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Zhong Nanshan was propelled into the public eye in a way he wished had never happened.

For years a leading Chinese specialist in respiratory diseases, Zhong was well known among his peers, but the outbreak of SARS has turned him into a household name across the country.

In early February, he appeared at a press conference in Guangzhou, where the potentially fatal epidemic had, for some time, haunted local residents.

The local government officially declared the outbreak of atypical pneumonia, later described by the World Health Organization (WHO) as severe acute respiratory syndrome (SARS), in Guangdong Province at that conference.

Zhong, 66 and head of the expert task force appointed to fight the disease in the province, briefed the media on the new contagious disease.

The disease, for which there is no known cure or vaccination, was known at the time to have broken out and spread across the province rapidly.

Zhong has since appeared in increasing sections of the media, not only in Guangdong, but across the nation, as the disease spread to other cities and provinces around China.

This week, he is in Bangkok, sharing his experiences of dealing with it at the Association of Southeast Asian Nation leaders' special meeting on SARS.

Earliest encounter

Zhong was one of a limited number of doctors informed of the disease from the moment the first few cases were reported through the inner medical network in Guangdong.

He and his colleagues had been engaged in combatting it for more than a month before he appeared at the press conference in Guangzhou.

During that time Zhong witnessed how it had spread from a single patient to the doctors, nurses and others who had close contact with the infected man.

The patient, from the Heyuan County of Guangdong, was admitted into the Centre for Respiratory Diseases in Guangdong in early December last year. After being treated for one month as a pneumonia case, far from improving, the patient's condition worsened. Mystified by the illness, it was then Zhong and his colleagues realized something unusual about their "pneumonia" patient.

Although experiencing difficulty in breathing, he did not have a high temperature, as is typical with pneumonia. It was also realized that his lungs were hardening, leading to ever serious breathing difficulties.

"His lungs were as hard as plastic, which is unseen in regular pneumonia or even cases related to symptoms of other unidentified pneumonia," Zhong recalled.

The usual treatment with antibiotics also had no effect and it was only after the patient was given intravenous injections of corticosteroid (steroid hormone produced by the cortex of the adrenal glands) that his condition began to respond.

"We were very surprised at its effect," said Zhong.

But worst surprises were soon to follow as doctors and nurses who had had close contact with the patient fell ill with the same disease, one after another.

The infected man's relatives and the ambulance driver who brought him to hospital were also found to have caught the virus, taking the then total number of infections to eight.

Zhong began to realize that he and his colleagues were facing an apparently highly infectious, unknown disease. Similar cases were reported in Zhongshan, another city in Guangdong. He was invited by the provincial Bureau of Health to lead an expert team to investigate the incidences, which by then had reached 30.

Those inquiries suggested the cases concerned the same type of disease, which Zhong described as "atypical pneumonia" in the subsequent report on his findings.

"Some symptoms of the disease are similar to those of pneumonia and they may be confused with each other at first glance," explained Zhong. "But they are not."

The patient they admitted in December was later identified as the second such case in Guangdong, with the first traced to the city of Foshan.

The number of cases rose sharply in Guangzhou in late January and continued in coming weeks. Deaths were being reported daily, driving local residents into a state of near panic by early February.

Zhong was appointed by the provincial government as head of the expert task force to direct all the province's hospitals handling of the disease.

The Centre for Respiratory Diseases, of which he is director, admitted the patients with very serious conditions. Zhong not only saw new patients brought in each day, but also noticed, to his dismay, that his colleagues were becoming infected whilst treating their patients.

Fourteen doctors and nurses at the centre have, to date, fallen to SARS infection, Zhong said, and this in spite of stringent preventive measures.

He spoke of a doctor who became infected whilst treating a dying patient. Within three days that doctor and two nurses had fallen ill, none of whom have yet fully recovered.

"They are my colleagues and friends," said Zhong. "I feel great pain seeing them suffer. They do it knowing the great risk of being infected, but none of them has quit in the face of the threat."

Neither has Zhong, who examines every patient admitted to the centre.

His medical knowledge and first hand experience makes him well aware of the danger posed by SARS. Throughout he has refused to compromise his professional integrity by concealing the facts or by making misleading remarks about the disease.

He voiced his concerns over the possibility of a SARS outbreak in other regions at a conference in Beijing in early March, when Beijing was thought to be free from the disease.

Doubts

He also expressed his reservations when Zhang Wenkang, the sacked former Minister of Health, erroneously announced at a press conference early this month that only 12 cases of SARS had been found in Beijing and that the disease had been "brought under control."

Zhong challenged these official remarks at another conference held a week later, arguing that the disease had not yet been effectively controlled in medical terms.

"How can you bring the disease under control when you don't know its cause?" he told that forum.

Zhong's challenges were not confined to the underestimation of the severity of the disease, but also at those who might make hasty investigative conclusions concerning it.

When SARS cases peaked in late February in Guangdong, researchers at the Chinese Centre for Disease Prevention and Control announced they had detected the pathogen of SARS and identified it as a new type of chlamydia.

This discovery was quickly made public by the media and reported to the WHO.

But Zhong and other doctors in Guangdong questioned the finding. With their rich clinical experience of the disease, they believed SARS was much more likely to be caused by an unknown virus.

The family of bacteria called chlamydia can be contained by antibiotics, yet antibiotics have proved ineffectual against SARS.

Zhong and his Guangdong colleagues warned any treatment based on such a conclusion may have serious adverse consequences.

The doubts of Zhong and his colleagues proved well-founded when early this month, several laboratories across the world, working together, succeeded in pinpointing the SARS pathogen to a new coronavirus.

Zhong and his colleagues, meanwhile, on April 12 also isolated the coronavirus from specimens taken from SARS patients.

Four days later, the WHO announced that the coronavirus alone is responsible for causing the typical symptoms of SARS.

With the SARS virus properly identified, attention can be focused on developing appropriate diagnostic measures, treatment and a vaccine.

Zhong says he does not know how long it will take for a vaccine to be produced, but would continue to fight the disease with all available and resources until an effective treatment is found.

"It is within the sphere of my speciality," he said. "I want to know its cause, its pathogen and how to cure it. This is the biggest drive for me."

Editor: Wings

By:WEN JIAO  Source：China Daily