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Anil T. Ahuja; Clara G.C. Ooi
Chest. 2005;128(2):1076-1077. doi:10.1378/chest.128.2.1076
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Perhaps readers of this review will never need to open Imaging in SARS. With luck, this book will become an historical curiosity, and neither severe acute respiratory syndrome (SARS) nor any like virus will jump from nonhuman species to humans and spread in epidemic form. However, humanity’s luck with infectious diseases has not been particularly good over the last 30 years, and a prudent person would not relegate this text to a dust-laden archive just yet.

Imaging in SARS contains an in-depth description of the radiologic findings in SARS patients as observed at hospitals in both Hong Kong and Toronto during 2003. It also details procedures for SARS screening and the prevention of the spread of SARS among patients and health-care workers at the Chinese University of Hong Kong, Prince of Wales Hospital. The text is written by both radiologists and clinicians in internal medicine, pediatrics, and intensive care.

Separate chapters discuss the acute manifestations of SARS as seen on chest radiographs and chest CT scans. Additional chapters detail the role of chest radiography in the clinical management of SARS and the imaging of chronic sequelae of SARS among survivors. These chapters are well-constructed, with short tables containing key points scattered liberally through the text and high-quality images of radiographs and CT scans clearly illustrating the radiologic findings being emphasized.

Several chapters explain the impact of SARS on the workings of the radiology department and the practical steps taken to control the spread of SARS among the community and the medical staff. The segregation of patients with suspected SARS proved to be essential, and included measures such as the establishment of satellite radiography units adjacent to the SARS clinical site (using portable equipment) to prevent the spread of the virus from patients being evaluated during the early stages of disease. The authors’ experience in these matters would be of considerable value should SARS again spread in epidemic form and may still be useful in the likely event that another respiratory pathogen (such as avian influenza) confronts the public health system.

Unfortunately, in the literary arena it is often a difficult task to take a great short story and stretch it to novel length. In the case of Imaging in SARS, the authors start with an important story that was (fortunately) rather brief, and their success in bringing it to book form is dampened by problems of repetitiveness and loss of focus. The two chapters discussing the radiology of community-acquired pneumonias (in both children and adults) are adequately illustrated and referenced but contain much material that is not salient to the differential diagnosis of SARS. The information on SARS in the chapter on ICU management might have been readily incorporated into the chapter on SARS treatment.

Ultimately, it is not the strengths and weaknesses described above that will determine the utility of Imaging in SARS. Rather, the worth of this book will depend on the course of infectious diseases in the coming decades. Either Imaging in SARS will become an anachronism, a sort of radiologic version of Defoe’s A Journal of the Plague Year, or it will be used as a handbook during the reemergence of SARS or the outbreak of a similar new respiratory pathogen. Clinicians and hospital librarians should purchase this book for their collections and hope for the former. As Vegetius said: “Let him who desires peace prepare for war.”




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