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PUBLIC ANNOUNCEMENT

1. SUBJECT: FACT SHEET: SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

The U.S. Department of State encourages American citizens traveling or residing abroad to familiarize themselves with the information available from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) about Severe Acute Respiratory Syndrome (SARS). This Fact Sheet updates the March 21, 2003, version and reflects changes in the geographic spread of SARS cases and includes additional information. In light of the evolving nature of the SARS situation, American citizens should regularly consult the CDC website http://www.cdc.gov/ and the WHO website http://www.who.int/ for updates.

In Hanoi, Vietnam and Hong Kong, the appearance of SARS has had an impact on medical facilities, due to the closing and/or quarantine of hospitals and the spread of the disease to health care workers. Medical evacuation of SARS patients currently is not available by commercial carrier; additionally, the number of countries willing to accept SARS patients is very limited.

Prospective parents of adoptees from mainland China and Vietnam should consult the appropriate link on adoptions at the CDC website, http://www.cdc.gov/ncidod/sars/adoption.htm

In addition to Vietnam, Hong Kong, mainland China and Singapore, the CDC has received reports of outbreaks of SARS elsewhere in Asia and in Europe and North America, including Canada, the United States, Thailand, Germany, and Switzerland. Most cases appear to involve health- care workers caring for SARS patients and close family contacts. CDC is working closely with WHO and country partners to define the origin of this infection, to track patterns of its transmission, and to determine effective strategies for its control and prevention. Local health authorities should be notified of all suspected cases of SARS.

The CDC has identified the following three criteria, which must ALL be present, by which a potential SARS case may be identified, for those with the onset of illness after February 1, 2003:

--Fever greater than 380 C (100.40F), AND
--One or more signs or symptoms of respiratory illness including cough, shortness of breath, difficulty breathing, hypoxia (low oxygen in the blood), x-ray findings of pneumonia, or respiratory distress, AND.

One or more of the following within 2-7 days of the onset of symptoms: Travel to mainland China, Hong Kong, Singapore, or Vietnam; and/or close contact*, with a person who has been infected with SARS (*close contact means having cared for, lived with, or having had direct contact with respiratory secretions (such as coughs and sneezes) and body fluids of a person with SARS).

The incubation period between exposure to infection and the development of symptoms appears to range from 2-7 days. For more specific information regarding case definition updates and empiric treatment clinicians should consult and monitor the CDC's and WHO's web sites.

Currently, prevention of new cases is based on individuals avoiding close contact with SARS-infected persons, as described above. Persons matching the case description for SARS should be promptly evaluated by medical personnel and, if indicated, admitted to a hospital. Persons suspected of having SARS should limit their interactions outside hospital settings.

Contact Information for the CDC:

Public Inquiries: English (888) 246-2675
Spanish (888) 246-2857
TTY (866) 874-2646
Mon-Fri 8am-11pm EST
Sat-Sun 10am-8pm EST

Address: The Centers for Disease Control and Prevention'
1600 Clifton Rd. Atlanta,
GA 30333 USA
(404) 639-3311

2. SUBJECT: PUBLIC ANNOUNCEMENT - SARS IN ASIA

This Public Announcement is being issued to alert Americans that the CDC has issued a travel advisory, and health alert notices, which are being distributed at ports of entry to people returning from the three affected regions. CDC advises that people planning elective or nonessential travel to mainland China and Hong Kong; Singapore; and Hanoi, Vietnam, may wish to postpone their trips until further notice. This Public Announcement expires on June 26, 2003.

The Centers for Disease Control (CDC) and the World Health Organization (WHO) are tracking SARS's origin and method of transmission as well as determining how its spread can be contained. In light of the continually evolving nature of the geographic spread of SARS, American citizens should regularly consult the CDC website http://www.cdc.gov/ and the WHO website http://www.who.int/ for updates.

American citizens currently in or planning to travel to SARS-affected areas of Asia should consult the Department of State's Fact Sheet on SARS, Public Announcements, Travel Warnings, and Consular Information Sheets for China, Hong Kong, Singapore, and Vietnam, all of which are available at the Consular Affairs Internet web site at http://travel.state.gov. American citizens may also contact the Department of State toll-free at 1-888-407- 4747, or if calling from overseas, 317-472-2328, for SARS information.

SUBJECT: PUBLIC ANNOUNCEMENT – CANADA

This Public Announcement is being issued to alert U.S. citizens to the declaration of a Provincial health emergency in Ontario, Canada. This Announcement expires on June 26, 2003.

On March 26, the Government of Ontario declared Severe Acute Respiratory Syndrome (SARS) to be a provincial emergency. The declaration follows the deaths of three individuals from SARS and the apparent manifestations of the disease in more than 50 individuals across the province. Canada is attempting to limit the spread of the outbreak by screening all passengers at airports for SARS symptoms. Health Canada sent staff to Pearson and Vancouver International Airports to help monitor passengers arriving on direct flights from affected areas for flu- like symptoms and to assist those who appear to be ill. Two major hospitals have been closed or restricted in the past 24-48 hours; other hospitals may also be affected. Ontario hospitals are operating under severe measures such as limiting access, restricting patient transfers between hospitals and requesting that those at risk of developing SARS place themselves under voluntary quarantine in their homes.

Detailed information on SARS is available from the Centers for Disease Control, http://www.cdc.gov, the World Health Organization http://www.who.int and the Canadian Health Organization, http://www.health.gov.on.cal. A Fact Sheet for American citizens traveling abroad based on information from those websites is also available at the website of the Department of State's Bureau of Consular Affairs, http://travel.state.gov. Information from Health Canada is available at www.hc-sc.qc.ca. For further information on travel to Canada, please consult the Department of State's Consular Information Sheet, available on the Bureau of Consular Affairs home page at http://www.travel.state.gov. The U.S. Embassy is located in Ottawa, Canada at 490 Sussex Drive, Ottawa, Ontario K1N 1G8, telephone (613) 238-5335; website at http://usembassy.state.gov/canada.

For updated information on Nicaragua, please contact the American Citizens Services Unit of the U.S. Embassy. The Embassy is located at Kilometer 4.5 (4 ˝) Carretera Sur, Managua; telephone (505) 266-6010 or 268-0123; after hours telephone (505) 266-6038; Consular Section fax (505) 266-9943; e-mail: consularmanagua@state.gov; web page at http://managua.usembassy.state.gov or http://nicaragua.usembassy.state.gov

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