Severe acute respiratory syndrome (SARS)

Severe acute respiratory syndrome (SARS) is a respiratory illness that has recently been reported in Asia, North America, and Europe. This fact sheet provides basic information about the disease and what is being done to combat its spread. To find out more about SARS, go to www.cdc.gov/ncidod/sars/ and www.who.int/csr/sars/en/ . The Web sites are updated daily.

Symptoms of SARS
In general, SARS begins with a fever greater than 100.4°F [>38.0°C]. Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms. After 2 to 7 days, SARS patients may develop a dry cough and have trouble breathing.

How SARS spreads
The primary way that SARS appears to spread is by close person-to-person contact. Most cases of SARS have involved people who cared for or lived with someone with SARS, or had direct contact with infectious material (for example, respiratory secretions) from a person who has SARS. Potential ways in which SARS can be spread include touching the skin of other people or objects that are contaminated with infectious droplets and then touching your eye(s), nose, or mouth. This can happen when someone who is sick with SARS coughs or sneezes droplets onto themselves, other people, or nearby surfaces. It also is possible that SARS can be spread more broadly through the air or by other ways that are currently not known.

Who is at risk for SARS
Most of the U.S. cases of SARS have occurred among travelers returning to the United States from other parts of the world with SARS. There have been very few cases as a result of spread to close contacts such as family members and health care workers. Currently, there is no evidence that SARS is spreading more widely in the community in the United States.

Possible cause of SARS
Scientists at CDC and other laboratories have detected a previously unrecognized coronavirus in patients with SARS. The new coronavirus is the leading hypothesis for the cause of SARS.

What CDC is doing about SARS
CDC is working closely with the World Health Organization (WHO) and other partners in a global effort to address the SARS outbreak. For its part, CDC has taken the following actions:

CDC RECOMMENDATIONS
CDC has issued recommendations and guidelines for people who may be affected by this outbreak.

For individuals considering travel to areas with SARS:
CDC has issued two types of notices to travelers: advisories and alerts. A travel advisory recommends that nonessential travel be deferred; a travel alert does not advise against travel, but informs travelers of a health concern and provides advice about specific precautions. CDC updates information on its website on the travel status of other areas with SARS as the situation evolves.

For individuals who must travel to an area with SARS:
CDC advises that travelers in an area with SARS should wash their hands frequently to protect against SARS infection. In addition, CDC advises that travelers may wish to avoid close contact with large numbers of people as much as possible to minimize the possibility of infection. CDC does not recommend the routine use of masks or other personal protective equipment while in public areas. For more information, read the Interim Guidelines about Severe Acute Respiratory Syndrome (SARS) for Persons Traveling to Areas with SARS.

For individuals who think they might have SARS:
People with symptoms of SARS (fever greater than 100.4°F [>38.0°C] accompanied by a cough and/or difficulty breathing) should consult a health-care provider. To help the health-care provider make a diagnosis, tell them about any recent travel to places where SARS has been reported or whether there was contact with someone who had these symptoms.

For family members caring for someone with SARS:
CDC has developed interim infection control recommendations for patients with suspected SARS in the household. These basic precautions should be followed for 10 days after respiratory symptoms and fever are gone. During that time, SARS patients are asked to limit interactions outside the home (not go to work, school, or other public areas).

For health-care workers:
Transmission of SARS to health-care workers appears to have occurred after close contact with sick people before recommended infection control precautions were put into use. CDC has issued interim infection control recommendations for health-care settings as well as for the management of exposures to SARS in health-care and other institutional settings.

Are there any travel restrictions related to SARS?
At this time there are no travel restrictions in place that are directly related to SARS. However, a CDC travel advisory recommends that individuals who are planning nonessential or elective travel to China, Hong Kong and Taiwan may wish to postpone their trip until further notice. CDC has also issued a travel alert for Singapore to recommend that U.S. travelers observe precautions to safeguard their health. On May 15, CDC lifted the travel alert for Hanoi, Vietnam; on May 20, CDC lifted the alert for Toronto, Ontario, Canada. For additional information and updates about these travel notices, check the SARS information for travelers web site, which will be updated as necessary or check the Department of State web site for a list of DOS travel warnings related to SARS.

What if I must travel to a country where there is community spread of SARS? What precautions can I take?
As with all infectious illnesses, the first line of defense is careful hand hygiene. As a general rule, it is good practice to wash hands frequently with soap and water; if hands are not visibly soiled, alcohol-based hand rubs may be used as an alternative.

To minimize the possibility of infection, you may wish to avoid close contact with large numbers of people as much as possible. CDC does not recommend the routine use of masks while in public areas. For more information, visit CDC’s website and specifically read the Interim Guidelines about Severe Acute Respiratory Syndrome (SARS) for Persons Traveling to Areas with SARS.

What should I do if I have recently traveled to a country where cases of SARS have been reported?
You should monitor your own health for 10 days following your return. If you become ill with a fever of more than 100.4°F [>38.0°C] that is accompanied by a cough or difficulty breathing or that progresses to a cough and/or difficulty breathing, you should consult a health-care provider. To help your health-care provider make a diagnosis, tell him or her about any recent travel to regions where cases of SARS have been reported and whether you were in contact with someone who had these symptoms.

What is the difference between a “travel alert” and a “travel advisory” issued by CDC?
CDC issues two types of notices to travelers depending on specific situations: travel alerts and travel advisories. Travel alerts inform travelers of a health concern in a particular area and provide advice about specific precautions that should be taken. A travel advisory notifies travelers of potentially more serious situations and advises that non-essential travel be postponed.

What information about SARS is being provided to people traveling on ships?
SARS information contained on CDC's health alert cards is being provided by the major shipping associations and the International Council of Cruise Lines to people traveling on cargo ships and cruise ships at U.S. ports. Inspectors also are boarding ships if a passenger or crew member has been reported with symptoms matching the case definition of SARS.

What are CDC's quarantine officials doing to prevent and control the spread of SARS?
CDC's quarantine inspectors or their designees are distributing health alert cards to air passengers returning in airplanes either directly or indirectly to the United States from China, Hong Kong, Taiwan and Singapore. The notices inform travelers about SARS and its symptoms and asks them to monitor their health for 10 days and to see a doctor if they get a fever with a cough or have difficulty breathing. CDC distributes more than 20,000 health alert notices each day to air travelers returning from the affected regions. Inspectors also are boarding airplanes if a traveler has been reported with symptoms matching the case definition of SARS.

WHO has recommended procedures for pre-departure screening of airline passengers from some countries for respiratory illnesses or other symptoms of SARS.

What is the risk to individuals who may have shared a plane or boat trip with a suspected SARS patient?
Cases of SARS continue to be reported primarily among people who have had direct close contact with an infected person, such as those sharing a household with a SARS patient and health-care workers who did not use infection control procedures while attending to a SARS patient. SARS also has occurred among air travelers, primarily travelers to and from Hong Kong, Hanoi, Singapore, and mainland China.

CDC is requesting locating information from travelers who are on flights with people suspected of having SARS. CDC, with the help of state and local health authorities, is attempting to follow-up with these travelers for 14 days to make sure no one develops symptoms consistent with SARS.

If I'm on board an airplane or ship with someone suspected of having SARS, will I be allowed to continue to my destination?
CDC does not currently recommend that the onward travel of healthy passengers be restricted in the event that a passenger or crew member suspected of having SARS is removed from the ship or airplane by port health authorities. All passengers and crew members may be advised by port health authorities to seek medical attention if they develop SARS symptoms.

Source: http://www.cdc.gov/ncidod/sars/basics.htm

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