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Important Information on SARS

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From the Provost
 

 

As many of you know, the medical and public health communities throughout 2003 grappled with a new illness known as Severe Acute Respiratory Syndrome or SARS. We want you to know that we remain in constant contact with the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) as more information about SARS unfolds. In accordance with the CDC and WHO, following are recommendations regarding Severe Acute Respiratory Syndrome (SARS):

  • Students, faculty and staff with travel plans to the affected areas are advised to check the travel advisories on the CDC and WHO websites before making their travel decision.

  • Visitors entering the U.S. from China; Vietnam; Singapore; Toronto, Canada; and any other areas with known outbreaks of SARS should monitor their health for the appearance of symptoms for at least 10 days. If you experience elevated temperature, cough, or shortness of breath, you should avoid contact with others, seek immediate medical evaluation and inform the physician that you have been in an infected area.

Our healthcare professionals recommend that those returning from any of the affected areas keep a log of contacts and places visited during the 10 days following their arrival in the U.S.

General Information

  • The majority of the cases were diagnosed in Canada, China, Hong Kong, Indonesia, the Philippines, Singapore, Thailand and Vietnam.

  • To date, there have been NO reported cases of SARS or SARS symptoms on our campus or in the Washington, DC, metropolitan area.

  • The incubation period for SARS is typically 2 to 7 days (although a few cases suggest an incubation period up to 10 days). 

  • SARS is transmitted by close contact between people either by droplets (from a sneeze or cough) or hand contamination.

  • SARS can survive on environmental surfaces for up to three hours.

  • SARS can cause serious and potentially life threatening infections in the lower respiratory tract.

  • Symptoms include fever, cough, difficulty breathing and severe respiratory distress.

  • Cases of SARS continue to be reported mainly among people who have had direct close contact with an infected person, such as those sharing a household with a SARS patient and healthcare workers who did not use infection control procedures while taking care of a SARS patient.

  • The CDC case definition includes only those who are symptomatic, have or have had contact with an infected person or have traveled to areas with suspected or documented transmission of SARS.

  • Anyone who fits the definition and presents with symptoms should contact his/her physician immediately or Student Health Services at GW at 202-741-2650.

For more information, you can link to the CDC website at www.cdc.gov.

John F. Williams, MD, EdD
Provost and Vice President for Health Affairs
Dean, School of Medicine and Health Sciences
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UNIVERSITY INTERIM POLICY RELATED TO SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

The international public health community has been grappling with Severe Acute Respiratory Syndrome or SARS. SARS is a contagious illness that was reported in Asia, North America, and Europe. In general, SARS begins with a fever greater than 100.4°F [>38.0°C]. Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms. After two to seven days, SARS patients may develop a dry cough and have trouble breathing. The possible diagnosis of SARS applies to those who have traveled to or from affected countries or have come in close contact with people from affected countries and who are symptomatic. Currently there are no reported cases in the Washington, D.C. metropolitan area.

Out of concern for the health, safety and well-being of our faculty, students and staff and those with whom they come in contact, and after careful consideration by a task force of University officials and physicians, the University adopted an Interim Policy for faculty, students and staff related to SARS. Due to the changing nature of this newly reported syndrome, this Interim Policy may be revised consistent with the latest health guidance. GW's SARS Task Force will have the ongoing responsibility to reassess the Center for Disease Control and Prevention (CDC) recommendations and how they impact the University community and our Interim Policy. While the University will inform our community of any substantive changes to the Interim Policy, we strongly encourage you to visit the University's Web site, at www.gwu.edu for updates.

I. Affected Countries

Although SARS has been identified in a number of locations, the CDC breaks down affected locations into two enhanced risk categories, based on the latest information. For purposes of this policy, locations subject to a CDC Travel Advisory or a Travel Alert will be referred to as "affected countries." Currently, no areas are reporting ongoing transmission of SARS. Information about travel alerts and advisories may be found at www.cdc.gov/travel.

Travel Advisory: 
A travel advisory means there is a recommendation against non-essential travel to the area because of a large number of cases in the area.

Travel Alert:
A travel alert means there is no recommendation against non-essential travel to the area but that the area does have a large number of cases.

Please check the CDC website at www.cdc.gov for the latest travel information before making your arrangements

A travel alert for Vietnam was recently lifted by the CDC. Back to top.

II. Guidelines for Travel to a Country with a Travel Advisory

The University will not provide funding for, nor may University funding be used to support, travel to countries with a travel advisory for University sponsored programs or business. This also applies to individual or group travel or other related expenses, including funding for research or study in the countries under a travel advisory and any other scholarship related or staff related travel with or without students.

All University sponsored or affiliated study abroad program assignments for countries with a travel advisory are under review. Please visit the Office of Study Abroad Web site at www.gwu.edu/~studyabr for the status of these programs. Should it be determined that students may not participate in such programs, the University will assist with alternative arrangements to facilitate students being able to fulfill any academic requirements associated with such travel or programs.

