What is Severe Acute Respiratory Syndrome (SARS)?

SARS is a respiratory illness that has recently been reported worldwide. The countries that have
been most severely affected are in Southeast Asia, specifically the People’s Republic of China
(including Hong Kong), Hanoi, Vietnam and Singapore.
For additional information, check the World Health Organization’s (WHO) website at
www.who.int/en or visit the U.S. Centers for Disease Control and Prevention’s (CDC) website at
www.cdc.gov/ncidod/sars.

When was SARS first recognized?

SARS was first reported among people in the Guandong Province of China, Hong Kong and
Vietnam in March 2003. It has since spread to other countries.


What are the signs and symptoms of SARS?

People are suspected of having SARS if they have traveled to an affected area in Southeast Asia within ten days of symptom onset or had close contact with a SARS patient within ten days of symptom onset.
The following are the usual symptoms:

• Fever greater than 100.4ºF
• One or more respiratory symptoms including cough, shortness of breath, difficulty
  breathing, hypoxia (low oxygen level), or a chest x-ray showing findings of pneumonia.

The illness usually starts with a fever and is sometimes associated with chills, headache, fatigue,
body aches and an overall feeling of discomfort. After 3 to 7 days, the person may develop a dry
cough and have trouble breathing.


What causes SARS?

SARS is a newly recognized disease. There is early evidence to suggest that SARS is caused by a virus, but the exact cause is still unknown. The Centers for Disease Control and Prevention has identified a new virus, a previously unknown type of coronavirus in some patients with SARS.  More studies are being done to determine if this or other viruses cause SARS.

What are coronaviruses?

Coronaviruses are a group of viruses that have a crown-like (corona) appearance under a
microscope. This family of viruses is a common cause of mild to moderate respiratory illness in  humans. These viruses can survive in the environment for as long as 3 hours.


How is SARS spread?

As SARS is a new disease, we do not yet know for sure exactly how it is spread but it seems to require close contact with a SARS patient. Scientists believe that SARS is usually spread when someone with SARS coughs or sneezes droplets into the air and someone else breathes them in. This more often occurs when people are in close contact, like people who live in the same home as a SARS patient or a healthcare worker who is takes care of a SARS patient. SARS may also be spread by touching something that has been contaminated with the secretions (from the nose or mouth) from a SARS patient. People with SARS should wear a mask if they are coughing and sneezing, wash their hands frequently and avoid sharing eating utensils (forks, spoons, glasses), towels and bedding with other people in the household. These items can be used by others after routine cleaning with soap and water. Patients with SARS should NOT share cigarettes or canned drinks.


Who is most at risk of getting sick with SARS?

SARS appears to spread most easily among close personal contacts – such as those who have
cared for, lived with, or had direct contact with an infected person. Persons most at risk are those
who live in the same home as a SARS patient or health care workers who do not use infection
control procedures when providing medical care to a SARS patient. Those who have had only
casual contact with an individual with SARS do not appear to be at risk of infection.
In the United States, almost all SARS patients have recently traveled to countries, such as Hong
Kong and China, where large outbreaks of SARS are occurring. There has been no evidence to
date of community spread in the United States.


How long does it take to get sick after being exposed to someone with SARS?

The incubation period (the period between when someone is first exposed to a SARS patent until
he/she gets sick) is usually 2 to7 days but can be as long as 10 days. The illness usually begins
with a fever greater than 100.4ºF.


How long is a person with SARS infectious (able to spread the disease to others)?

Evidence suggests that people are most likely to be infectious when they have symptoms, such
as fever and cough. It is not yet known how long after symptoms begin that people with SARS
might be able to spread the disease to others.


Is SARS dangerous?

Most people who have gotten SARS have recovered, but a small percentage (less than 5 per
cent) of people have died. The disease may be more serious among older persons or those with
other medical problems.


Are there any suspect cases of SARS in New Jersey?

To date, there have been several New Jersey residents who are suspected to have SARS based
on the Centers for Disease Control and Prevention’s disease criteria for SARS.

All of the cases had onset of symptoms during travel or shortly after return from Asia, a continent
with known community outbreaks of SARS.

Because the initial symptoms of SARS are similar to the symptoms of many common illnesses
seen this time of year (such as colds and flu), and because many New Jersey residents travel to
Southeast Asia, the number of suspect cases may increase. Many of these persons, however,
will likely have unrelated illnesses.

The New Jersey Department of Health and Senior Services (DHSS) has been monitoring cases
and their household contacts until 10 days after the SARS patient has recovered. There has been
no evidence to date of spread to health care workers or household members, nor evidence of
community spread of SARS in New Jersey.


What should I do, if I or someone in my family has recently traveled in Southeast Asia?

