CDC: new guidelines for controlling SARS: scenarios with and without transmission.(Clinical Rounds)

Until severe acute respiratory syndrome pops up again, it should be considered as a diagnosis only for patients hospitalized for pneumonia who also raise epidemiologic suspicions, according to new clinical guidelines released by the Centers for Disease Control and Prevention.

The suspicion of SAILS is raised if, within 10 days of symptom onset, the patient:

* Has a history of recent travel to mainland China, Hong Kong, or Taiwan.

* Is employed in an occupation, such as health care or laboratory work, at particular risk for SARS exposure.

* Is part of a cluster of cases of atypical pneumonia without an alternative diagnosis.

Because there are no specific clinical or laboratory findings that can distinguish SAPS from other respiratory illnesses, early recognition will rely on a combination of clinical and epidemiologic features. While laboratory tests--such as enzyme immunoassay, indirect fluorescent-antibody, and reverse transcription-polymer chain reaction--can be helpful, none can reliably detect infection early in the course of the illness.

If SARS transmission is documented somewhere in the world, a SARS diagnosis should be considered for patients meeting the above criteria. In addition, all patients with fever or respiratory symptoms should be questioned about whether, within 10 days of symptom onset, they have had: