SARS surveillance during emergency public health response, United States, March-July 2003.
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.
Schrag
Stephanie J
SJ
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
Brooks
John T
JT
Van Beneden
Chris
C
Parashar
Umesh D
UD
Griffin
Patricia M
PM
Anderson
Larry J
LJ
Bellini
William J
WJ
Benson
Robert F
RF
Erdman
Dean D
DD
Klimov
Alexander
A
Ksiazek
Thomas G
TG
Peret
Teresa C T
TC
Talkington
Deborah F
DF
Thacker
W Lanier
WL
Tondella
Maria L
ML
Sampson
Jacquelyn S
JS
Hightower
Allen W
AW
Nordenberg
Dale F
DF
Plikaytis
Brian D
BD
Khan
Ali S
AS
Rosenstein
Nancy E
NE
Treadwell
Tracee A
TA
Whitney
Cynthia G
CG
Fiore
Anthony E
AE
Durant
Tonji M
TM
Perz
Joseph F
JF
Wasley
Annemarie
A
Feikin
Daniel
D
Herndon
Joy L
JL
Bower
William A
WA
Klibourn
Barbara W
BW
Levy
Deborah A
DA
Coronado
Victor G
VG
Buffington
Joanna
J
Dykewicz
Clare A
CA
Khabbaz
Rima F
RF
Chamberland
Mary E
ME
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
D004279:DNA, Viral