Reporting Potential SARS Cases

New York State Department of Health

In April 2003, on an emergency basis, Severe Acute Respiratory Syndrome (SARS) was added to the New York State reportable disease list. Physicians should immediately report any potential SARS cases (as defined by the reporting criteria below) to the local health department (LHD). SARS reporting criteria will be based on the level of SARS activity worldwide. The two categories of SARS activity are: (1) absence of SARS-CoV transmission worldwide, and (2) presence of SARS-CoV transmission in the world.

SARS Reporting Criteria

1. Absence of SARS-CoV TransmissionWorldwide.

Medical providers should ask all patients being admitted to the hospital with radiographic evidence of pneumonia or acute respiratory distress syndrome (ARDS) of unknown etiology about recent travel, employment history and/or exposure to another person who was recently diagnosed with pneumonia. Providers should immediately report to the LHD any patient who meets the following clinical and at least one epidemiologic criteria:

  • Clinical criteria
    • Severe respiratory illness, characterized by radiographic evidence of pneumonia or ARDS of unknown etiology, which warrants hospitalization.
      AND
  • Epidemiologic criteria (at least one of the following)
    • Within 10 days of onset, travel to mainland China, Hong Kong, or Taiwan,
      OR
    • Within 10 days of onset, close contact with other ill person(s) who recently traveled to mainland China, Hong Kong, or Taiwan,
      OR
    • Employment as a healthcare worker with direct patient contact or a worker in a laboratory that contains live SARS coronavirus (SARS-CoV),
      OR
    • Within 10 days of onset, close contact with person(s) with pneumonia without an alternative diagnosis.

Additional factors that increase the likelihood of SARS-CoV infection

Additional information should be obtained on patients who meet the above reporting criteria to determine if there are factors that would increase the likelihood of SARS-CoV infection, including,

  • While traveling, visited a healthcare setting.
  • While traveling, had close contact with a person hospitalized for a respiratory infection.
  • Part of a cluster of unexplained pneumonia in which one case is linked to travel to a previously SARS-affected area or to an ill healthcare worker.

Travel to other areas with SARS-CoV transmission in 2003:

In the absence of SARS transmission worldwide, it is felt that the most likely sites of SARS recurrence are mainland China and the neighboring locations of Taiwan and Hong Kong. Hospitalized persons with radiographic confirmed pneumonia who have a travel history to other areas with SARS-CoV transmission in 2003 (Singapore; Toronto, Canada; and Hanoi, Vietnam) do not need to be reported unless there are factors that increase the likelihood of SARS-CoV infection (see above section).

Pediatric Populations

Based on the limited information available from the 2003 SARS outbreak, the role of pediatric patients in the transmission of SARS-CoV disease is thought to be much less significant than the role of adults. Thus, in the absence of SARS transmission worldwide, the screening of persons requiring hospitalization for radiographic evidence of pneumonia or ARDS of unknown etiology should be limited to adults, unless there are special circumstances that make the clinician and public health personnel consider a child to be of potentially high risk for having SARS-CoV disease.

2. Presence of SARS-CoV Transmission in the World.

Medical providers should ask all patients presenting with fever or respiratory symptoms about recent travel history or exposure to someone who may have SARS. Providers should immediately report to the LHD any patient who meets the following reporting criteria:

  • Any patient meeting the reporting criteria listed for when there is no SARS activity
    (e.g., healthcare workers hospitalized with radiographic evidence of pneumonia; clusters of unexplained pneumonia)
    OR
  • Any patient meeting the following clinical criteria and epidemiologic criteria:
    • Clinical criteria (at least one of the following)
      • Fever >38° C (100.4° F)
        OR
      • Lower respiratory infection (e.g., cough, shortness of breath, difficulty breathing).
        AND
    • Epidemiologic criteria (at least one of the following)
      • Within 10 days of onset, close contact with a person with known or suspected SARS infection,
        OR
      • Within 10 days of onset, history of travel (or close contact with an ill person will a history of travel) to a location with documented or suspected SARS-CoV,
        OR
      • Within 10 days of onset, exposure to a domestic location with documented or suspected SARS-CoV (including a laboratory that contains live SARS-CoV), or close contact with an ill person with such an exposure history.

How to Report Potential SARS Cases

  • Providers should report immediately by telephone to the LHD any patient meeting the SARS reporting criteria.
  • If there are difficulties reaching the LHD, the provider should contact the New York State Department of Health. During business hours, call 518-473-4436; after hours, call 1-866-881-2809.
  • In New York City, contact the New York City Department of Health and Mental Hygiene during business hours through the Provider Access Line at 1-866-NYC-DOH1 (1-866-692-3641). At all other times, call the Poison Control Center at 1-212-764-7667.