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Severe Acute Respiratory Syndrome (SARS)

What is Severe Acute Respiratory Syndrome (SARS)?
SARS is a viral disease that causes respiratory (lung) symptoms and is spread by close person-to-person contact.
When was SARS first recognized?
An outbreak of an unusual pneumonia now known as SARS was first reported in the Guangdong Province of China in November 2002. But it was not until cases began to be reported in Hong Kong and Vietnam in March 2003 that SARS was officially recognized. Over the next 3 months, SARS spread to 29 countries and caused over 8,098 cases and 774 deaths.
What are the signs and symptoms of SARS?
The illness usually starts with a fever and sometimes chills, headache, fatigue, body aches, and an overall feeling of discomfort. After 3-7 days, an infected person may develop a dry cough and have trouble breathing. In severe cases, pneumonia may occur. Some patients may also experience diarrhea.
What causes SARS?
SARS is caused by a previously unknown type of coronavirus called SARS-CoV.
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 frequent cause of mild to moderate respiratory illness in humans, such as the common cold. People who have the common cold do not need to worry that they might have SARS.
Is there a laboratory test for SARS?
Yes. Tests are available that can detect both the virus itself and antibodies to the coronavirus. The New York State and City Public Health Laboratories now test for SARS. Because of the limited number of laboratories performing the tests, testing is only available for those people suspected to have SARS. Your doctor can order the test, which must first be approved by the New York City Department of Health and Mental Hygiene.
How is SARS spread?
SARS is usually spread when someone with SARS coughs or sneezes droplets of mucus into the air, and someone else breathes them in. This happens most often when people are in close contact, such as when a person lives in the same home as a SARS patient or a healthcare worker is caring for a SARS patient.

SARS can also be spread by touching something that has been contaminated with the secretions (from the nose or mouth) or stool of a SARS patient.

People with SARS should wear a mask when around other people, wash their hands often (especially after using the toilet or coughing), and make sure they do not share eating utensils (forks, spoons, glasses), towels and bedding with other people in the household. These items should be cleaned with soap and water before use by others. . Patients with SARS should NOT share cigarettes or drinks.

How long can the SARS coronavirus survive outside the body?
Studies show that the SARS coronavirus may survive in the environment for several days, especially in the stool of an infected person.
Who is most at risk of getting sick with SARS?
SARS spreads 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 include those who live in the same home as a SARS patient or health care workers who do not strictly follow infection control procedures when providing medical care to a SARS patient. Those who have had only casual contact (such as in school or at work) with an individual with SARS do not seem to be at risk of infection.
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 patient until he/she gets sick-is usually 2-7 days, but can be up to 10 days or even longer in rare cases. The illness usually begins with fever (greater than 100.4ºF).
How long is a person with SARS infectious (able to spread the disease to others)?
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 or whether they are still contagious after their illness ends.
Is SARS dangerous?
Most people who have gotten SARS have recovered, but as many as 10-15% of SARS patients have died. The disease is more severe among older persons and those with other medical problems.
Have there been any confirmed cases of SARS in New York City?
No. The New York City Department of Health and Mental Hygiene has been watching for cases since the outbreak began in early 2003. There have been no laboratory positive cases, nor has there been any evidence of spread to health care workers or household members, nor evidence of community spread of SARS in New York City.

For an update on the number of cases in New York City, visit our web page

Since the outbreak ended this past summer, have there been any cases of SARS in the world?
There has been no documented person-to-person transmission of SARS anywhere in the world during the 2003-4 winter respiratory viral season. Only three confirmed and one probable case of SARS have been reported this winter, all from the Guangdong Province of China. There were no epidemiologic links between these three patients and the source(s) of their exposures is unknown and remains under investigation. All three patients have recovered, and investigations of their close contacts (including healthcare worker contacts) revealed no evidence of secondary spread. There has been no other evidence of SARS anywhere in the world. However, public health officials and health care providers are on alert for the possibility that SARS may return during the winter respiratory viral season, especially in areas of China where the outbreak first occurred last year.
If SARS does occur again, what should I do if I, or someone in my family, recently traveled to an area affected by SARS?
You should pay close attention to your own health for 10 days after your return. If you become ill with a high fever (greater than 100.4ºF) OR a cough or have trouble breathing, you should stay at home for at least 72 hours (3 days) to be sure that your illness does not get worse. If you begin to have BOTH fever and cough OR fever and difficulty breathing, it is important that you immediately notify your doctor or visit a hospital emergency department. Be sure to tell your doctor that you have recently traveled in an area affected by SARS.

