Home Health Q&A: Severe Acute Respiratory Syndrome

Question: What criteria should raise a suspicion of Severe Acute Respiratory Syndrome (SARS) for home health clinicians?

Answer: According to the Centers for Disease Control and Prevention (CDC), a combination of clinical, epidemiological, and laboratory criteria are needed to classify a case as suspected or probable SARS. The home health nurse can use the following clinical and epidemiological criteria in the home:

Clinical Criteria

Asymptomatic or mild respiratory illness.

Moderate respiratory illness.

— Temperature of >100.4° F (>38° C).

— One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty breathing, or hypoxia).

Severe respiratory illness.

— Temperature of >100.4° F (>38° C).

— One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty breathing, or hypoxia), as well as one of the following:

• radiographic evidence of pneumonia;

• respiratory distress syndrome;

• autopsy findings consistent with pneumonia or respiratory distress syndrome without an identifiable cause.

Epidemiological Criteria

Travel (including transit in an airport) within 10 days of onset of symptoms to an area with current or recently documented or suspected community transmission of SARS.

Close contact within 10 days of onset of symptoms with a person known or suspected to have SARS infection.

Question: What infection control procedures should be followed with a suspected SARS patient?

Answer: Placing a surgical mask on suspected SARS patients during contact with others at home is recommended. If the patient is unable to wear a surgical mask, it may be prudent for household members to wear surgical masks when in close contact with the patient. Household members in contact with the patient should be reminded to practice careful hand hygiene including hand washing with soap and water; if hands are not visibly soiled, alcohol-based hand rubs may be used as an alternative to hand washing.

Question: What countries are considered SARS-affected areas?

Answer: The CDC has issued a travel advisory suggesting that people planning elective or nonessential travel to Mainland China, Hong Kong, Singapore, and Hanoi, Vietnam, may wish to postpone their trips until further notice. CDC also has issued a travel alert for Toronto to recommend that U.S. travelers to that city observe precautions to safeguard their health.

Source: Centers for Disease Control and Prevention, Atlanta.