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This is an official
CDC HEALTH UPDATE

Distributed via Health Alert Network
Friday, April 18, 2003, 18:06 EDT (6:06 PM EDT)
CDCHAN-00136-03-04-18-UPD-N

Updated Interim U.S Case Definition of Severe Acute Respiratory Syndrome (SARS)

The Centers for Disease Control and Prevention (CDC) has made two modifications to the U.S. case definition of SARS as follows:

  1. CDC has added Toronto, Canada to the list of areas with documented or suspected community transmission of SARS. This is in response to reports that SARS has resulted in serious illness among some members of the Bukas-Loob Sa Diyos (BLD) Covenant Community who attended a large gathering in Toronto on March 28 - 29, 2003. According to Public health officials in the City of Toronto SARS has been diagnosed among members of their households as well as other close contacts.

BLD has multiple outreach areas throughout the United States (Reno, NV, Seattle, WA, Oakland, CA, Albany, Trenton, NJ, Long Island, NY, Los Angeles, CA and the metro DC (Maryland /Virginia/Washington DC) area. Therefore, state and local health officials are advised to be alert for cases of SARS among persons who traveled to Toronto and participated in events sponsored by the BLD Community. Such cases should be reported to CDC. Toronto health officials are continuing to compile a complete listing of attendees who attended formal and informal events organized for the BLD Community.

Public health officials in Pennsylvania have notified CDC of a probable case of SARS in a resident who traveled to Toronto and attended BLD Community events during March 28 – 30. This person was hospitalized with pneumonia on April 14; a serum sample was obtained and has tested positive for coronavirus antibody. CDC is working with public health officials in Pennsylvania to conduct a comprehensive investigation including the notification of all potential contacts of the infected Pennsylvania resident.

2. U.S. cases of SARS will now be classified as either suspect or probable as outlined in the attached updated interim CDC case definition. Local and state health departments are requested to continue reporting all (i.e., both suspect and probable) cases of SARS. Although CDC will continue to report both suspect and probable cases to WHO, we anticipate that WHO will include only probable cases in its daily case report.

The Updated Interim U.S. SARS Case Definition is as follows:

Suspect Case

Respiratory illness of unknown etiology with onset since February 1, 2003, and the following criteria:

· Measured temperature greater than 100.4 °F (greater than 38° C) AND

· One or more clinical findings of respiratory illness (e.g. cough, shortness of breath, difficulty breathing, hypoxia, or radiographic findings of either pneumonia or acute respiratory distress syndrome) AND

· Travel within 10 days of onset of symptoms to an area with documented or suspected community transmission of SARS (see list below; excludes areas with secondary cases limited to healthcare workers or direct household contacts) OR

Close contact* within 10 days of onset of symptoms with a person known to be a suspect SARS case.

Probable Case

A suspect case with one of the following:

· Radiographic evidence of pneumonia or respiratory distress syndrome

· Autopsy findings consistent with respiratory distress syndrome without an identifiable cause

Travel includes transit in an airport in an area with documented or suspected community transmission of SARS

Areas with documented or suspected community transmission of SARS: Peoples' Republic of China (i.e., mainland China and Hong Kong Special Administrative Region); Hanoi, Vietnam; Singapore; and Toronto, Canada.

*Close contact is defined as having cared for, having lived with, or having direct contact with respiratory secretions and/or body fluids of a patient known to be suspect SARS case.

This updated information will be available at http://www.cdc.gov

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

DEPARTMENT OF HEALTH AND HUMAN SERVICES


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