CDC HEALTH ALERT UPDATE
MARCH 22, 2003

FROM THE CENTERS FOR DISEASE CONTROL

UPDATED INTERIM U.S. SARS CASE DEFINTION

For purposes of case finding and surveillance in the United States, the March 17th CDC SARS case definition has been updated as follows:

• Temperature must be measured
  
  
• SARS areas are limited to those with suspected or documented community transmission; this differs from the WHO definition as it excludes areas where secondary transmission has been limited to only health care workers or direct household contacts. Note: the list of SARS areas will be updated as new information becomes available.

Suspected Case:

Respiratory illness of unknown etiology with onset since February 1, 2003, and the following criteria:

• Measured temperature >100.4 °F (>38° C)
  
  
• One or more clinical findings of respiratory illness (e.g. cough, shortness of breath, difficulty breathing, hypoxia, or radiographic findings of either pneumonia or acute respiratory distress syndrome)
  
  
• Travel within 10 days of onset of symptoms to an area with suspected or documented community transmission of SARS (see list below; excludes areas with secondary cases limited to healthcare workers or direct household contacts)
  
  OR
  
  Close contact* within 10 days of onset of symptoms with either a person with a respiratory illness and travel to a SARS area or a person under investigation or suspected of having SARS

* Close contact is defined as having cared for, having lived with, or having had direct contact with respiratory secretions and /or body fluids of a patient suspected of having SARS.

List of areas with documented or suspected community transmission of SARS: Hong Kong Special Administrative Region and Guangdong province, Peoples' Republic of China; Hanoi, Vietnam; and Singapore

Note: Suspect cases with either radiographic evidence of pneumonia or respiratory distress syndrome; or evidence of unexplained respiratory distress syndrome by autopsy are designated "probable" cases by the WHO case definition.

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