Outbreak preparedness & control

PPHSN Guidelines

For the Preparedness, Surveillance And 

Response To Severe Acute Respiratory Syndrome (SARS) 

in Pacific Island Countries And Territories

  April 9^th 2003 

SARS is a new disease syndrome. Our knowledge about the best way to prevent and treat it is constantly evolving. These guidelines will be continuously updated. Please regularly check PPHSN website for the most up to date guidance. These guidelines have also been ‘harmonised’ with the WHO WPRO guidelines published on 4^th April.   

SURVEILLANCE (Updated 09.04.03)

Please note that a SINGLE case of suspected/probable SARS is an outbreak.

PPHSN Case Definitions for hospital based surveillance

Suspected case 

Clinicians should be alert for persons with onset of illness after November 1, 2002 with: 

Fever (>38° C) 

      AND 

One or more signs or symptoms of respiratory illness, including: 

• cough, 

• shortness of breath, 

• difficulty breathing, 

     AND 

A history of either of the following: 

• close contact*, within 14 days of onset of symptoms, with a person who has been diagnosed with SARS. 

• history of travel, within 14 days of onset of symptoms, to an area** (see table below) in which there are reported foci of transmission of SARS.

* 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.

Note 

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.

Probable case 

• A suspected case with chest X-ray findings of pneumonia or adult 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.

Surveillance and reporting

• If travel questionnaires are issued to arriving passengers or passengers from affected areas are requested to identify themselves, record number of arrivals with a travel history that puts them in the at risk group (travel to an affected area within the previous 14 days). 

• Report all suspected/probable cases immediately to National Public Health Authorities, using the PPHSN reporting form (see ANNEX 2). 

• Report all suspected/probable cases immediately to PPHSN Coordinating Body (CB) Focal point or WHO Suva (through local WHO Office if present) using the PPHSN reporting form (a copy of the completed form used to report to the National Public Health Authorities) (see contacts list in ANNEX 1) 

• Report to PacNet or PacNet-restricted.

Minimum dataset

• Upon arrival:

o   affected area visited in the last 10 days and presence of symptoms.

o   identify of individuals and residence/contact in the next 14 days 

    (purpose: active surveillance retrieving contacts of suspected or 

     probable case on board a plane or boat).

o   national health or port authorities may consider routinely collecting a 

    copy of the passenger seating list of every flight arriving from SARS 

    affected areas.

• Please see PPHSN reporting form for data items. 

• For PacNet or PacNet-restricted, same as on reporting form, EXCEPT reporter and patient details (you can send the form on PacNet or PacNet-restricted, but delete the 2nd page).

PPHSN SARS Guidelines - 09/04/2003

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