During the
2003 epidemic, CDC and the Council of State and Territorial Epidemiologists (CSTE) developed surveillance criteria to identify persons with SARS.
The surveillance case definition changed throughout the epidemic as
understanding of the clinical, laboratory, and transmission characteristics
of SARS-CoV increased. On June 26, 2003, CSTE adopted a position statement to add SARS-CoV disease to
the list of nationally reportable diseases. The position statement included
criteria for defining a SARS case for national reporting. On October
30, CSTE issued a new
interim position statement ,
with a revised SARS case definition. The position statement and case
definition were revised further on November 3. The revised CSTE
case definition, subsequently adopted by CDC,
will be the basis for ongoing SARS surveillance. Future revisions to
the CSTE SARS position statement will be posted on the CSTE
website as
necessary.
Surveillance case definitions are used primarily for identifying and
classifying cases for national reporting purposes. However, for conditions
of public health importance such as SARS-CoV disease, disease-control
activities should be initiated as soon as possible after a potential
case is recognized, even though information sufficient to determine case
status may be lacking. Therefore, the revised case definition distinguishes
1) cases of SARS-CoV disease that are classified as confirmed (i.e.,
clinically compatible illness with laboratory confirmation) or probable
(i.e., severe respiratory illness with epidemiologic linkage to a laboratory-confirmed
case), from 2) other SARS reports under investigation (RUI), which include
patients whose illnesses are less severe or whose exposures to SARS-CoV
are not definitive.
Detailed
descriptions of revised criteria and classifications for cases of SARS-CoV
disease and SARS RUI criteria are provided in Appendix
B1 and MMWR of December 12, 2003.
SARS case definitions may be modified as the understanding of the clinical,
virologic, and transmission characteristics of SARS-CoV evolves. Up-to-date
versions of SARS case definitions will be available on CDC's
SARS website.
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