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Update: Severe Acute Respiratory Syndrome --- United States, 2003
CDC continues to work with state and local health departments, the World Health Organization (WHO), and
other partners to investigate cases of severe acute respiratory syndrome (SARS). This report updates reported SARS cases
worldwide and in the United States, and summarizes changes in travel recommendations for Beijing and Taiwan, where travel advisories have been downgraded to travel alerts.
During November 1, 2002--July 2, 2003, a total of 8,442 probable SARS cases were reported to WHO from 29
countries, including 73 cases from the United States; 812 deaths (case-fatality proportion: 9.6%) have been reported, with no SARS-related deaths reported from the United States
(1). In the United States, a total of 419 SARS cases have been
reported from 42 states and Puerto Rico, with 346 (83%) cases classified for investigation purposes as suspect SARS and 73 (17%) as probable SARS (more severe illnesses characterized by the presence of pneumonia or acute respiratory
distress syndrome) (2).
Serologic testing for antibody to SARS-associated coronavirus (SARS-CoV) infection has been completed for 162
suspect and 47 probable cases; no suspect and eight probable cases have demonstrated antibodies to SARS-CoV, all of which
have been previously described (3,4). Of the 39 probable cases in which no demonstrated antibody to SARS-CoV was identified in a convalescent blood specimen, 25 (64%) patients had specimens that were negative for >28 days after onset of
symptoms (range: 29--61 days), and 14 (36%) had specimens that were negative for 22--28 days after onset of symptoms. Of the remaining 26 probable cases, convalescent serum specimens for 25 persons have not been submitted to CDC, and one person, who has recovered, has refused further testing.
Obtaining convalescent serum samples is critical to making a final determination about infection with SARS-CoV.
Median age of the eight laboratory-confirmed SARS
patients is 43 years (range: 22--53 years); four are female. Seven
were hospitalized, and one required mechanical ventilation. All have recovered.
On June 25, CDC downgraded the travel alert status for both Beijing and Taiwan from advisory to alert
(5,6). Reasons for this change include information that SARS transmission in China, including Beijing, and Taiwan, is limited to a small number of specific settings through direct person-to-person spread with no evidence of ongoing community transmission. In
addition, monitoring by the health ministries in China and Taiwan indicates that no new outbreaks of illness are
occurring.
Reported by: State and local health departments. SARS investigative team, CDC.
CDC. Interim travel alert: mainland China, including Beijing. Available at
http://www.cdc.gov/travel/other/sarschina2.htm.
CDC. Interim travel alert: Taiwan. Available at
http://www.cdc.gov/travel/other/sarstaiwan.htm.
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