You should monitor your own health for ten days following your return. If you become ill with a
high fever (> 100.4 ºF) and a cough or difficulty breathing, you should notify your doctor or visit a
hospital emergency department and be sure to tell your doctor that you have have recently
traveled in Southeast Asia. If you are not sick, it is not necessary to stay at home or limit your
activities in any way. It is okay to go to work or school, or for young children to go to daycare or
other child care programs. You do not need to use a mask or see a doctor as long as you are
feeling well.


Is it safe to travel to Southeast Asia?

At this time, there are no travel restrictions in place directly related to SARS. However, a travel
advisory from the Centers for Disease Control and Prevention recommends that persons
planning nonessential or elective travel to the People's Republic of China, Hong Kong, Hanoi,
Vietnam or Singapore may wish to postpone their trip until further notice. This temporary
recommendation will be re-evaluated daily as this outbreak evolves. The recommendation does
not apply to passengers simply passing through the airports in these areas, if they are not
spending any time in the affected countries.

Persons who travel to Southeast Asia should be aware of the symptoms of SARS. If they develop
high fever and cough or difficulty breathing, they should see a doctor immediately and be sure to
mention their recent travel to Southeast Asia. There is no recommendation at this time to wear
masks while traveling. Updates on SARS, recommendations, and travel advisories can be found
on the World Health Organization website at http://www.who.int/en/ and the Centers for Disease
Control and Prevention’s website at www.cdc.gov.


How can I help prevent SARS?

The Centers for Disease Control and Prevention has issued guidelines for how to prevent SARS
from spreading to family contacts of SARS patients and in the hospital setting. In medical care
settings, it is important that health care providers follow special precautions when caring for a
patient who may have SARS. For others, the best way to prevent SARS is by not traveling to
places where there are known outbreaks of SARS, unless absolutely necessary.


If I am traveling to Southeast Asia, is there a medicine I can take to prevent SARS?

No, there is no known medicine you can take to prevent SARS. However, if you do become ill in
Southeast Asia, or after you get back, you should see a doctor and mention that you have
recently traveled to that region.


What is being done to prevent SARS patients from coming into the United States?

For people traveling by plane, federal quarantine inspectors stationed at the airports are
screening travelers from Southeast Asia for symptoms of SARS. In addition, health alert cards
are being distributed to air passengers asking travelers to monitor their health for ten days and to
see a doctor if they become sick with a fever and cough or difficulty breathing. These health alert
cards are also being provided by the major shipping associations to people traveling on cargo
ships and cruise ships into ports in the United States. Inspectors are also boarding ships if a
passenger or crew member is suspected of having SARS.


What if I have been on board an airplane or ship with someone who is suspected of having
SARS?

All passengers and crew members will be advised by port authorities to seek medical attention if
they develop symptoms of SARS (see above).


Is there a treatment for SARS?

Because the exact cause of the illness is still being investigated, there is currently no known
treatment for SARS. Different types of treatment regimens have been used for severely ill
hospitalized patients with SARS, including antibiotics, anti-virus medications and steroids, but it is
too soon to tell if any of these will be effective. Supportive treatment, such as intravenous fluids
and medicines to control fever or pain, is critical.


Is there any reason to believe that SARS is linked to bioterrorism?

The pattern of spread as far as is known is what would typically be expected in a contagious
respiratory or flu-like illness. People most at risk are either health care workers taking care of sick
people or family members or household contacts of people infected with SARS. There is no
evidence to suggest bioterrorism.


What is being done about SARS overseas?

The World Health Organization and the Centers for Disease Control and Prevention are
aggressively responding to cases of SARS and working to identify a cause of the illness.


What is being done about SARS in New Jersey?

The New Jersey Department of Health and Senior Services is working closely with hospitals and
public health agencies to increase their awareness of SARS and to help them rapidly identify any
cases that arrive in New Jersey. The DHSS has held weekly teleconferences with New Jersey
hospitals and public health agencies to provide updates, explain how to identify potential cases
and to detail appropriate reporting mechanisms. Health officials in New Jersey have been
instructed to immediately report any suspected cases by telephone to both DHSS and local
health officials.


Why has the New Jersey Department of Health and Senior Services asked hospitals to be
on the alert for SARS?

Identifying possible cases early will allow special precautions to be taken in the hospital to
prevent its spread. In addition, the Department will assist hospitals in sending laboratory
specimens to the Centers for Disease Control and Prevention to help identify the cause of the
disease.


Who can I call if I have questions or concerns?

The public can visit the Department of Health and Senior Services web site at
www.nj.state.nj.us/health or call the Department at 609-588-7500.
For additional information, see the World Health Organization’s website at http://www.who.int/en/
or the Centers for Disease Control and Prevention’s website at www.cdc.gov.

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