*EPF520 03/21/2003
Text: Cases of Fast-Moving Flu Still Rising
(World Health Org. updates case numbers; CDC answers questions) (1660)

The international medical network tracking a fast-moving flu-like illness reports 350 suspected and probable cases of Severe Acute Respiratory Syndrome (SARS) as of March 21.

Issuing daily updates on the progress of the disease, the World Health Organization (WHO) reports that likely cases have been spotted in 13 countries. So far 10 deaths are attributed to the illness, which begins with a high fever and respiratory problems such as a cough or breathing difficulties. SARS appears to have originated in East Asia.

The U.S. Centers for Disease control and Prevention (CDC) is an active member of the international organizations attempting to find the answer to this medical mystery.

Further information is available at http://www.who.int/csr/sars/en/ and http://www.cdc.gov/sars/en

CDC issued a document March 20 answering basic information about SARS. Following is the text:

(begin text)

U.S. Centers for Disease Control and Prevention
Frequently Asked Questions: Severe Acute Respiratory Syndrome (SARS)

The Illness

What is Severe Acute Respiratory Syndrome (SARS)?

SARS is a respiratory illness of unknown cause that has recently been reported in a number of countries. For additional information, check the World Health Organization's (WHO) website at www.who.int/en or visit CDC's website at www.cdc.gov/ncidod/sars.

What are the symptoms and signs of Severe Acute Respiratory Syndrome (SARS)?

According to the World Health Organization (WHO) the main symptoms and signs of SARS include a fever greater than 38 degrees Celsius (100.4 degrees Fahrenheit) and cough, shortness of breath, or difficulty breathing.

What is causing SARS? Is it something new?

The cause of SARS is not known at this time. Researchers at CDC and around the world are exploring every possibility to find the cause of SARS. At this early stage of the investigation, it seems more likely that SARS is caused by an organism that we have less experience with rather than a commonly occurring, known organism.

Recent reports from Germany and Hong Kong suggest that the cause of SARS may be a paramyxovirus. What kind of virus is this? Is it the cause of SARS?

Paramyxovirus is a family of viruses that include many common, well-known viruses such as viruses that cause respiratory infections and childhood illnesses including mumps, measles and croup. The Paramyxovirus family also includes more rare and recently recognized viruses such as Hendra virus and Nipah virus that caused an outbreak of severe disease in Malaysia a few years ago. When nose and throat swab specimens from a small number of SARS patients were examined under an electron microscope, researchers in Germany and Hong Kong reported seeing a particle that looked like a paramyxovirus. These are preliminary findings and at this time, it's not certain that a paramyxovirus is the cause of SARS. Some of the paramyxoviruses that cause respiratory infections are widespread, especially during the winter season, so it is not unexpected to see them in an upper respiratory specimen.

What medical treatment is recommended for patients with SARS?

Because the cause of SARS has not yet been determined, no specific treatment recommendations can be made at this time. CDC currently recommends that patients with SARS receive the same treatment that would be used for any patient with serious community acquired atypical pneumonia of unknown cause. For more information on SARS visit http://www.cdc.gov/ncidod/sars/ and see "Interim Information and Recommendations for Health Care Providers."

If I were exposed to Severe Acute Respiratory Syndrome (SARS), how long would it take for me to become sick?

Initial information from the investigations in Hong Kong and Hanoi indicates that the incubation period for SARS is between 2 and 7 days on average.

How many cases of Severe Acute Respiratory Syndrome (SARS) have been reported so far?

Visit www.who.int/en for daily updates on case reports.

Are there any reports of people having contracted SARS in the US?

Visit www.who.int/en for daily updates on case reports.

How many people have died from SARS?

Visit www.who.int/en for a daily update of SARS cases and deaths.

How does the disease (SARS) spread?

It is difficult this early in the investigation to say exactly how SARS spreads. Close contacts of cases, including health care workers and family members, have developed similar illnesses. Examples of close contact include having cared for, lived with, or had direct contact with respiratory secretions and body fluids of people with SARS.

Can SARS be transmitted in schools or other public settings?