All non-essential and elective travel should be deferred. Elective travel will not be covered under applicable University insurance policies relating to actions or work within the scope of employment.

III. Guidelines for Travel to a Country with a Travel Alert

University funding may be used for University-sponsored or supported programs or business, in accordance with University policies, but the University strongly advises that non-essential travel be deferred to affected countries under a travel alert.

All University-sponsored or affiliated study abroad program assignments for affected countries with a travel alert are under review. Please visit the Office of Study Abroad Web site www.gwu.edu/~studyabr for the status of these programs. Should it be determined that students may not participate in such programs, the University will assist with alternative arrangements to facilitate students being able to fulfill any academic requirements associated with such travel or programs. Back to top.

IV. General Guidelines Relating to Travel to and from Affected Countries

The University urges faculty, students and staff to become informed about SARS and its symptoms and to consult the CDC travel advisories and local health conditions before traveling to an affected country. The University or your insurer may not be able to evacuate you from an affected country, and if you become infected with SARS, you may be forced to obtain medical treatment in the affected country. Further, your return to the United States may be delayed.

Faculty, students, staff and visitors who travel to or from an affected country or who come in close contact with people from affected countries should closely monitor their health for 10 days upon their return to the United States. If such individuals are symptomatic within that time frame, they should seek prompt medical attention. The University reserves the right to conduct a screening, by telephone or in person, for signs and symptoms of SARS or to require a written certification that such a screening was performed by a personal physician. The University also may impose additional requirements in its sole discretion.

V. Additional Information on SARS

Any person who has recently traveled to a country under a travel advisory of alert or who has come into close contact with an individual infected with SARS should be screened by a physician as soon as possible, particularly if there is fever above 100.4 degrees F (or 38 degrees C), persistent cough, or shortness of breath. Back to top.

For the latest information on SARS and travel related advisories, please visit the following Web Sites:

www.gwu.edu (GW's main Web site)
http://www.cdc.gov/ncidod/sars/ (Centers for Disease Control and Prevention)
http://www.who.int/csr/sars/en/ (World Health Organization)

Frequently Asked Questions
What is SARS?
 A respiratory illness (Severe Acute Respiratory Syndrome) that has recently been reported in Asian, North America and Europe.
What are the symptoms of SARS?
 Usually SARS begins with a fever (greater than 100.4°F) and may be associated with chills or other symptoms including headache, general feeling of discomfort and body aches. Some individuals may also experience mild respiratory symptoms at the beginning. After 2-7 days, individuals with SARS may develop a dry, nonproductive cough that may be accompanied by or progress to the point where insufficient oxygen is getting to the blood. In 10-20 percent of the cases, individuals will require mechanical ventilation.
After exposure to SARS, how long will it take to become sick?
 Typically the incubation period is 2-7 days; however, there are some reports that the incubation period is as long as 10 days. Again, the illness usually begins with a fever. Back to top.

 
Is there a possibility that people who have recovered from SARS become sick again or relapse?
 CDC and other scientist are trying to learn the answer to this and other questions. They are learning what factors might influence the progression of the illness and recovery.

 
What medical treatment is recommended for SARS patients?
 The CDC recommends that SARS patients receive the same treatment that would be used for any patient with serious community-acquired atypical pneumonia.

 

What areas are involved in the travel advisories and alerts put out by the CDC?
  • There are no Travel Advisories at this time.
  • There are no Travel Alerts at this time.
    Back to top.
What is a travel alert and travel advisory?  A travel alert is a distinction by the CDC that an outbreak is occurring in a geographic area. The purpose of an alert is to provide accurate information to travelers about the status of the outbreak, how to reduce their risk for infection and what to do if they become ill. The risk for the individual traveler is felt to be definable and limited; transmission has occurred in defined settings or is associated with specific risk factors (e.g., transmission in a healthcare or hospital setting where ill patients are being cared for). There is NOT a recommendation against nonessential travel to the area.

A travel advisory is a distinction by the CDC that an outbreak is occurring in a geographic area. The purpose of an advisory is to provide accurate information to travelers about the status of the outbreak and how to reduce their risk for infection. It also serves to reduce the volume of traffic to affected areas which in turn can reduce the risk of translocating the disease to previously unaffected sites. There IS a recommendation against nonessential travel to the area because the risk for the traveler is considered to be much higher than for a simple travel alert notice—for example, the risk is increased because of evidence of community transmission and/or inadequate containment. Back to top.

GUIDELINES AND RECOMMENDATIONS

Interim Guidance for Institutions or Organizations Hosting Persons Arriving in the United States from Areas with Severe Acute Respiratory Syndrome (SARS) Issued by the CDC, May 14, 2003, 12:00 PM ET

To date, most reported cases of Severe Acute Respiratory Syndrome (SARS) in the United States have been acquired during international travel to countries where SARS is being transmitted in the community. (These areas are described at the case definition page). In this country, only a small number of suspected or probable cases of SARS have been detected among exposed healthcare personnel and household contacts of SARS patients. Casual contact with SARS patients at schools, other institutions, or public gatherings (e.g., attending the same class or meeting) has not resulted in documented transmission in the United States.

