the senior most public health official in the region he had to make a tricky call about this disease which was mimicking other respiratory conditions, but was not amenable to known treatments.

"Carlo's death was the most coherent and eloquent epilogue his life could produce," said Nicoletta Dentico, a friend from the Italian chapter of Médecins Sans Frontières, or Doctors Without Borders, which Dr. Urbani once headed. "His death was as a giver of new life," Nicoletta told The New York Times. And it was in keeping with his medical philosophy. When Dr. Urbani spoke in 1999 at the ceremony in which Doctors Without Borders accepted the Nobel Peace Prize, he described doctors' duty "to stay close to the victims". "It's possible to study an epidemic with a computer or to go to patients and see how it is in them," said Dr. William Claus, the group's emergency coordinator for Asia. "Carlo was in the second category."

Before he checked into the Vietnam-France Hospital, Chen had infected at least 80 people, including more than half of the health workers who cared for him. The virulence of his case alarmed world health officials, which led to the extraordinary health alert that WHO issued on March 15. Dr Urbani quickly recognized that the disease was highly contagious and began instituting anti-infection procedures like high-filter masks and double gowning, which are not a routine in impoverished Vietnam. Then he called public health authorities.

On 9 March , Dr Urbani and Dr Pascale Brudon, the WHO director in Hanoi, met for four hours with officials at the Vietnam Health Ministry, trying to explain the danger and the need to isolate patients and screen travelers, despite the possible damage to its economy and image. The hospital was quarantined on March 11. Infection-control practices were instituted at other hospitals, including the large Bach Mai state hospital, where Dr Claus of Doctors Without Borders oversaw them. In the middle of it, Dr Savioli said, Dr Urbani had an argument with his wife, Giuliani Chiorrini. She questioned the wisdom of the father of three children of ages 4 to 17 treating such sick patients.

Dr Savioli said Dr Urbani replied: "If I can't work in such situations, what am I here for? Answering e-mails, going to cocktail parties and pushing paper?"

In an interview with an Italian newspaper, Ms Chiorrini said her husband knew the risks. "He said he had done it other times," she recalled, "that there was no need to be selfish, that we must think of others."

Dr Urbani was an expert in Schistosoma mekongi in Vietnam, in the food-borne nematodes and trematodes of Laos and Cambodia and the hookworms of the Maldives.

Dr Lorenzo Savioli, who worked with Dr Urbani in the Maldives, told The New York Times that they worked from sunup to sundown, ignoring the famous beaches and reefs, tracking hookworm epidemiology and training workers at a malaria control laboratory, who were used to working with blood, in testing for worms. Over rice and fish in the evenings, Dr. Savioli said, they had joked, " Nobody at headquarters was going to believe we were spending our days in the Maldives over fecal samples."

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