|
Severe Acute
Respiratory Syndrome (SARS) |
During
the 2003 global response, the control strategy for the United States
included issuing travel notifications,1
distributing health alert notices to travelers arriving from areas
with SARS, and conducting visual inspections of arriving travelers
to facilitate early identification of imported cases and response
to reports of ill passengers. CDC staff met more than 11,000 direct
and indirect flights from SARS-affected areas and distributed more
than 2.7 million health alert notices to arriving passengers as well
as to persons arriving at 13 U.S. land border crossings near Toronto
and departing passengers bound for the United States from the Toronto
airport. Health alert notices informed returning travelers of potential
exposure to SARS-CoV. They alerted travelers to the symptoms of SARS-CoV
disease and advised them to promptly seek medical attention if symptoms
develop. The notices also provided information and instructions for
physicians.
Travel
Alerts and Travel Advisories
- Travel
alerts and advisories are notifications of an outbreak of
disease occurring in a geographic area. A travel
alert, a lower-level notice, provides information
about the disease outbreak and informs travelers how to reduce
their risk of acquiring the infection. An alert does not
include a recommendation against nonessential travel to the
area.When the health risk for travelers is thought to be
high, a travel advisory recommending
against nonessential travel to the area is issued. Travel
advisories are intended to reduce the number of travelers
to high-risk areas and the risk for spreading disease to
other areas.
- CDC
issues travel alerts and advisories based on evidence of
transmission, spread of disease, and effectiveness of local
prevention efforts. The quality of local disease surveillance
and the accessibility of medical care are additional considerations.
|
During the outbreak response, CDC quarantine staff met planes reporting an ill passenger to facilitate 1) evaluation of the passenger for possible SARS-CoV disease, 2) collection of locating information on the other passengers, and 3) coordination with federal and local authorities. If the ill passenger was determined to be a possible SARS case, then the locating information was forwarded to state and local health departments for contact tracing.
Border and travel-related activities implemented in countries more seriously affected by SARS included pre-departure temperature and symptom screening, arrival screening (asking passengers about travel history and possible exposure to SARS-CoV), "stop lists" (maintaining lists of persons who were possible SARS cases or contacts to prevent them from traveling), and quarantine of travelers returning from other SARS-affected areas.
Lessons learned from this response support the recommendations included in this Supplement. These lessons included the following:
- SARS-CoV can spread rapidly on a global scale through international travel if control measures are not implemented.
- SARS-CoV transmission is usually localized and often limited to healthcare settings and households; the risk of SARS-CoV disease to travelers visiting an affected area is low unless travelers are exposed in these settings.
- Patients
with SARS can transmit infection to other passengers on conveyances
and should postpone travel until they are no longer infectious.
- SARS-CoV transmission can occur within the close confines of conveyances. Resulting infections usually represent a failure to recognize symptomatic index cases and their high-risk contacts, who should have been prevented from traveling.
- Active follow-up of passengers on conveyances with SARS cases can help prevent further spread by informing passengers of their exposure and providing instructions for monitoring their health and seeking medical evaluation if they become ill.
1 During the 2003 SARS outbreak, CDC issued two types of travel
notifications about disease occurrences in specific geographic areas.
A travel
alert, a lower-level notice, provided information about the
disease outbreak and informed travelers about how to reduce their risk of
acquiring the infection. When the health risk for travelers was thought to
be high, CDC issued a travel advisory recommending
against nonessential travel to the area. Travel advisories were intended to
reduce the number of travelers to high-risk areas and the risk for spreading
disease to other areas. The levels of notification have since been revised
to include four
types of travel notices: In the News, Outbreak
Notice, Travel Health Precaution,
and Travel Health Warning.
|
|
|