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Where Has SARS Gone? The Strange Case of the Disappearing Coronavirus
The emergence of Severe Acute Respiratory Syndrome (SARS) in China’s Guangdong Province in the winter of 2002 was an exemplary spillover event: it marked the passage of a lethal pathogen from nonhuman to human animals and was widely heralded as the first “plague” of the twenty-first century. The SARS coronavirus seemed to burst out of nowhere and demonstrated pandemic potential from February 2003 when it diffused globally via Hong Kong. After SARS was officially declared contained by the World Health Organization (WHO) on 5 July 2003, there were a few isolated cases but none since 2004
© Institut Pasteur//Meriadeg Le Gouil
Incertitude, Hepatitis B, and Infant Vaccination in West and Central Africa
This comparative study explores incertitude about hepatitis B (HBV) and its implications for childhood vaccination in Bangui, Central African Republic, and the Cascades region, Burkina Faso. Anthropological approaches to vaccination, which counter stereotypes of “ignorant” publics needing education to accept vaccination, excavate alternative ways of knowing about illness and vaccination. We build on these approaches, evaluating different kinds of incertitude (ambiguity, uncertainty, ignorance) about infancy, HBV, health protection, and vaccination. Using interviews and participant observation, we find that Bangui and Cascades publics framed their incertitude differently through stories of infancy, illness, and protection. We locate different forms of incertitude within their historical contexts to illuminate why vaccination practices differ in the Cascades region and Bangui. A more nuanced approach to incomplete knowledge, situated in political, economic, and social histories of the state and vaccination, can contribute to more appropriate global health strategies to improve HBV prevention.
“Nature does things well, why should we interfere?”: Vaccine hesitancy among mothers
Parents’ decision to use vaccination services is complex and multi-factorial. Of particular interest are “vaccine-hesitant” parents who are in the middle of the continuum between vaccine acceptance and refusal. The objective of this qualitative longitudinal study was to better understand why mothers choose to vaccinate—or not—their newborns. Fifty-six pregnant mothers living in different areas of Quebec (Canada) were interviewed. These interviews gathered information on mothers’ views about health and vaccination. Almost half of the mothers were categorized as vaccine-hesitant. A second interview was conducted with these mothers 3 to 11 months after birth to look at their actual decision and behavior concerning vaccination. Our results show the heterogeneity of factors influencing vaccine decision making. Although the majority of vaccine-hesitant mothers finally chose to follow the recommended vaccine schedule for their child, they were still ambivalent and they continued to question their decision
© Institut Pasteur/Tamara Giles-Vernick
Vaccination Campaigns in Postsocialist Ukraine: Health Care Providers Navigating Uncertainty
Vaccination anxieties grew into a public health issue during the 2008 failed measles and rubella immunization campaign in Ukraine. Here I explore how health care providers bend official immunization policies as they navigate media scares about vaccines, parents’ anxieties, public health officials’ insistence on the need for vaccination, and their own sense of expertise and authority. New hierarchies are currently being renegotiated, and I follow health care providers as they attempt to parcel out their new position in the Ukrainian society and beyond. Public health control is reframed in a postsocialist context as a condition of acceptance into the European community as a sanitary democracy, and a contestation point between citizens and state. I untangle how relationships between citizens and states shape the construction of medical risk. [vaccination anxieties; health care providers; postsocialism; Ukraine]
Becoming Modern after SARS. Battling the H1N1 Pandemic and the Politics of Backwardness in China′s Pearl River Delta
This article traces the early evolution of the H1N1 pandemic as it played out in China′s Pearl River Delta in the spring and summer of 2009, as local public health professionals there tried to contain the virus when their American counterparts did not do so. My informants′ difficulties in escaping their perceived status as a source, rather than a victim, of dangerous viruses; their use of disease control tactics that were portrayed abroad as excessive, unscientific, and unsophisticated; and their fatalism about reforming their local system of governance; all frustrated their ambitions. At the same time, the gulf between their reactions to H1N1 and the reactions across the Pacific suggests the need for a more serious global debate about what local places in all parts of the globe should and should not be prepared to do in the name of pandemic preparedness. [SARS; H1N1; pandemic; China; preparedness]
© Institut Pasteur/M-C. Prévost, M. Desdouits et P-E. Ceccaldi, S. Van der Werf et N. Naffakh. Colorisation J-M. Panaud
The sars-associated stigma of SARS victims in the post-sars Era of Hong Kong
This article explores the disease-associated stigma attached to the SARS victims in the post-SARS era of Hong Kong. I argue that the SARS-associated stigma did not decrease over time. Based on the ethnographic data obtained from 16 months of participant observation in a SARS victims' self-help group and semistructured interviews, I argue that the SARS-associated stigma was maintained, revived, and reconstructed by the biomedical encounters, government institutions, and public perception. I also provide new insight on how the SARS-associated stigma could create problems for public health development in Hong Kong. As communicable diseases will be a continuing threat for the human society, understanding how the disease-associated stigma affects the outcomes of epidemic control measures will be crucial in developing a more responsive public health policy as well as medical follow-up and social support service to the diseased social groups of future epidemic outbreaks.
Ethical and Legal Challenges Posed by Severe Acute Respiratory Syndrome
The appearance and spread of severe acute respiratory syndrome (SARS) on a global level raised vital legal and ethical issues. National and international responses to SARS have profound implications for 3 important ethical values: privacy, liberty, and the duty to protect the public's health. This article examines, through legal and ethical lenses, various methods that countries used in reaction to the SARS outbreak: surveillance and contact tracing, isolation and quarantine, and travel restrictions. These responses, at least in some combination, succeeded in bringing the outbreak to an end. The article articulates a set of legal and ethical recommendations for responding to infectious disease threats, seeking to reconcile the tension between the public's health and individual rights to privacy, liberty, and freedom of movement. The ethical values that inform the recommendations include the precautionary principle, the least restrictive/intrusive alternative, justice, and transparency. Development of a set of legal and ethical recommendations becomes even more essential when, as was true with SARS and will undoubtedly be the case with future epidemics, scientific uncertainty is pervasive and urgent public health action is required.
© Institut Pasteur
A note on language
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No
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