15 March 2003

WHO Issues emergency travel advisory

Severe Acute Respiratory Syndrome (SARS) Spreads Worldwide

Geneva -- During the past week, WHO has received reports of more than 150
new suspected cases of Severe Acute Respiratory Syndrome (SARS), an
atypical pneumonia for which cause has not yet been determined. Reports to
date have been received from Canada, China, Hong Kong Special
Administrative Region of China, Indonesia, Philippines, Singapore,
Thailand, and Viet Nam. Early today, an ill passenger and companions who
travelled from New York, United States, and who landed in Frankfurt,
Germany were removed from their flight and taken to hospital isolation.

Due to the spread of SARS to several countries in a short period of time,
the World Health Organization today has issued emergency guidance for
travellers and airlines.

"This syndrome, SARS, is now a worldwide health threat," said Dr. Gro
Harlem Brundtland, Director General of the World Health Organization. "The
world needs to work together to find its cause, cure the sick, and stop
its spread."

There is presently no recommendation for people to restrict travel to any
destination. However in response to enquiries from governments, airlines,
physicians and travellers, WHO is now offering guidance for travellers,
airline crew and airlines. The exact nature of the infection is still
under investigation and this guidance is based on the early information
available to WHO.

TRAVELLERS INCLUDING AIRLINE CREW: All travellers should be aware of main
symptoms and signs of SARS which include:

* high fever (38oC)

AND

* one or more respiratory symptoms including cough, shortness of
breath, difficulty breathing
*
* AND one or more of the following:
*
* close contact* with a person who has been diagnosed with SARS
* recent history of travel to areas reporting cases of SARS.

In the unlikely event of a traveller experiencing this combination of
symptoms they should seek medical attention and ensure that information
about their recent travel is passed on to the health care staff. Any
traveller who develops these symptoms is advised not to undertake further
travel until they have recovered.

AIRLINES: Should a passenger or crew member who meets the criteria above
travel on a flight, the aircraft should alert the destination airport.
On arrival the sick passenger should be referred to airport health
authorities for assessment and management. The aircraft passengers and
crew should be informed of the person's status as a suspect case of SARS.
The passengers and crew should provide all contact details for the
subsequent 14 days to the airport health authorities. There are currently
no indications to restrict the onward travel of healthy passengers, but
all passengers and crew should be advised to seek medical attention if
they develop the symptoms highlighted above. There is currently no
indication to provide passengers and crew with any medication or
investigation unless they become ill.

In the absence of specific information regarding the nature of the
organism causing this illness, specific measures to be applied to the
aircraft cannot be recommended. As a general precaution the aircraft may
be disinfected in the manner described in the WHO Guide to Hygiene and
Sanitation in Aviation.

* * *
As more information has become available, WHO-recommended SARS case
definitions have been revised as follows:
Suspect Case
A person presenting after 1 February 2003 with history of :

* high fever (38oC)

AND

* one or more respiratory symptoms including cough, shortness of
breath, difficulty breathing
*
* AND one or more of the following:
*
* close contact* with a person who has been diagnosed with SARS
* recent history of travel to areas reporting cases of SARS
Probable Case

A suspect case with chest x-ray findings of pneumonia or Respiratory
Distress Syndrome

OR

A person with an unexplained respiratory illness resulting in death, with
an autopsy examination demonstrating the pathology of Respiratory Distress
Syndrome without an identifiable cause.

Comments
*Close contact means having cared for, having lived with, or having had
direct contact with respiratory secretions and body fluids of a person
with SARS.

In addition to fever and respiratory symptoms, SARS may be associated
with other symptoms including: headache, muscular stiffness, loss of
appetite, malaise, confusion, rash, and diarrhea.

Until more is known about the cause of these outbreaks, WHO recommends
that patients with SARS be isolated with barrier nursing techniques and
treated as clinically indicated. At the same time, WHO recommends that any
suspect cases be reported to national health authorities.

WHO is in close communication with all national authorities and has also
offered epidemiological, laboratory and clinical support. WHO is working
with national authorities to ensure appropriate investigation, reporting
and containment of these outbreaks. -keralamonitor.com