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SARS returns: Look for pneumonia, travel history
Will China cases spread beyond borders?
On Jan. 13, 2004, the World Health Organization (WHO) reported a new suspect case of severe acute respiratory syndrome (SARS) in a 35-year-old man living in Guangdong province, China. The case is the third recent report of suspected or confirmed SARS in patients in southern China. No link has been established at present between the confirmed case and the two recent suspect SARS cases, and the source of exposure for all three cases is unclear.
In light of these reports, the CDC is recommending that clinicians in the United States maintain a greater index of suspicion of SARS in patients who require hospitalization for radiographically confirmed pneumonia or acute respiratory distress syndrome (ARDS) AND who have a history of travel to Guangdong province (or close contact with an ill person with a history of recent travel to Guangdong province) in the 10 days before onset of symptoms. When such patients are identified, the following actions should be taken:
In addition, the CDC continues to recommend that health care providers and public health officials identify and report patients who require hospitalization for radiographically confirmed pneumonia or ARDS without identifiable etiology AND who have one of the following risk factors in the 10 days before the onset of illness:
Diagnostic testing for SARS should be considered in such patients, as described in the guidelines at www.cdc.gov/ncidod/sars/absenceofsars.htm. "Infection control practitioners and other health care personnel should also be alert for clusters of pneumonia among two or more health care workers who work in the same facility," the CDC warned.