title: SARS surveillance during emergency public health response, United States, March-July 2003.
abstract: In response to the emergence of severe acute respiratory syndrome (SARS), the United States established national surveillance using a sensitive case definition incorporating clinical, epidemiologic, and laboratory criteria. Of 1,460 unexplained respiratory illnesses reported by state and local health departments to the Centers for Disease Control and Prevention from March 17 to July 30, 2003, a total of 398 (27%) met clinical and epidemiologic SARS case criteria. Of these, 72 (18%) were probable cases with radiographic evidence of pneumonia. Eight (2%) were laboratory-confirmed SARS-coronavirus (SARS-CoV) infections, 206 (52%) were SARS-CoV negative, and 184 (46%) had undetermined SARS-CoV status because of missing convalescent-phase serum specimens. Thirty-one percent (124/398) of case-patients were hospitalized; none died. Travel was the most common epidemiologic link (329/398, 83%), and mainland China was the affected area most commonly visited. One case of possible household transmission was reported, and no laboratory-confirmed infections occurred among healthcare workers. Successes and limitations of this emergency surveillance can guide preparations for future outbreaks of SARS or respiratory diseases of unknown etiology.
authors.affiliation: Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. zha6@cdc.gov
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Schrag
authors.forename: John T
authors.initials: JT
authors.lastname: Brooks
authors.forename: Chris
authors.initials: C
authors.lastname: Van Beneden
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Griffin
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Anderson
authors.forename: William J
authors.initials: WJ
authors.lastname: Bellini
authors.forename: Robert F
authors.initials: RF
authors.lastname: Benson
authors.forename: Dean D
authors.initials: DD
authors.lastname: Erdman
authors.forename: Alexander
authors.initials: A
authors.lastname: Klimov
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Ksiazek
authors.forename: Teresa C T
authors.initials: TC
authors.lastname: Peret
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Talkington
authors.forename: W Lanier
authors.initials: WL
authors.lastname: Thacker
authors.forename: Maria L
authors.initials: ML
authors.lastname: Tondella
authors.forename: Jacquelyn S
authors.initials: JS
authors.lastname: Sampson
authors.forename: Allen W
authors.initials: AW
authors.lastname: Hightower
authors.forename: Dale F
authors.initials: DF
authors.lastname: Nordenberg
authors.forename: Brian D
authors.initials: BD
authors.lastname: Plikaytis
authors.forename: Ali S
authors.initials: AS
authors.lastname: Khan
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Rosenstein
authors.forename: Tracee A
authors.initials: TA
authors.lastname: Treadwell
authors.forename: Cynthia G
authors.initials: CG
authors.lastname: Whitney
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Fiore
authors.forename: Tonji M
authors.initials: TM
authors.lastname: Durant
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Perz
authors.forename: Annemarie
authors.initials: A
authors.lastname: Wasley
authors.forename: Daniel
authors.initials: D
authors.lastname: Feikin
authors.forename: Joy L
authors.initials: JL
authors.lastname: Herndon
authors.forename: William A
authors.initials: WA
authors.lastname: Bower
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Klibourn
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levy
authors.forename: Victor G
authors.initials: VG
authors.lastname: Coronado
authors.forename: Joanna
authors.initials: J
authors.lastname: Buffington
authors.forename: Clare A
authors.initials: CA
authors.lastname: Dykewicz
authors.forename: Rima F
authors.initials: RF
authors.lastname: Khabbaz
authors.forename: Mary E
authors.initials: ME
authors.lastname: Chamberland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D004630:Emergencies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011634:Public Health; D012141:Respiratory Tract Infections / Q000175:diagnosis; D045473:Severe acute respiratory syndrome-related coronavirus / Q000235:genetics / Q000302:isolation & purification; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D014481:United States / Q000453:epidemiology
chemical_list: D004279:DNA, Viral