The Delaware Division of Public Health (DPH) continues to investigate reports of SARS in Delaware, but none have met the clinical and epidemiologic case definition. This Advisory provides three updates from the Centers for Disease Prevention and Control (CDC).
Thousands of people arrive in the United States from areas where SARS outbreaks are occurring to participate in gatherings such as academic courses, business meetings, or sporting events. Guidance is needed to provide a consistent, rational approach to SARS prevention without unnecessarily stigmatizing these groups or interfering with collegial pursuits, commerce, and other important activities.
At this time, CDC does not recommend canceling or postponing classes, meetings or other gatherings that will include persons traveling to the United States from areas with SARS. CDC also does not recommend quarantine of persons arriving from areas with SARS. [Quarantine is the restriction of activities of well persons.]
If organization representatives become aware of a person from an area with SARS who develops fever or respiratory symptoms, the following steps should be taken:
The full text of this advisory, including additional steps that organizations can take to address SARS concerns, can be found at http://www.cdc.gov/ncidod/sars/hostingarrivals.htm.
In this country, only a small number of suspected or probable cases of SARS have been detected among exposed healthcare personnel and household contacts of SARS patients. Casual contact with SARS patients at schools, other institutions, or in non-healthcare work settings has not resulted in documented transmission in the United States. Persons returning from areas with SARS should be vigilant for fever (i.e., measure temperature twice a day) and respiratory symptoms (cough, shortness of breath, or difficulty in breathing) over the 10 days after departure. These persons need not limit their activities and should not be excluded from work, meetings, or other public areas, unless fever or respiratory symptoms develop. Persons returning from areas with SARS should notify their healthcare provider immediately if fever OR respiratory symptoms develop within 10 days after departure. The healthcare provider should be contacted in advance so arrangements can be made, if necessary, for infection control measures to prevent transmission to others in the healthcare setting.
The full text of this advisory can be found at http://www.cdc.gov/ncidod/sars/business_guidelines.htm.
The previous CDC SARS case definition (published April 30, 2003) has been updated as follows:
|Area||First date of illness onset for inclusion as reported case ‡||Last date of illness onset for inclusion as reported case †|
|China (mainland)||November 1, 2002||Ongoing|
|Hong Kong||February 1, 2003||Ongoing|
|Hanoi, Vietnam||February 1, 2003||May 25, 2003|
|Singapore||February 1, 2003||Ongoing|
|Toronto, Canada||April 23, 2003||May 30, 2003|
|Taiwan||May 1, 2003||Ongoing|
‡ The WHO has specified that the surveillance period for China should begin on November 1; the first recognized cases in Hong Kong, Singapore and Hanoi (Vietnam) had onset in February 2003. The dates for Toronto and Taiwan are linked to CDC’s issuance of travel recommendations.
† The last date for illness onset is 10 days (i.e., one incubation period) after removal of a CDC travel alert. The case patient’s travel should have occurred on or before the last date the travel alert was in place.
The full text of the updated case definition can be found at http://www.cdc.gov/ncidod/sars/casedefinition.htm.