84 Prevention

in an area where there has been recent local transmission of SARS in the last 10 days are advised to contact a doctor (WHO WER 14/2003).

To further reduce the risk that travelers may carry the SARS virus to new areas, international travelers departing from areas with local transmission in the B or C categories (see "Areas with recent local transmission", http://www.who.int/csr/sarsareas/en/) should be screened for possible SARS at the time of departure. Such screening involves answering two or three questions and may include a temperature check. Travelers with one or more symptoms of SARS and who have a history of exposure, or who have fever, or who appear acutely ill should be assessed by a healthcare worker and may be advised to postpone their trip until they have recovered.

See also "Recommended procedures for prevention and management of probable cases of SARS on International Cruise Vessels", http://www.who.int/csr/sars/travel/vessels/en/.

Management of SARS in the post-outbreak period

A detailed document published by the WHO describes a SARS alert mechanism for the post-outbreak period. It provides guidance for managing a SARS "alert" through to laboratory confirmation or exclusion of persons under investigation as SARS cases and guidance to clinicans on the clinical presentation, laboratory and radiological findings to assist in diagnosis of SARS and in decisions to implement transmission-based infection control (WHO, August 14).

National Measures

The primary focus of SARS surveillance activities in countries without or with very few SARS cases is on the early identification and isolation of patients who have suspected SARS.

In contrast, countries which are affected by a severe SARS outbreak must immediately take a variety of sometimes unpopular measures to contain the epidemic. These measures generally include

1.the creation of an emergency operating center

2.the designation of one or more SARS hospitals

www.SARSreference.com