This
version of Supplement B includes the revised U.S. SARS surveillance
case definition and an updated domestic case reporting form.
The revised surveillance case definition reflects changes in
the interim position statement on SARS surveillance adopted by
the Council of State and Territorial Epidemiologists (CSTE) in
November 2003.
The
current version of Supplement B clarifies and revises questions
to be used by healthcare providers to screen persons requiring
hospitalization for radiographically confirmed pneumonia. The
screening question related to travel now includes specific geographic
locations that are likely sites for a reappearance of SARS-CoV.
Employment in a laboratory that contains live SARS-CoV has been
added as an epidemiologic risk factor for SARS-CoV exposure.
The
revised Supplement clarifies that, in the absence of SARS-CoV
transmission in the world, children hospitalized for radiographically
confirmed pneumonia need not be screened for potential SARS-CoV
disease, unless circumstances suggest that a child might be at
high risk for exposure to SARS-CoV.
The
recommendations for surveillance in healthcare settings have
been revised for consistency with the recommendations in Supplement
C. The guidance clarifies that, in a setting of ongoing
SARS-CoV transmission in a facility or community, the presence
of either fever or lower respiratory symptoms should
prompt further evaluation. In addition, in accordance
with the new SARS case definition, when persons have a high risk
of exposure to SARS-CoV (e.g., persons previously identified
through contact tracing or self-identified as close contacts
of a laboratory-confirmed case of SARS-CoV disease; persons who
are epidemiologically linked to a laboratory-confirmed case of
SARS-CoV disease), the clinical screening criteria should
be expanded to include, in addition to fever or lower respiratory
symptoms, the presence of any early symptoms of SARS-CoV disease.
The
current version provides some guidance for prioritization of
contacts for monitoring if health department resources become
overburdened during an ongoing outbreak. General reporting requirements
have also been clarified. |