Thousands of people arrive in the United States from areas where SARS outbreaks are occurring to participate in gatherings such as academic courses, business meetings, or sporting events. Guidance is needed to provide a consistent, rational approach to SARS prevention without unnecessarily stigmatizing these groups or interfering with collegial pursuits, commerce, and other important activities.

At this time, CDC does not recommend canceling or postponing classes, meetings or other gatherings that will include persons traveling to the United States from areas with SARS. CDC is working closely with WHO and other partners as part of a global collaboration to address the SARS outbreak. Back to top.

The following comprehensive activities are taking place to prevent importation and spread of SARS from inbound passengers:

  • Stringent outbreak control measures, including isolation of SARS patients
  • and quarantine of their exposed contacts, in countries with SARS;
  • Pre-embarkation screening of persons traveling from areas with SARS to
  • defer travel for those with symptoms or signs of SARS or exposure to known
  • SARS patients in the past 10 days;
  • Assessment by health authorities of ill persons aboard arriving flights
  • from an area with SARS to ensure that ill passengers are isolated and
  • evaluated promptly upon arrival and that appropriate follow-up of other
  • passengers occurs, as necessary;
  • Distribution of health alert notices to travelers arriving in the United
  • States from areas with SARS to notify them of the importance of monitoring
  • their health closely for a period of 10 days following departure, and for
  • persons who develop fever or respiratory symptoms, the need to promptly
  • seek medical evaluation; and
  • Rapid detection and isolation of persons in the United States who have traveled from an area with SARS and have symptoms compatible with early suspected SARS within 10 days of arrival.

At this time, CDC does not recommend quarantine of persons arriving from areas with SARS. The following are interim recommendations to assist persons who are organizing gatherings of students and other persons traveling to the United States from areas with SARS, including gatherings in academic settings, business meetings, or sporting events, etc. These recommendations are based on the experience in the United States to date and may be revised as more information about the SARS situation in the United States and globally becomes available. If organization representatives become aware of a person from an area with SARS who develops fever or respiratory symptoms, the following steps should be taken: Back to top.

  • Exclude the ill person from activities (e.g., classes, meetings, and other public areas) and locate him/her in a separate area to minimize contact with other people while awaiting further medical evaluation.
  • Alert appropriate healthcare personnel that an individual from an area with SARS requires evaluation, so that advance preparations can be made to implement infection control procedures to prevent transmission to others during transport and in the healthcare setting.
  • Remind the treating healthcare provider to notify the appropriate state or local health officials if SARS is suspected. Further information for healthcare providers about the management of persons with suspected SARS is available at www.cdc.gov/ncidod/sars/exposuremanagement.htm.

Organizations that would like to take additional steps should consider the following actions: Back to top.

  • Send basic information about SARS, including information in the health alert notice and a reminder about the importance of hand hygiene, to the participants before departure (by email, for example).
  • Notify the participants (prior to departure) that persons traveling from areas with SARS with fever or respiratory symptoms or exposure to SARS patients within 10 days prior to scheduled departure should not travel and should seek medical evaluation.
  • Contact state or local public health officials before the event, and collaborate to ensure that appropriate public health guidelines are followed.
  • Include basic information about SARS, including the information in the health alert notice and a reminder about the importance of hand hygiene, in the orientation or meeting registration packet.
  • Give participants tools for self-monitoring, which may include a complimentary thermometer, a temperature log, and contact information, as well as alcohol-based hand rubs for hand hygiene.
  • Work with state or local public health officials to identify an emergency room or other healthcare facility where an ill visitor may be evaluated and where recommended infection control measures can be followed, and/or arrange for healthcare providers to be available on site.
  • Establish a health information hotline or website.
  • Screen participants to identify those at high risk for SARS; sample questions that may be useful include:
    • In the past 10 days, have you been in an area with SARS?
    • If so, do you have any of the following symptoms: fever, cough, difficulty breathing, or shortness of breath?
    • In the past 10 days, have you had close contact with any person who has been diagnosed with SARS? (Close contact is defined as caring for or living with someone with SARS, or having direct contact with infectious material such as respiratory secretions from a person who has SARS.)
    • Work with local and state public health officials to determine where patients with SARS (who do not medically require hospitalization) will be housed until their symptoms resolve. (Persons should be hospitalized unless they can be housed in a designated residential facility for isolation of convalescing cases where recommended infection control measures can be followed.)

For more information, visit CDC's SARS Website, or call the CDC public response hotline at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646 (TTY)

CDC protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations. Back to top.
Alert- Emergency Information This site is regularly updated based upon the latest information from the CDC.—last update 10/30/03.

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