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Four cases of possible SARS have been reported in China. CDC is recommending that U.S. physicians maintain a greater index of suspicion of SARS in patients who require hospitalization for radiographically confirmed pneumonia or acute respiratory distress syndrome (ARDS) AND who have a history of travel to mainland China (or close contact with an ill person with a history of recent travel to mainland China) in the 10 days before onset of symptoms.
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Below is the CDC Health Update.
April 23, 2004,19:13 EDT (7:13 PM EDT)
On April 23, 2004, the Chinese Ministry of Health (MOH) reported four patients with possible severe acute respiratory syndrome (SARS) to the World Health Organization (WHO). Two of the cases are from Beijing and two are from Anhui Province, located in east-central China. One of the patients in Anhui Province died. Below is a brief description of the four cases.
An epidemiologic investigation of these cases by Chinese public health authorities is under way. The Chinese MOH has requested local health authorities in China to enhance surveillance for SARS, influenza-like illness, and pneumonia of unknown etiology, and has initiated measures to prevent the spread of SARS among travelers, including screening of travelers at ports of entry. Chinese health authorities are also actively identifying contacts of these four patients and have identified 188 close contacts of the third patient (the nurse). Five of these 188 contacts have developed fever, and all the febrile contacts have been hospitalized and isolated. The National Institute of Virology Laboratory in Beijing has been closed, potentially exposed personnel are being screened, and possible sources of infection for the two laboratory workers are being investigated.
The U.S. Centers for Disease Control and Prevention (CDC) remains in close communication with WHO about the reported cases of SARS in China and will provide additional information as it becomes available. At this time, CDC is not advising changes in the current U.S. SARS control measures other than the recommendations stated in the HAN Advisory for April 22 (provided below).
CDC is recommending that U.S. physicians maintain a greater index of suspicion for SARS in patients who 1) require hospitalization for radiographically confirmed pneumonia or acute respiratory distress syndrome (ARDS) AND 2) who have a history of travel to mainland China (or close contact with an ill person with a history of recent travel to mainland China) in the 10 days before onset of symptoms . When such patients are identified, they should be considered at high risk for SARS-CoV infection and the following actions should be taken:
Health care providers are reminded to obtain a travel history for patients presenting with acute respiratory illness. In addition, this new case of possible SARS provides a reminder to all healthcare settings, especially physician offices, outpatient clinics, and emergency departments, of the importance of implementing infection control precautions at the point of first contact with patients who have symptoms of a respiratory infection. These include respiratory hygiene/cough etiquette, hand hygiene, and droplet precautions (i.e., masks for close patient contact). For additional information, see "Respiratory Hygiene/Cough Etiquette in Healthcare Settings" at: http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm
The reported possible cases of SARS in China represent an evolving situation, and CDC will distribute updates as additional information is learned. For more about SARS and the current U.S. SARS control guidelines, please visit the CDC SARS website at: http://www.cdc.gov/ncidod/sars