If you are not sick, it is not necessary to stay at home or change 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.

If SARS does occur again, will it be safe to travel to areas affected by SARS?
If SARS recurs, updates on SARS, including travel advisories, can be found on the World Health Organization's website and the CDC's website.
How can I help prevent the spread of SARS?
The Centers for Disease Control and Prevention has issued guidelines on how to prevent SARS from spreading in the household of SARS patients and in the hospital setting. People with SARS should wash their hands often (especially after using the toilet or coughing) and make sure they do not share eating utensils (forks, spoons, glasses), towels and bedding with family contacts and other people in the household. These items should be cleaned with soap and water before use by others. Patients with SARS should NOT share cigarettes or drinks.

In health 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 the spread of SARS is to avoid traveling to places where there are known outbreaks, unless absolutely necessary.

If I am traveling to an area affected by SARS, is there a medicine I can take to prevent SARS?
No. There is no known medicine you can take to prevent SARS. However, the best prevention for SARS and other respiratory viruses is frequent hand washing with soap and water. If you do become ill while traveling, or after you get back, you should see a doctor and mention that you have recently traveled to a region affected by SARS.
If SARS does occur again overseas, what will be done to prevent SARS patients from coming into the United States?
For people traveling by plane, federal quarantine inspectors stationed at the airports will screen travelers returning from countries where there are outbreaks for symptoms of SARS. In addition, health alert cards will be given to air passengers asking travelers to watch their health for 10 days and to see a doctor if they become sick with a fever OR cough or difficulty breathing. These health alert cards will also be distributed by major shipping associations to people traveling on cargo ships and cruise ships into United States ports. Finally, inspectors will board any ship carrying a passenger or crewmember suspected of having SARS and take appropriate action.
Is there a cure for SARS?
At this time, there is no known cure for SARS. Different types of treatments have been used for very ill hospitalized patients with SARS, including antibiotics, anti-virus medications and steroids, but none has been successful. Supportive treatment, such as intravenous fluids and medicines to control fever or pain, is very important.
Is there any reason to believe that SARS is linked to bioterrorism?
There is no evidence to suggest SARS is due to bioterrorism. The pattern of spread during the Spring 2003 outbreak was typical for a contagious respiratory or flu-like illness. People most at risk were health care workers taking care of sick people and family members or household contacts of people infected with SARS.
What is being done about SARS overseas?
The World Health Organization and the Centers for Disease Control and Prevention are aggressively monitoring for cases of SARS. For more information, visit the World Health Organization's website and the CDC's website.
What is being done about SARS in New York City?
The New York City Department of Health and Mental Hygiene is working closely with hospitals and medical providers to increase their knowledge of SARS and to help them identify any cases. The Department has reminded hospitals to immediately report any illnesses suspected of being SARS. If SARS does appear again, any person suspected of having SARS will be isolated at home or in a hospital until 10 days after the person is no longer sick. The Department will also follow the close contacts of a SARS patient on a daily basis to be sure they do not develop symptoms of SARS.

The New York City Department of Health and Mental Hygiene is also providing ongoing information to the public through the media, presentations to community groups, and our website.

Why has the New York City Department of Health and Mental Hygiene asked hospitals to be on the alert for SARS?
Early identification of possible cases can prevent the spread of SARS to hospital staff and other patients. The Department will help hospitals transport laboratory specimens to the New York City Public Health Laboratory for testing.
Who can I call if I have questions or concerns?
The public can call the New York City Department of Health and Mental Hygiene at 311.

For more information, visit World Health Organization's website or the CDC's website.

Last Updated: December 19, 2012