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| Severe Acute
Respiratory Syndrome (SARS) |
This
is part 5 of Supplement E of the Public
Health Guidance for Community-Level Preparedness ansonse
to Severe Acute Respiratory Syndrome (SARS).
A SARS patient on a conveyance presents a risk of transmission to other
passengers and crew and to non-passengers on arrival and a risk of further
spread from passengers who become infected. Many of the activities listed
below are performed by CDC staff at the eight current quarantine stations
and by public health workers in locations near other ports of entry with
assistance by CDC quarantine station staff from that region.
Objective: Protect co-passengers and crew members from SARS-CoV-infected
passengers and from transmission associated with passengers exposed to
the index case.
Activities
Management of a potential SARS patient on a conveyance
- Separate
the potential SARS patient as completely as possible from other
passengers and the crew. The ill passenger should wear a surgical mask.
- Ensure
that persons caring for the ill passenger follow infection control
measures recommended for cases of SARS (See Supplement
I and
Guidance about SARS for Airline Flight Crews, Cargo and Cleaning Personnel, and Personnel Interacting with Arriving Passengers).
- If
possible, designate a separate toilet for the exclusive use of
the ill passenger.
- Notify
the airport or land port authorities at the destination so that
health authorities are informed and prepared to meet the conveyance
upon arrival, to manage the ill passenger, and to evaluate other
passengers.
Management on arrival
- Separate
the ill passenger from exposed, well co-passengers at the soonest
moment both in transit and after arrival.
- Place
the ill passenger in an isolation facility (if available), and
assess.
- Assess
other passengers for illness, types of exposures to the ill passenger,
and other potential SARS-CoV exposures. EMS personnel and local
emergency department staff can perform these evaluations using
appropriate precautions (See Supplement
I and Guidance about SARS for
Airline Flight Crews, Cargo and Cleaning Personnel, and Personnel
Interacting with Arriving Passengers).
- Transfer
the ill passenger to a local healthcare facility for further evaluation
if needed. Protocols and memoranda of agreement with ambulance
services and hospitals with appropriate infection control measures
in place should be established in advance (see Section
VIII: Preparedness Planning.)
Management of passengers and crew on the same conveyance
- Collect
locating information for all passengers and crew. This information
should be obtained directly from passengers, if possible. If a potential
SARS case on a conveyance is not detected until after arrival, this
information can be obtained from passenger manifests, staff lists,
and/or customs forms.
- Inform
all passengers on board about SARS, and advise them to seek immediate
medical attention if fever or respiratory symptoms develop within
10 days of the flight. Pay particular attention to close contacts
of the case.
- Consider
temporary detention of the plane and arrangements for monitoring
and quarantine of all passengers and crew in some circumstances
(e.g., if the ill passenger had contact with a laboratory-confirmed
SARS case and had significant respiratory symptoms during a prolonged
flight). Home quarantine may be used for persons who live in or
near the port of arrival; a designated facility should be arranged
for the others (See Supplement D).
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