Severe Acute Respiratory Syndrome - Worldwide:alert

[Dave Farber <dave () farber net>]

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Date: Sat, 15 Mar 2003 10:05:28 -0500 (EST)
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Subject: PRO/ALL> Severe Acute Respiratory Syndrome - Worldwide:alert


SEVERE ACUTE RESPIRATORY SYNDROME - WORLDWIDE:ALERT
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[We are changing the name of this threat to Severe Acute Respiratory
Syndrome - Worldwide to reflect the appearance of cases now outside of East
Asia, and in keeping with the name of they syndrome as defined by WHO --
"Severe Acute Respiratory Syndrome" (SARS).  In addition, given the
severity of this situation, we have chosen to post this alert to ALL
ProMED-mail subscribers, irrespective of specialty list preferences to
assist in a further, widespread dissemination of this alert information. -
Mod.MPP]


Date: 15 Mar 2003
From: ProMED-mail <promed () promedmail org>
Source:  WHO Press release
<http://www.who.int/mediacentre/releases/2003/pr23/en/>


World Health Organization issues emergency travel advisory
Severe Acute Respiratory Syndrome (SARS) Spreads Worldwide
----------------------
15 March 2003 | GENEVA -- During the past week, WHO has received reports of
more than 150 new suspected cases of Severe Acute Respiratory Syndrome
(SARS), an atypical pneumonia for which cause has not yet been determined.
Reports to date have been received from Canada, China, Hong Kong Special
Administrative Region of China, Indonesia, Philippines, Singapore,
Thailand, and Viet Nam. Early today, an ill passenger and companions who
travelled from New York, United States, and who landed in Frankfurt,
Germany were removed from their flight and taken to hospital isolation.

Due to the spread of SARS to several countries in a short period of time,
the World Health Organization today has issued emergency guidance for
travellers and airlines.

"This syndrome, SARS, is now a worldwide health threat," said Dr. Gro
Harlem Brundtland, Director General of the World Health Organization. "The
world needs to work together to find its cause, cure the sick, and stop its
spread."

There is presently no recommendation for people to restrict travel to any
destination. However in response to enquiries from governments, airlines,
physicians and travellers, WHO is now offering guidance for travellers,
airline crew and airlines. The exact nature of the infection is still under
investigation and this guidance is based on the early information available
to WHO.

TRAVELLERS INCLUDING AIRLINE CREW: All travellers should be aware of main
symptoms and signs of SARS which include:

? high fever (greater than 38 C)

AND

? one or more respiratory symptoms including cough, shortness of breath,
difficulty breathing

AND one or more of the following:

? close contact* with a person who has been diagnosed with SARS

? recent history of travel to areas reporting cases of SARS.

In the unlikely event of a traveller experiencing this combination of
symptoms they should seek medical attention and ensure that information
about their recent travel is passed on to the health care staff. Any
traveller who develops these symptoms is advised not to undertake further
travel until they have recovered.

AIRLINES: Should a passenger or crew member who meets the criteria above
travel on a flight, the aircraft should alert the destination airport. On
arrival the sick passenger should be referred to airport health authorities
for assessment and management. The aircraft passengers and crew should be
informed of the person's status as a suspect case of SARS. The passengers
and crew should provide all contact details for the subsequent 14 days to
the airport health authorities. There are currently no indications to
restrict the onward travel of healthy passengers, but all passengers and
crew should be advised to seek medical attention if they develop the
symptoms highlighted above. There is currently no indication to provide
passengers and crew with any medication or investigation unless they become
ill.

In the absence of specific information regarding the nature of the organism
causing this illness, specific measures to be applied to the aircraft
cannot be recommended. As a general precaution the aircraft may be
disinfected in the manner described in the WHO Guide to Hygiene and
Sanitation in Aviation.

*****

As more information has become available, WHO-recommended SARS case
definitions have been revised as follows:

Suspect Case

A person presenting after 1 Feb 2003 with history of :

? high fever (greater than 38 C)

AND

? one or more respiratory symptoms including cough, shortness of breath,
difficulty breathing

AND one or more of the following:

? close contact* with a person who has been diagnosed with SARS

? recent history of travel to areas reporting cases of SARS

Probable Case

A suspect case with chest x-ray findings of pneumonia or Respiratory
Distress Syndrome

OR

A person with an unexplained respiratory illness resulting in death, with
an autopsy examination demonstrating the pathology of Respiratory Distress
Syndrome without an identifiable cause.

Comments

In addition to fever and respiratory symptoms, SARS may be associated with
other symptoms including: headache, muscular stiffness, loss of appetite,
malaise, confusion, rash, and diarrhea.

****

Until more is known about the cause of these outbreaks, WHO recommends that
patients with SARS be isolated with barrier nursing techniques and treated
as clinically indicated. At the same time, WHO recommends that any suspect
cases be reported to national health authorities.

WHO is in close communication with all national authorities and has also
offered epidemiological, laboratory and clinical support. WHO is working
with national authorities to ensure appropriate investigation, reporting
and containment of these outbreaks.

*Close contact means having cared for, having lived with, or having had
direct contact with respiratory secretions and body fluids of a person with
SARS.

For more information contact:

--
Dick Thompson - Communication Officer
Communicable Disease Prevention, Control and Eradication
WHO, Geneva
Telephone: (+41 22) 791 26 84
<thompsond () who int>

[see also:
Acute respiratory syndrome - Canada (Ontario) 20030314.0631
Acute respiratory syndrome - East Asia 20030314.0630
Acute respiratory syndrome - China (HK), VietNam (03) 20030313.0624
Acute respiratory syndrome - China (Hong Kong), Vietnam (02) 20030313.0623
Acute respiratory syndrome - China (Hong Kong), Vietnam 20030312.0602
Undiagnosed illness - Vietnam (Hanoi): RFI 20030311.0595
Influenza, H5N1 human case - China (Hong Kong) (05) 20030228.0500
Pneumonia - China (Guangdong) (07) 20030221.0452
Pneumonia - China (Guangdong) (02) 20030211.0369
Pneumonia - China (Guangdong) (03) 20030214.0390
Pneumonia - China (Guangdong) (04) 20030219.0427
Pneumonia - China (Guangdong) (05) 20030220.0446
Pneumonia - China (Guangdong) (06) 20030220.0447
Pneumonia - China (Guangdong): RFI 20030210.0357
Avian influenza - China (Hong Kong) (03) 20030204.0300]
.................................mpp


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