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Guidance about SARS for Persons Traveling to Areas Where SARS Cases Have Been Reported

February 11, 2004

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There is currently no evidence of person-to-person transmission of SARS in the world. Since the end of the global outbreak in July 2003, two cases of SARS associated with laboratory exposures have been reported - one case in Singapore in September 2003 and one in Taiwan in December 2003. In addition, since December 16, 2003, a few sporadic cases of SARS have been reported in China. However, none of the contacts of these cases has developed a SARS-like illness, and there is no evidence of any association among the cases. The source of infection in these persons has not been determined. See CDC's SARS website for details and updated information on these sporadic cases. Travel information is provided on CDC's Traveler's Health website.

During the 2003 global outbreak, most persons reported as SARS cases in the United States were exposed through foreign travel to countries with outbreaks of SARS, with only limited secondary spread to close contacts^* such as family members and healthcare workers. Guidance for the management of SARS exposures in healthcare settings, as well as infection control precautions for SARS patients and their close contacts in household settings, is provided in Supplement I, Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS).

The following guidance is provided for persons (other than healthcare workers or household contacts) who are traveling to areas where SARS cases have been reported. These recommendations are based on the experience to date and may be revised as more information becomes available.

Before you leave:

Assemble a travel health kit containing basic first aid and medical supplies. Be sure to include alcohol-based hand rub for hand hygiene.
Inform yourself and others who may be traveling with you about SARS. Information about SARS is provided on CDC's SARS website.
Be sure you are up to date with all of your shots, and see your healthcare provider at least 4 to 6 weeks before travel to get any additional shots or information you may need. Information on CDC's health recommendations for international travel is provided on CDC's Travelers' Health website.
You may wish to check your health insurance plan or get additional insurance that covers medical evacuation in the event of illness. Information about medical evacuation services is provided on the website of the U.S. Department of State.
Identify in-country healthcare resources in advance of your trip.

While you are in an area where SARS cases have been reported:

As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand washing. Cleaning your hands often using either soap and water or a waterless, alcohol-based hand rub removes potentially infectious materials from your skin and helps prevent disease transmission.
To minimize the possibility of infection, observe precautions to safeguard your health. This includes avoiding settings where SARS is most likely to be transmitted, such as healthcare facilities caring for SARS patients.
On the basis of limited available data, it would be prudent for travelers to China to avoid visiting live food markets and to avoid direct contact with civets and other wildlife from these markets. Although there is no evidence that direct contact with civets or other wild animals from live food markets has led to cases of SARS, viruses very similar to SARS-CoV?the virus that causes SARS?have been found in these animals. In addition, some persons working with these animals have evidence of infection with SARS-CoV or a very similar virus.
CDC does not recommend the routine use of masks or other personal protective equipment while in public areas.

After your return:

Persons returning from an area where SARS cases have been reported should monitor their health for 10 days.
Anyone who becomes ill with fever or respiratory symptoms during this 10-day period should consult a healthcare provider. Before your visit to a healthcare setting, tell the provider about your symptoms and recent travel so that arrangements can be made to prevent potential transmission to others in the healthcare setting.
Close contacts of a person with known or possible SARS should follow the recommendations for SARS patients and their close contacts.

* Close contact is defined as having cared for or lived with a person known to have SARS or having a high likelihood of direct contact with respiratory secretions and/or body fluids of a patient known to have SARS. Examples of close contact include kissing or embracing, sharing eating or drinking utensils, close conversation (<3 feet), physical examination, and any other direct physical contact between persons. Close contact does not include activities such as walking by a person or briefly sitting across a waiting room or office.

Information provided by the United States Centers for Disease Control and Prevention (CDC).