Available data indicate that transmission seems to require direct or close contact. Cases have occurred among health care workers caring for ill patients and close family contacts.

Can SARS be transmitted through contact with an inanimate object?

What has been seen so far is a pattern of transmission related to direct close contact with a person with SARS. In areas where person-to-person transmission has been documented, cases have occurred almost exclusively in health care workers or in persons in very close contact with patients, such as family members. Currently, available data indicate that transmission of the infectious agent requires direct and close contact. There is no evidence to date of transmission following casual contact or contact with inanimate objects.

Is SARS an outbreak of the Avian flu?

There is no evidence at this time that the current cases of SARS are related to Avian flu.

Who is most at risk of contracting SARS?

At this time, cases appear to primarily involve health care workers caring for patients with SARS and close family contacts.

What is known about the 7 cases of SARS that stayed in the same hotel in Hong Kong?

On March 19, 2003, the Hong Kong Health Department reported that at least 7 of the initial patients stayed or visited a hotel in Kowloon during the month of February. The significance of this finding is being explored.

CDC Activities

What is CDC doing to combat this health threat?

CDC has activated its Emergency Operations Center (EOC); deployed CDC scientists to assist the World Health Organization (WHO) in the global investigation; is distributing health alert notices to travelers who may have been exposed to cases of SARS; is assisting state and local health departments in investigating possible cases of SARS in the United States; and is analyzing laboratory specimens to identify a cause for SARS. As always, CDC is committed to communicating regularly and effectively with public health professionals, elected leaders, clinicians and the general public.

Which travelers are being given health alerts?

Travelers returning from Hong Kong, Guangdong Province, People's Republic of China and Hanoi, Vietnam are being given printed information (health alert notices) that they may have been exposed to cases of severe acute respiratory syndrome (SARS). Travelers are advised to monitor their health for at least seven days, to contact their physicians if they become ill with a fever accompanied by a cough or difficulty in breathing, and to inform their physician of their recent travel. CDC quarantine officers or their designees are providing information to returning travelers at all U.S. airports with direct flights from Hong Kong (Chicago, Los Angeles, Newark, New York City, San Francisco, Guam, and Anchorage). This coverage is being expanded to include travelers returning on commercial flights that have connecting service from the three affected areas of Southeast Asia. No commercial flights return directly to the United States from Hanoi, Vietnam or Goungdong Province China.

CDC Recommendations

What should I do if I think I have SARS?

If you are ill with fever accompanied by cough or difficulty breathing, you should consult a health care provider. To help your health care provider make a diagnosis, tell them 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 should I do if I have recently traveled to a country where cases of SARS have been reported?

If you become ill with fever, accompanied by cough or difficulty in breathing, you should consult a health care provider and tell them about your recent travel.

What has CDC recommended to prevent transmission of SARS?

CDC has developed interim infection control recommendations for patients with suspected SARS in the health care and community setting. Visit www.cdc.gov/ncidod/sars and review CDC Interim Information and Recommendation for Health Care Providers and CDC Interim Guidance for State and Local Health Departments

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 individuals who are planning nonessential or elective travel to parts of China (Hong Kong, SAR, and Guangdong Province) and Hanoi, Vietnam may wish to postpone their trip until further notice. For additional information about travel advisories, check www.cdc.gov/travel, which will be updated as necessary.

Should potential SARS patients be quarantined?

CDC has developed guidelines that address infection control precautions in the health care and community setting. These can be found at CDC's website at http://www.cdc.gov/ncidod/sars/ and will be updated as new information about SARS becomes available.

How should a suspected SARS patient be transported to ensure infection control?

To minimize the potential of transmission outside the hospital, case patients should limit interactions outside the home until more is known about transmission of SARS. Placing a surgical mask on case patients in ambulatory health care settings, during transport, and during contact with others at home is recommended.

Other

Is there any reason to think SARS is or is not related to terrorism?

Information currently available about SARS indicates that people who appear to be most at risk are either health care workers taking care of sick people or family members or household contacts of those who are infected with SARS. That pattern of transmission is what would typically be expected in a contagious respiratory or flu-like illness.

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(Distributed by the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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