SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

RISK ASSESSMENT AND RISK MANAGEMENT CONSIDERATIONS

Definitive information about the spread of SARS is continuing to develop. However, public health officials and research scientists have recommended prevention and hygiene processes based on known information about the spread of respiratory illnesses.

Lung infections caused by viruses are usually spread when a healthy person comes into contact with secretions from the nose, mouth and throat of an infected person, usually when the infected person coughs or sneezes, releasing droplets of infected fluid into the air. Contact with saliva also may spread viruses. The U.S. Centers for Disease Control also reports that it is possible SARS may be transmitted more broadly through the air and through surfaces or objects that have been contaminated when someone with SARS coughs or sneezes. Therefore, items such as toys, facial tissues and room surfaces touched by an infected person may contribute to the spread of a virus. Regular, thorough handwashing and adequate surface cleaning may be critical to reducing the transmission of the disease.

Viruses vary in their ability to survive on surfaces or outside the body. Researchers studying the SARS virus have found that it may survive 12 to 72 hours on common surfaces, such as wood, plastic, and stainless steel. The survival of the virus outside the body may contribute to the spread of the virus via contact with contaminated objects such as toys, doorknobs and other surfaces.

Public health officials are recommending the use of good hygiene and cleaning practices to help curb the spread of SARS. The U.S. Centers for Disease Control recommends washing hands frequently with soap and water. "If hands are not visibly soiled, alcohol-based handrubs may be used as an alternative" to soap-and-water washing, the CDC states. According to the CDC, the use of gloves in healthcare or other settings does not eliminate the need for handwashing. Regular, thorough disinfection of all surfaces that may be contaminated directly (such as forks or drinking glasses) or indirectly (such as doorknobs, tables, and bathroom surfaces) are critical to breaking the chain of infection from person to person. Currently, no virucide products are EPA approved specifically for use against SARS, because the specific coronavirus causing SARS has just been identified and research continues.

Any person suspected to be infected with SARS should be under medical care. Health officials will recommend appropriate precautions to prevent the spread of the disease to family members and health care workers.

Local, worldwide public health officials regularly post information updates. The World Health Organization, the U.S. Centers for Disease Control and your local or regional public health officials all have information about SARS, including its incidence in your country, updated information about prevention and treatments, and recommendations or requirements related to public buildings, travel and the like.

Links to updated case reports
Click here for listings of reported cases by country.
http://www.who.int/csr/sarscountry

Click here for listings of reported cases by states in the U.S.
http://www.cdc.gov/od/oc/media/sars.htm

While public health officials and research scientists continue to study the coronavirus that causes SARS, and to study means of transmission of the illness, the World Health Organization and the U.S. Centers for Disease Control have issued interim recommendations for cleaning and disinfection in a variety of environments. These recommendations are based on disinfection procedures known to reduce the spread of other viruses, including other coronaviruses. These recommendations are updated by the World Health Organization and the U.S. Centers for Disease Control as new information becomes available about the transmission of the SARS virus. Use following links to obtain guidance directly from the WHO of the CDC.

Research on Virus Survival Outside the Body
WHO:
http://www.who.int/csr/sars/survival_2003_05_04/en/ (scroll to bottom right of chart for information on SARS virus survival on common surfaces)

Health Care:
WHO: Hospital Infection Control Guidance for SARS
www.who.int/csr/sars/infectioncontrol/en

CDC: Updated Interim Domestic Infection Control Guidance in the Health Care and Community Setting for Patients with Suspected SARS
http://www.cdc.gov/ncidod/sars/infectioncontrol.htm

CDC: Interim Recommendations for Cleaning and Disinfection of the SARS Patient Environment
http://www.cdc.gov/ncidod/sars/cleaningpatientenviro.htm

CDC: Hand Hygiene
http://www.cdc.gov/handhygiene/

CDC: Infection Control in Health Care Personnel (1998) (links to a PDF)
http://www.cdc.gov/ncidod/hip/GUIDE/infectcont98.htm

CDC: Interim Domestic Infection Control Precautions for Aerosol-Generating Procedures on Patients with Severe Acute Respiratory Syndrome (SARS)
http://www.cdc.gov/ncidod/sars/aerosolinfectioncontrol.htm

Schools:
CDC: Interim Domestic Guidance for Management of School Students Exposed to SARS
http://www.cdc.gov/ncidod/sars/exposurestudents.htm

Travel Industry: Aircraft and Cruise Ships
CDC: Interim Guidance for Cleaning of Commercial Passenger Aircraft Following a Flight with a Passenger with Suspected SARS
http://www.cdc.gov/ncidod/sars/aircraftcleanup.htm

CDC: Interim Guidelines about SARS for Cruise Ship Passengers and Crew Members
http://www.cdc.gov/ncidod/sars/cruiseship.htm

Workplace:
CDC: Interim Guidelines about SARS for Persons in the General Workplace Environment
http://www.cdc.gov/ncidod/sars/workplaceguidelines.htm

CDC: Interim Guidelines for Businesses and Other Organizations with Employees Returning to the United States from Areas with SARS
http://www.cdc.gov/ncidod/sars/business_guidelines.htm

CDC: Interim Guidelines about Severe Acute Respiratory Syndrome (SARS) for Workers Handling Cargo or Other Packages
http://www.cdc.gov/ncidod/sars/cargoworkers.htm

Homes:
CDC: Interim Guidelines on Infection Control Precautions for Patients with Suspected SARS and Close Contacts in Households
http://www.cdc.gov/ncidod/sars/cargoworkers.htm