SARS Guidelines

Severe acute respiratory syndrome (SARS) is a respiratory illness that has recently been reported in Asia, North America, and Europe. This fact sheet describes the disease and important guidelines for preventing the spread of SARS.

Symptoms of SARS
In general, SARS begins with a fever greater than 100.4°F [>38.0°C]. Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms. After 2 to 7 days, SARS patients may develop a dry cough and have trouble breathing.

How SARS spreads
The primary way that SARS appears to spread is by close person-to-person contact. Most cases of SARS have involved people who cared for or lived with someone with SARS, or had direct contact with infectious material (for example, respiratory secretions) from a person who has SARS. Potential ways in which SARS can be spread include touching the skin of other people or objects that are contaminated with infectious droplets and then touching your eye(s), nose, or mouth. This can happen when someone who is sick with SARS coughs or sneezes droplets onto themselves, other people, or nearby surfaces. It also is possible that SARS can be spread more broadly through the air or by other ways that are currently not known.

Who is at risk for SARS
Cases of SARS continue to be reported mainly among people who have had direct close contact with an infected person, such as those sharing a household with a SARS patient and healthcare workers who did not use infection control procedures while taking care of a SARS patient. In the United States, there is no indication of community spread at this time. CDC continues to monitor this situation very closely.

What you should do to protect yourself
CDC has issued interim guidelines for patients with suspected SARS in the healthcare setting and in households. These guidelines may change as we learn more about SARS. If you get sick with the symptoms described above and have been in close contact with someone who might have SARS, see your healthcare provider and follow the guidelines below.

GUIDELINES

If you think you (or someone in your family) might have SARS, you should:

Consult a health care provider as soon as possible.
Cover your mouth and nose with tissue when coughing or sneezing. If you have a surgical mask, wear it during close contact with other people. A mask can reduce the number of droplets coughed into the air.

If you have SARS and are being cared for at home, you should:

Follow the instructions given by your health care provider.
Limit your activities outside the home until 10 days after the resolution of the fever, provided respiratory symptoms are absent or improving. . For example, do not go to work, school, or public areas.
Wash your hands often and well, especially after contact with body fluids such as after blowing your nose or using the bathroom.
Cover your mouth and nose with tissue when you sneeze or cough.
If possible, wear a surgical mask when around other people in your home. If you can't wear a mask, the members of your household should wear one when they are around you.
Don't share silverware, towels, or bedding with anyone in your home until these items have been washed with soap and hot water.
Clean surfaces (counter or tabletops, door knobs, bathroom fixtures, etc.) that have been contaminated by body fluids (sweat, saliva, mucous, or even vomit or urine) from the SARS patient with a household disinfectant used according to the manufacturer's instructions. Wear disposable gloves during all cleaning activities. Throw these out when you are done. Do not reuse them.
Follow these instructions for 10 days after your fever and respiratory symptoms have gone away.

If you are caring for someone at home who has SARS, you should:

Be sure that the person with SARS has seen a healthcare provider and is following instructions for medication and care.
Be sure that all members of your household are washing their hands frequently with soap and hot water or using alcohol-based hand wash.
Wear disposable gloves if you have direct contact with body fluids of a SARS patient. However, the wearing of gloves is not a substitute for good hand hygiene. After contact with body fluids of a SARS patient, remove the gloves, throw them out, and wash your hands. Do not wash or reuse the gloves.
Encourage the person with SARS to cover their mouth and nose with a tissue when coughing or sneezing. If possible, the person with SARS should wear a surgical mask during close contact with other people in the home. If the person with SARS cannot wear a surgical mask, other members of the household should wear one when in the room with that person.
Do not use silverware, towels, bedding, clothing, or other items that have been used by the person with SARS until these items have been washed with soap and hot water.
Clean surfaces (counter or tabletops, door knobs, bathroom fixtures, etc.) that have been contaminated by body fluids (sweat, saliva, mucous, or even vomit or urine) with a household disinfectant used according to the manufacturer's instructions. Wear disposable gloves during all cleaning activities. Throw these out when done. Do not reuse them.
Follow these instructions for 10 days after the sick person's fever and respiratory symptoms have gone away.
If you develop a fever or respiratory symptoms, contact your health care provider immediately and tell him or her that you have had close contact with a SARS patient.

