Editorial

SARS, the Internet, and the Journal

Jeffrey M. Drazen, M.D., and Edward W. Campion, M.D.

N Engl J Med 2003; 348:2029May 15, 2003

Article

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.1-3 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

References

1. 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
   Full Text | Web of Science | Medline

2. 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
   Full Text | Web of Science | Medline

3. 3

   Drazen JM. Case clusters of the severe acute respiratory syndrome. N Engl J Med 2003;348:e6-e7
   Full Text | Medline

4. 4

   Gerberding JL. Faster . . . but fast enough? Responding to the epidemic of severe acute respiratory syndrome. N Engl J Med 2003;348:2030-2031
   Full Text | Web of Science | Medline

5. 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
   Full Text | Web of Science | Medline

6. 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
   Full Text | Web of Science | Medline

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   Drosten C, Gunther 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
   Full Text | Web of Science | Medline

Citing Articles (4)

Citing Articles

1. 1

   Tikki Pang, G. Emmanuel Guindon. (2004) Globalization and risks to health. EMBO reports 5, S11-S16
   CrossRef

2. 2

   Damon C Scales, William J Sibbald. (2004) Medical technology in the intensive care unit. Current Opinion in Critical Care 10:4, 238-245
   CrossRef

3. 3

   (2003) SARS and the Internet. New England Journal of Medicine 349:7, 711-712
   Full Text

4. 4

   Gunther Eysenbach. (2003) SARS and Population Health Technology. Journal of Medical Internet Research 5:2, e14
   CrossRef

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