'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 travellers of a health concern and provides advice about specific precautions.

For individuals who must travel to an area with SARS:

CDC advices that travelers in an area with SARS should wash their hands frequently to protect against SARS infection. In addition, CDC advices that travels 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 individuals who think they might have SARS:

People with symptoms of SARS (fever greater than 100.4o F (>38o C) accompanied by a cough and / or difficulty in breathing) should consult a health-care provider. To help the –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:

The 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. Clinicians evaluating suspected cases should use standard precautions (Eg. - hand hygiene) together with airborne (Eg - N -  95 repirator) and contact (Eg - gloves and gowns) precautions. The suspected cases or travelers coming from Endemic areas should be isolated for a period of 3 weeks.

Management of Symptomatic, Exposed Visitors:

Close contact (e.g. family members) of SARS patients are at risk for infection. Close contacts with either fever or respirator symptoms should not be allowed to enter the health-care facility as visitors and should be educated about this policy. A system for screening SARS close contacts who are visitors to the facility6 for fever or respiratory symptoms should be in place. Health-care facilities should educate all visitors about use of infection control precautions when visiting SARS patients and their responsibility for adherence to them.

References:

1)      Centers for Disease Control and Prevention. Outbreak of severe acute  respiratory syndrome worldwide, 2003.

2)      World Health Organisation. Who issues emergency travel advisory: severe acute respiratory syndrome (SARS) spreads worldwide. (accessed March 15, 2003). Available from:
URL: http:// www.who.int/mediacentre/release/2003/pr23/en

3)      Poutanen SM, Low DE, Henry B, Finkelsstein S, Rose D,Green k, et al. identification  of sever acute respiratory syndrome in CANADA.  N Engl  J Med 2003 Apr 10; (epub ahead of print).

4)      Tsang KW, Ho, PL, Ooi GC, Yee Wk, Wang T, Chan-Yeung M, et al. A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003 Apr 11.

5)      Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. a Major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003 Apr 14.

6)      JAPI - April 2003 (Vol.51)

7)      BMJ -  April 2003.