May 2, 2003

SARS scare forces students to come home

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Steve Gimple

SARS scare forces students to come home

Robert Peck

Robert Peck

In mid March, about two weeks before fourth-year medical students Robert Peck and Steve Gimple left Vanderbilt for Chengdu, China for a month’s volunteer work, the world was first hearing about severe acute respiratory syndrome (SARS).

There were only 500 cases worldwide, mostly in Hong Kong, Vietnam and southern China, so the students didn’t feel threatened. They both had some free time late into their fourth year, so they had volunteered to teach medical English to medical students and residents at West China University of Medical Sciences, one of the key universities in China financed and directed by the Ministry of Health of the People’s Republic of China. It’s the center of medical care, teaching and training for medical management for the southwestern part of China.

Gimple and Peck also planned to learn about changes in the Chinese medical education system in Chengdu, a political, economical and cultural center in southwest China. It would be Gimple’s third trip to China, and Peck’s first, although Peck has traveled extensively to other countries for volunteer work throughout medical school. Gimple taught English at a university in China for a semester after graduating from college, then he and his wife returned after his first year of medical school.

“The day after we arrived in March, the World Health Organization issued a travel advisory for Mainland China,” Gimple said. “They were saying they knew of cases in Beijing and other places in China, but we still weren’t really concerned. Chengdu is far to the southwest, and even if there were three or four cases in a city of 10 million, statistically we felt safe.”

But since the Chinese government was slow to report the severity of the outbreak, the students were getting very little official information. They took it upon themselves to find out what they could. They read everything there was to read on the Internet about SARS, and kept watch. After being there for about five days, they heard a rumor that there were SARS patients at West China University of Health Sciences.

Peck e-mailed Dr. Peter F. Wright, professor of Pediatrics, to ask what they should do. Wright told them if SARS was in the hospital, not to go back.

“We never came in contact with anybody who had SARS,” Gimple said. “We were assured there were no cases the first day, then after we heard about the cases, we didn’t go back to the wards after that.”

Wright forwarded the e-mail to Dr. Mark R. Denison, associate professor of Pediatrics and Microbiology and Immunology at Vanderbilt, who is collaborating with the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the U.S. Army Medical Research Institute of Infectious Diseases (USAMRID) to understand the replication process of the coronavirus.

Denison wrote back and told the students to come home, and “work on the SARS problem in my lab instead of there in China,” Gimple said. Denison forwarded the e-mail to Dr. Bonnie M. Miller, associate dean for Medical Students, who strongly encouraged the students to come home.

“We heeded wise counsel and left,” Gimple said. By the time the students left, there were more than 3,000 cases reported in Asia. The World Health Organization reports more than 5,000 reported cases to date.

“The medical director of the Peace Corps in China was living in the same apartment complex as we were, and the Peace Corps had already pulled out of China the week before,” Gimple said. “We talked to professors at the hospital, who confirmed there were cases there. Other foreign medical people who were coming later in the month had already cancelled, so they were expecting that we’d leave.

“Cases were increasing and we were also very worried about flights being cancelled. We were flying through Beijing, and they weren’t canceling flights there, but we were worried about the domino effect — if one flight attendant got sick, they’d all strike.”

So a trip that was supposed to end on April 27 was cut in half, and the medical students returned home two weeks early to work with Denison on a coronavirus vaccine project.

“It was very nice of Dr. Denison to let us do that,” Gimple said. “We were disappointed about having to come home. Our wives were supposed to come over the day we had to come back, but knowing how the epidemic has progressed, we know we made the right decision.”

Denison said he has enjoyed the opportunity to work with Peck and Gimple.

“I felt bad having to tell them to come home, but we take the welfare of our students very seriously. So I wanted to have an opportunity to use their experience to attack an important, emerging human disease. They have done a remarkable job in uncovering the details of years of work on animal coronaviruses, work not easily found, and little appreciated in the past.

“Their work is already helping me to shape the discussion on vaccine approaches for SARS at the national level. It is possible that their disappointing travel and cultural/medical experience may result in great benefit for many people around the world. I am very pleased with their commitment to this project.”

Gimple said he hopes to eventually return to China. After graduation, he will be an internal medicine resident at Vanderbilt, and Peck will begin a medicine-pediatrics residency at Massachusetts General in Boston.