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This was an enormously consequential factor in the SARS episode—not just lucky but salvational. With influenza and many other diseases the order is reversed, high infectivity preceding symptoms by a matter of days. A perverse pattern: the danger, then the warning. That probably helped account for the scale of worldwide misery and death during the 1918–1919 influenza: high infectivity among cases before they experienced the most obvious and debilitating stages of illness.
Spillover: Animal Infections and the Next Human Pandemic
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