Interim Guidelines about Severe Acute Respiratory Syndrome (SARS) for Persons Traveling to SARS-Affected Areas

CDC has issued a travel advisory suggesting that people planning elective or nonessential travel to mainland China and Hong Kong, Singapore, and Hanoi, Vietnam, may wish to postpone their trips until further notice. CDC has also issued a travel alert for Toronto, Canada, to recommend that U.S. travelers to Toronto observe precautions to safeguard their health.

If you decide to go ahead with your travel to an area with SARS, please keep the following guidelines in mind.

Before you leave:

Assemble a travel health kit containing basic first aid and medical supplies. Be sure to include a thermometer, household disinfectant, a supply of surgical masks and disposable gloves (for use if you or someone you are traveling with becomes ill with SARS), and alcohol-based hand rubs for hand hygiene.
Inform yourself and others who may be traveling with you about SARS.
Be sure you are up to date with all your shots, and see your health-care provider at least four to six weeks before travel to get any additional shots or information you may need.
You may wish to check your health insurance plan or get additional insurance that covers medical evacuation in the event of illness.
Identify in-country healthcare resources in advance of your trip.

While you are in an area with SARS:

To protect against SARS infection, wash your hands frequently.
To minimize the possibility of infection, you may wish to avoid close contact with large numbers of people as much as possible. CDC does not recommend the routine use of masks or other personal protective equipment while in public areas.

If you think you have SARS or symptoms compatible with SARS:

If you become ill with fever and respiratory symptoms (for example, cough or shortness of breath), a visit to a healthcare provider is strongly recommended. Tell the provider about your symptoms prior to going to the office or emergency room so arrangements can be made, if necessary, to prevent transmission to others in the health-care setting. The nearest U.S. Embassy or Consular Office can help you find a provider in the area. Again, you are encouraged to identify these resources in advance. Do not travel while sick and limit your contact with others as much as possible to help prevent the spread of any infectious illness you may have.
The person who is ill should cover their mouth and nose with a facial tissue when coughing or sneezing. If possible, they should wear a surgical mask during close contact with healthy people to prevent spread of infectious droplets. If the sick person is unable to wear a surgical mask, other persons should wear surgical masks when in close contact with the person who is ill.
Use of disposable gloves should be considered for any direct contact with body fluids of a person with SARS. However, gloves are not intended to replace proper hand hygiene. Immediately after activities involving contact with body fluids, gloves should be removed and discarded and hands should be cleaned. Gloves must never be washed or reused.
All close contacts staying with a person with SARS should carefully follow recommendations for hand hygiene (e.g., frequent hand washing or use of alcohol-based hand rubs), particularly after contact with body fluids (e.g., respiratory secretions, urine, or feces).
People with SARS should avoid sharing eating utensils, towels, and bedding with others, although these items can be used by others after routine cleaning, such as washing or laundering with soap and hot water.
Environmental surfaces (e.g., toilets, sinks) soiled by body fluids should be cleaned with a household disinfectant according to manufacturer's instructions; gloves should be worn during this activity. Wash hands afterwards and throw the gloves away.
Other close contacts staying with a person with SARS do not need to restrict their outside activities unless they develop symptoms of SARS, such as a fever or respiratory illness.

After your return:

Persons returning from one of the affected areas should monitor their health for 10 days. Any family member who becomes ill with fever or respiratory symptoms during this period should consult a healthcare provider and tell him or her about their recent travel. Tell the provider about your symptoms prior to going to the office or emergency room so arrangements can be made, if necessary, to prevent transmission to others in the healthcare setting.
Close contacts of person with SARS who develop fever or respiratory symptoms should be evaluated by a health-care provider. Before the evaluation, health-care providers should be informed that the individual is a close contact of a person with SARS. These persons with symptoms of SARS should follow the same precautions recommended for people with SARS.