The 2003 SARS Outbreak: A Timeline

Lessons learned during the 2003 SARS pandemic may help us understand today's Wuhan coronavirus.
Marcia Wendorf

Like the new Wuhan coronavirus currently circulating worldwide, SARS, or Severe Acute Respiratory Syndrome, is also a coronavirus. These viruses have a crown-like appearance when viewed under a microscope.

According to The New York Times, the new virus has infected 14,000 people in 23 countries. Over 300 people have died, all but one in China.


In 2003, SARS caused a health emergency around the world. Here is a timeline of the events surrounding the SARS outbreak.

The virus first appears

November 16, 2002 - SARS first appears in a farmer in China's Guangdong Province.

January 31, 2003 - the first so-called "super-spreader" of the disease, a fish seller named Zhou Zuofen, checks into Sun Yat-sen Memorial Hospital in Guangzhou, Guangdong Province, where he infects 30 nurses and doctors.

February 10, 2003 - The People's Republic of China notifies the World Health Organization (WHO) of the disease, reporting 305 cases of which 105 were healthcare workers. They also reported five deaths which China will later revise to 806 cases and 34 deaths.

February 21, 2003 - one of the doctors who had treated Zhou Zuofen, Dr. Liu Jianlun, begins to feel unwell but proceeds with his plan to attend a family wedding in neighboring Hong Kong. Once there, he checks into Room 911 at the Metropole Hotel.

February 22, 2003 - feeling increasingly sick, Dr. Liu goes to the Kwong Wah Hospital, where he dies on March 4, 2003.

Soon, 23 other guests who are staying at the Metropole Hotel begin to fall ill, including seven who are also staying on the ninth floor. One of those staying on the ninth floor is a Chinese-American resident of Shanghai named Johnny Chen. Chen soon travels to Hanoi, Vietnam.

Dr. Liu's grandmother, Kwan Sui-Chu, returns to her home in Toronto, Canada, where she warmly embraces her son after debarking from the plane.

Kwan Sui-Chu dies of the virus on March 5th, and her son, Tse Chi Kawi, dies at Scarborough Grace Hospital on March 13th after spreading the disease there.

February 25, 2003 - a businessman who had visited Guangdong Province returns to his home in Taipei, Taiwan, setting off an outbreak there.

February 26, 2003 - Johnny Chen enters The French Hospital of Hanoi, Vietnam, where he infects over 38 staff members including Dr. Carlo Urbani, a WHO infectious disease specialist. Chen dies on March 13, 2003.

March 1, 2003 - 26-year-old Singapore resident Esther Mok, who has visited Hong Kong is admitted to Tan Tock Seng Hospital and starts an outbreak of the disease in Singapore. Mok would go on to recover.

March 4, 2003 - a 27-year-old man who had visited a guest on the ninth floor of the Metropole Hotel is admitted to the Prince of Wales Hospital in Sha Tin, Hong Kong where he infects over 99 medical workers.

The 2003 SARS Outbreak: A Timeline
Chinese people wearing facemasks during SARS outbreak, Source: Robert Wei/iStock

March 11, 2003 - Dr. Carlo Urbani flies to Bangkok, Thailand to attend a medical conference. Feeling ill during the flight, Urbani immediately goes to a hospital upon landing. Urbani dies on March 29th.

March 12, 2003 - WHO issues a global alert about the new coronavirus.

March 15, 2003 - WHO issues an emergency travel advisory. That same day, the U.S. Centers for Disease Control and Prevention (CDC) issues a travel advisory for U.S. citizens in Hong Kong, Singapore, Vietnam, and China.

March 17, 2003 - an international network of 11 laboratories is established to determine the cause of SARS and to develop a treatment.

The CDC holds its first briefing on SARS, announcing that there are 14 suspected cases of SARS in the U.S.

March 25, 2003 - 9 people come down with SARS after sharing an Air China Flight from Hong Kong to Beijing with an infected passenger.

Singapore begins enforcing compulsory quarantine for infected persons.

March 27, 2003 - Singapore announces that classes are canceled at all educational institutions except universities.

March 30, 2003 - Hong Kong authorities quarantine an entire building of the Amoy Gardens Apartments after over 200 people in the building come down with SARS.

The disease is traced to a Prince of Wales Hospital patient who visited his brother who lives on the seventh floor of the building. It is thought that the virus is spreading through sewage pipes in the building, but it's also possible that it is spreading through the air.

April 1, 2003 - all residents of the affected building are taken for quarantine at the Lei Yue Mun Holiday Camp and the Lady MacLehose Holiday Village.

The U.S. calls back all non-essential personnel from their consular offices in Guangzhou and Hong Kong and advises U.S. citizens against travel to the area.

April 2, 2003 - Guangdong provides reports showing 361 new cases and 9 new deaths. The virus appears in Shanghai and Beijing, and the WHO issues a travel advisory for Guangdong and Hong Kong.

April 8, 2003 - the virus appears at the Lower Ngau Tau Kok apartment complex, which is near to the Amoy Gardens complex.

April 9, 2003 - American James Salisbury dies of SARS at a hospital in Hong Kong where he had been teaching at Shenzhen Polytechnic. His son also comes down with the disease, but he survives.

April 11, 2003 - after observing its spread by air travel, the WHO issues a global health alert for SARS.

April 12, 2003 scientists at the British Columbia Cancer Agency announce that they have identified the complete genetic code of the new coronavirus, and the next day the virus receives the official name of SARS.

In Toronto, Canada, more people die of the disease, which brings the Canadian death toll to 13.

April 16, 2003 - 2 cases of SARS are identified in a village near Bangalore, India.

April 20, 2003 - officials announce 407 new cases in Beijing, China.

April 23, 2003 - all primary and secondary schools in Beijing, and several colleges at Peking University close for two weeks. WHO issues travel advisories for Beijing, Toronto, and Shanxi Province in China.

April 25, 2003 - the Taipei Municipal Hospital branch in Hoping is closed, and the Taiwanese government quarantines the hospital's 930 staff and 240 patients for two weeks.

April 26 - 27, 2003 - Chinese authorities close stores, restaurants, markets, bars, and movie theaters in Beijing in an attempt to control the spread of the virus.

April 30, 2003 - WHO lifts the SARS travel warning for Toronto.

May 3, 2003 - due to the outbreak, the FIFA Women's World Cup is moved from China to the U.S. China will host it four years later.

May 24, 2003 - 20 new cases are reported in Toronto, and five days later, 7,000 people are told by Canadian authorities to quarantine themselves.

Asian Palm Civet
Asian Palm Civet, Source: Praveenp/Wikimedia Commons

January 7, 2004 - China culls all Asian Palm Civets from markets. The civets are thought to be the reservoir for the disease after a WHO team found SARS in civet cages in a restaurant at which 2 workers came down with the disease.

The aftermath of the disease

In all, according to the CDC, 8,098 people around the world were infected with SARS, and 774 died. This is a mortality rate of about 10%.

In the U.S. 8 people were confirmed to have SARS, but there were no SARS-related deaths. All 8 people had traveled to areas where the coronavirus was occurring, which implies that there was no person-to-person transmission.

Person-to-person transmission of the Wuhan coronavirus has already been confirmed in both the U.S. and China.

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