In Hanoi, Vietnam and Hong Kong, the appearance of SARS has had an impact on medical facilities, due to the closing and/or quarantine of hospitals and the spread of the disease to health care workers. Medical evacuation of SARS patients currently is not available by commercial carrier; additionally, the number of countries willing to accept SARS patients is very limited.

In addition to Vietnam, Hong Kong, mainland China and Singapore, the CDC has received reports of outbreaks of SARS elsewhere in Asia and in Europe and North America, including Canada, the United States, Thailand, Germany, and Switzerland. Most cases appear to involve health-care workers caring for SARS patients and close family contacts. CDC is working closely with WHO and country partners to define the origin of this infection, to track patterns of its transmission, and to determine effective strategies for its control and prevention. Local health authorities should be notified of all suspected cases of SARS.

On March 26, the Government of Ontario declared Severe Acute Respiratory Syndrome (SARS) to be a provincial emergency. The declaration follows the deaths of three individuals from SARS and the apparent manifestations of the disease in more than 50 individuals across the province. Canada is attempting to limit the spread of the outbreak by screening all passengers at airports for SARS symptoms. Health Canada sent staff to Pearson and Vancouver International Airports to help monitor passengers arriving on direct flights from affected areas for flu-like symptoms and to assist those who appear to be ill. Two major hospitals have been closed or restricted in the past 24-48 hours; other hospitals may also be affected. Ontario hospitals are operating under severe measures such as limiting access, restricting patient transfers between hospitals and requesting that those at risk of developing SARS place themselves under voluntary quarantine in their homes.

The CDC has identified the following three criteria, which must ALL be present, by which a potential SARS case may be identified, for those with the onset of illness after February 1, 2003:

--Fever greater than 38° C (100.4°F), AND

--One or more signs or symptoms of respiratory illness including cough, shortness of breath, difficulty breathing, hypoxia (low oxygen in the blood), x-ray findings of pneumonia, or respiratory distress, AND

-- One or more of the following within 2-7 days of the onset of symptoms: Travel to mainland China, Hong Kong, Singapore, or Vietnam; and/or close contact*, with a person who has been infected with SARS (*close contact means having cared for, lived with, or having had direct contact with respiratory secretions (such as coughs and sneezes) and body fluids of a person with SARS).

The incubation period between exposure to infection and the development of symptoms appears to range from 2-7 days. For more specific information regarding case definition updates and empiric treatment clinicians should consult and monitor the CDC’s and WHO’s web sites.

Currently, prevention of new cases is based on individuals avoiding close contact with SARS-infected persons, as described above. Persons matching the case description for SARS should be promptly evaluated by medical personnel and, if indicated, admitted to a hospital. Persons suspected of having SARS should limit their interactions outside hospital settings.

Contact Information for the CDC:

Public Inquiries:
English (888) 246-2675
Spanish (888) 246-2857
TTY (866) 874-2646
Mon-Fri 8am-11pm EST
Sat-Sun 10am-8pm EST

Department of State travel information and publications are available at Internet address: http://travel.state.gov. U.S. travelers may hear recorded information by calling the Department of State in Washington, D.C. at 202-647-5225 from their touchtone telephone, or receive information by automated telefax by dialing 202-647-3000 from their fax machine.