CDC Extends SARS Travel Advisory; Offers Interim Infection Control Guidance

ATLANTA -- The Centers for Disease Control and Prevention (CDC) has extended its travel advisory for Severe Acute Respiratory Syndrome (SARS) to include all of mainland China as well as Hanoi, Vietnam and Singapore. The previous CDC travel advisory was for only Hong Kong and Guangdong Province, People's Republic of China and Hanoi, Vietnam.

The CDC advises that people planning elective or non-essential travel to mainland China and Hong Kong; Singapore; and Hanoi, Vietnam may wish to postpone their trips until further notice. CDC has been working closely with the World Health Organization (WHO) to investigate cases of SARS. At this time CDC is not advising against travel to or from Canada because there is not evidence of widespread community transmission.

CDC officials are meeting planes, cargo ships and cruise ships coming either directly or indirectly to the United States from China, Singapore and Vietnam and distributing health alert cards to disembarking passengers. CDC will distribute approximately 25,000 health-alert notices daily to people returning from the affected regions at more than 20 ports of entry.

In addition officials are assessing passengers returning from those areas for symptoms of SARS. The symptoms of SARS include:

-- A temperature of greater than 100.4 degrees Fahrenheit (38.0 degrees Celsius)

-- One or more clinical findings of respiratory illness including cough, shortness of breath, difficulty in breathing, hypoxia (deficiency in the amount of oxygen reaching the tissues of the body), and X-rays indicating the presence of pneumonia

CDC is also issuing guidance for patients with suspected SARS designed to prevent transmission of the illness to their family members and other close contacts. Healthcare officials are not certain how long a patient with SARS may be contagious to people with whom they have close contact.

"We've seen that secondary transmission of SARS has occurred among people who live and have had very close contact with a SARS patient, or are health care personnel who have also had close contact with a SARS patient and did not use respiratory infection control measures. That is why it is paramount that we provide these recommendations to prevent infection," said Dr. Julie Gerberding, director of the CDC.

The CDC recommends the following infection control measures for suspected patients with SARS in household or other residential settings:

Infection control precautions should be continued for SARS patients for 10 days after respiratory symptoms and fever are gone. SARS patients should limit interactions outside the home and should not go to work, school, out-of-home day care, or other public areas during the 10-day period;

During this 10-day period, all members of the household with a SARS patient should carefully follow recommendations for hand hygiene, such as frequent handwashing or the use of alcohol-based rubs;

Each patient with SARS should cover his or her mouth and nose with a tissue before sneezing or coughing. If possible, a person recovering from SARS should wear a surgical mask during close contact with uninfected persons. If the patient is unable to wear a surgical mask, other persons in the home should wear masks when in close contact with the patient;

Disposable gloves should be considered for any contact with body fluids from a SARS patient. However, immediately after activities involving contact with body fluids, gloves should be removed and discarded and hands should be washed. Gloves should not be reused, and are not intended to replace proper hand hygiene.

SARS patients should avoid sharing eating utensils, towels and bedding with other members of the household, although these items can be used by others after routine cleaning such as washing or laundering with soap and hot water;

Other members of the household need not restrict their outside activities unless they develop symptoms of SARS such as a fever or respiratory illness.

Source: CDC