March 19, 2003
CONTENTS OF THIS ISSUE
- CDC releases "Updated Interim Domestic Infection
Control Guidance in the Health Care and Community Setting for Patients
with Suspected Severe Acute Respiratory Syndrome (SARS)"
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March 19, 2003
CDC RELEASES "UPDATED INTERIM DOMESTIC INFECTION CONTROL GUIDANCE IN THE
HEALTH CARE AND COMMUNITY SETTING FOR PATIENTS WITH SUSPECTED SEVERE ACUTE
RESPIRATORY SYNDROME (SARS)"
CDC has asked its partners to distribute the
UPDATED INTERIM DOMESTIC INFECTION CONTROL GUIDANCE IN THE HEALTH CARE AND
COMMUNITY SETTING FOR PATIENTS WITH SUSPECTED SEVERE ACUTE RESPIRATORY
3/18/2003 1300 Eastern Standard Time
The Centers for Disease Control and Prevention (CDC) and the World Health
Organization (WHO) have received reports of patients with severe acute
respiratory syndrome (SARS). The cause of these illnesses is unknown and is
being investigated. Some close contacts, including health care workers, have
developed similar illnesses. In response to these developments, CDC is
issuing revised interim guidance concerning infection control precautions in
the health care and community setting. To minimize the potential for
transmission, these precautions are recommended, as feasible given available
resources, until the causative agent is isolated or the epidemiology of
illness transmission is better understood.
For all contact with suspect SARS patients, careful hand hygiene is urged,
including hand washing with soap and water; if hands are not visibly soiled,
alcohol-based handrubs may be used as an alternative to hand washing. Access
for more information on hand hygiene.
FOR THE INPATIENT SETTING:
If a suspect SARS patient is admitted to the hospital, infection control
personnel should be notified immediately. Infection control measures for
- Standard precautions (e.g., hand hygiene);
in addition to routine standard precautions, health care personnel should
wear eye protection for all patient contact.
- Contact precautions (e.g., use of gown and
gloves for contact with the patient or their environment)
- Airborne precautions (e.g., an isolation
room with negative pressure relative to the surrounding area and use of an
N-95 filtering disposable respirator for persons entering the room)
If airborne precautions cannot be fully
implemented, patients should be placed in a private room, and all persons
entering the room should wear N-95 respirators. Where possible, a
qualitative fit test should be conducted for N-95 respirators;
detailed information on fit testing can be accessed at
If N-95 respirators are not available for health care personnel, then
surgical masks should be worn. Regardless of the availability of facilities
for airborne precautions, standard and contact precautions should be
implemented for all suspected SARS patients.
FOR THE OUTPATIENT SETTING:
If possible, suspect SARS patients, on arrival to the outpatient or
ambulatory setting, e.g., clinic or Emergency Department (ED), should be
evaluated in a separate assessment area to determine if they meet the case
definition for suspected SARS and require isolation. A surgical mask should
be placed on the patient if possible.
All health care personnel should wear N-95 respirators while taking care of
patients with suspected SARS. Precautions should be used when evaluating or
transporting patients (e.g., emergency medical technicians), or in any
ambulatory healthcare setting (e.g., ED or clinic personnel). If N-95
respirators are not available, surgical masks should be worn by personnel.
FOR HOME OR RESIDENTIAL SETTING:
Placing a surgical mask on suspect 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.
CASE DEFINITION FOR SUSPECTED SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
Health care personnel should apply appropriate infection control precautions
for any contact with patients with suspected SARS. The case definition for
suspected SARS is subject to change, particularly concerning travel history
as transmission is reported in other geographic areas; the most current
definition can be accessed at
To obtain this information in camera ready (PDF) format, go to: