| GENERAL
INFORMATION
8 May 2003
WHAT IS SARS?
SARS, or Severe Acute Respiratory Syndrome, is
a new type of atypical pneumonia that affects
the lungs. The World Health Organization (WHO)
and the United States Center for Disease Control
(CDC) have pointed to a previously unknown member
of the family of coronaviruses as the cause for
SARS.
WHAT ARE THE TERMINOLOGIES
I NEED TO KNOW? (Based on
WHO - May 1, 2003)
Suspect Case
1. A person presenting after
1 November 20021 with history of:
- high fever (>38oC)
AND
- cough or breathing difficulty
AND one or more of the following exposures during
the 10 days prior to onset of symptoms:
- close contact2 with a person who is a suspect
or probable case of SARS;
- history of travel, to an area with recent local
transmission of SARS
- residing in an area with recent local transmission
of SARS
2. A person with an unexplained acute respiratory
illness resulting in death after 1 November 2002,1
but on whom no autopsy has been performedAND one
or more of the following exposures during 10 days
prior to onset of
symptoms:
- close contact2 with a person who is a suspect
or probable case of SARS;
- history of travel, to an area with recent local
transmission of SARS
- residing in an area with recent local transmission
of SARS
Probable case
1. A suspect case with radiographic evidence of
infiltrates consistent with
pneumonia or respiratory distress syndrome (RDS)
on chest X-ray (CXR).
2. A suspect case of SARS that is positive for
SARS coronavirus by one or
more assays.
3. A suspect case with autopsy findings consistent
with the pathology of RDS without an identifiable
cause.
Exclusion Criteria
A case should be excluded if an alternative diagnosis
can fully explain their illness.
Reclassification
of cases
As SARS is currently a diagnosis of exclusion,
the status of a reported case may change over
time. A patient should always be managed as clinically
appropriate, regardless of their case status.
- A case initially classified as suspect or probable,
for whom an alternative diagnosis can fully explain
the illness, should be discarded after
carefully considering the possibility of co-infection.
- A suspect case who, after investigation, fulfills
the probable case definition should be classified
as “probable”.
- A suspect case with a normal CXR should be treated,
as deemed appropriate, and monitored for 7 days.
Those cases in whom recovery is inadequate should
be re-evaluated by CXR.
- Those suspect cases in whom recovery is adequate
but whose illness cannot be fully explained by
an alternative diagnosis should remain as “suspect”.
- A suspect case who dies, on whom no autopsy
is conducted, should remain classified as “suspect”.
However, if this case is identified as being part
of a chain transmission of SARS, the case should
be reclassified as
“probable”.
- If an autopsy is conducted and no pathological
evidence of RDS is found, the case should be “discarded”.
1. The surveillance period begins
on November 2002 to capture cases of a typical
pneumonia in China now recognized as SARS. International
transmission of SARS was first reported in March
2003 for cases with onset in February 2003.
2. Close contact: having cared
for, lived with, or had direct contact with respiratory
secretions or body fluids of a suspect or probable
case of SARS.
next
page>>
|
