FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 348:2029 May 15, 2003 Number 20 Next

PDF PDA Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

On the Ides of March 2003, a physician was in transit from New York to Singapore by way of Germany. In Germany he was hospitalized and quarantined with a respiratory illness. The next day, the news media worldwide began to report on the spread of a major new infection, and suddenly attention everywhere focused on severe acute respiratory syndrome (SARS).

At the Journal on March 31, 2003, we posted two rigorously reviewed case series, one from Hong Kong and one from Toronto, on our Web site with editorial comment.^1,2,3 A notice of this publication was sent to our e-mail listserve. We asked Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, to comment on the SARS cases, and her editorial was posted on our Web site on April 2, 2003.⁴

Several days later, we posted a detailed report on an epidemiologic study of a large outbreak in one of Hong Kong's major hospitals.⁵ Notice of the posting of this paper was sent to our e-mail listserve subscribers. Two more papers, each describing the role of the putative cause of SARS, the SARS-associated coronavirus, were posted on our Web site on April 8, 2003.^6,7

We have made all this content free to all users. A number of the articles have been translated into Chinese and reprinted in the China Medical Tribune, which is distributed to more than 170,000 physicians in China. The five papers now appear in print — two months after the first World Health Organization announcement about SARS. They document the state of clinical and virologic knowledge at the outset of the epidemic; much progress has been made since they were posted.

Our experience shows the power of the Internet. Without electronic communication among our authors, editors, and reviewers, it would have taken weeks to handle these papers. With e-mail, a paper from Hong Kong arrives in our office within minutes. In the case of SARS, we used electronic communication to review, revise, and publish rapidly. Under the best of circumstances, we could not have published the original case descriptions, much less all five articles, in print before late April. We hope this experience illustrates to our readers the importance of signing up (at www.nejm.org/alerts) to receive our electronic table of contents and e-mail alerts of all postings of early-release articles on the Web. This service is provided at no charge.

Our strength derives from how we evaluate what we publish, and that process can be lengthy. But from time to time, it makes sense to act with considerable speed; this was one of those times. We think that SARS will be with us for a while. What we do not know is whether the number of cases will grow exponentially or level off and decline. In the meantime, you can stay up to the minute by signing up for the Journal's e-mail alerts.

References

1. Tsang KW, Ho PL, Ooi GC, et al. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:1977-1985. [Free Full Text]
2. Poutanen SM, Low DE, Henry B, et al. Identification of severe acute respiratory syndrome in Canada. N Engl J Med 2003;348:1995-2005. [Free Full Text]
3. Drazen JM. Case clusters of the severe acute respiratory syndrome. N Engl J Med 2003;348:e6-e7. [Free Full Text]
4. Gerberding JL. Faster . . . but fast enough? Responding to the epidemic of severe acute respiratory syndrome. N Engl J Med 2003;348:2030-2031. [Free Full Text]
5. Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:1986-1994. [Free Full Text]
6. Ksiazek TG, Erdman D, Goldsmith CS, et al. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 2003;348:1953-1966. [Free Full Text]
7. Drosten C, Günther S, Preiser W, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med 2003;348:1967-1976. [Free Full Text]

PDF PDA Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

Related Letters:

SARS and the Internet
Hsieh Y.-H., Drazen J. M., Campion E. W.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:711-712, Aug 14, 2003. Correspondence

This article has been cited by other articles:

• Reed, K. D. (2004). Monkeypox, Marshfield Clinic and the Internet: Leveraging Information Technology for Public Health. Clin Med Res 2: 1-3 [Full Text]  
• Hsieh, Y.-H., Drazen, J. M., Campion, E. W. (2003). SARS and the Internet. NEJM 349: 711-712 [Full Text]