21 March 2003
Cases of Fast-Moving Flu Still Rising
(WHO 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.
(end text)
(Distributed by the Office of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)
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