Severe Acute Respiratory Syndrome (SARS) Update: Wednesday, March 19

March 19, 2003

Craig Sterritt, Editor, Medscape Infectious Diseases

Today's Leading News:

A preliminary report from scientists in Hong Kong suggests that severe acute respiratory syndrome (SARS) may be caused by a member of the paramyxoviridae family of viruses. Paramyoxoviruses are the cause of measles, mumps, and para-influenza, a common respiratory illness. Efforts to confirm this finding are underway.

Summary of Events:

On March 15, 2003, the World Health Organization (WHO) issues a global alert of a multicountry outbreak of SARS, an atypical pneumonia of as yet unidentified etiology. According to WHO, the syndrome was first recognized on February 26, 2003, in Hanoi, Vietnam.

According to WHO, as of March 18, 2003, isolated cases of suspected SARS continue to be reported in new countries, including Canada, China, Taiwan, Germany, Hong Kong, Singapore, Slovenia, Thailand, Vietnam, and the United Kingdom. A total of 219 cases and 4 deaths have been reported to date.

The U.S. Centers for Disease Control and Prevention has also reported 9 suspected cases in the United States (down from 14 cases on March 15).

SARS appears to be transmitted by close contact only, most probably via airborne droplets; the majority of new cases have been reported in healthcare workers and family members of affected persons. At the present time, there is no evidence of community spread of the disease.

CDC Interim Case Definition:

According to CDC, SARS should be suspected in persons presenting with:

One or more signs or symptoms of respiratory illness (cough, shortness of breath, difficulty breathing, hypoxia) or radiographic findings of pneumonia or acute respiratory distress syndrome, and

Fever >38° C (100.4° F), and

Close contact within 10 days of onset of symptoms with a person under investigation or suspected of having SARS, or

Travel within 10 days of onset of symptoms to an area with documented transmission of SARS: Hong Kong and Guangdong province, China; Hanoi, Vietnam; Singapore; Toronto, Ontario, Canada.

Key Resources:

WHO has established a SARS information page, which provides global and regional details, including the number of suspected and confirmed cases and deaths:

The U.S. Centers for Disease Control and Prevention has also set up an information page that provides an interim case definition, and infection control, diagnosis, and management recommendations, as well as other advisories:


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