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Severe Acute Respiratory Syndrome (SARS)
Questions and Answers: Travel and Quarantine
May 21, 2004
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What are the different types of travel notices that CDC issues about disease occurrences in the world?
CDC has changed the categories of travel notices about disease occurrences abroad. The new levels of travel notices are: In the News, Outbreak Notice, Travel Health Precaution, and Travel Health Warning . These new travel levels replace Travel Alerts and Travel Advisories. The categories of travel notices were refined to be more easily understood by international travelers, Americans living abroad, healthcare providers, and the general public, and to clarify the need for recommended preventive measures. From the public health perspective, the refined levels of travel notifications will enhance the usefulness of the travel notices, enabling them to be tailored readily in response to changing events and circumstances. Full descriptions of the new travel notice categories are provided at CDC’s Travelers’ Health website.

Are any travel notices related to SARS currently in effect?
Travel notices related to SARS are posted on CDC’s Travelers’ Health website.

What if I must travel to a country where SARS cases have been reported? What precautions can I take?
As with all infectious illnesses, the first line of defense is careful and frequent hand hygiene. As a general rule, it is a good practice to clean your hands often using either soap and water or an alcohol-based hand rub. CDC does not recommend the routine use of masks while in public areas. Guidance for persons traveling to areas where SARS cases have been reported is provided at this page.

What should I do if I have recently traveled to a country where cases of SARS have been reported?
Information for persons who have recently traveled to an area where SARS cases have been reported is provided at this page.

What is the risk to persons who may have shared a plane or boat trip with a possible SARS patient?
Most cases of SARS have involved persons who cared for or lived with someone with SARS or who had direct contact with infectious material (e.g., respiratory secretions) from a person with SARS. Transmission of SARS on airplanes and boats can occur, but the overall risk appears to be low. If a person with possible SARS flies on an airplane while ill, CDC will request locating information from other travelers on the flight. With the help of state and local health authorities, CDC will attempt to monitor these travelers for 10 days for the development of SARS-like symptoms.

Who notifies quarantine officials about potential SARS cases on an airplane or ship?
Under foreign quarantine regulations, the master of a ship or captain of an airplane coming into the United States from a foreign port is required by law to report certain illnesses among passengers. The illness must be reported to the nearest quarantine official. If possible, the crew of the airplane or ship will try to relocate the ill passenger or crew member away from others. If the passenger is only passing through a port of entry on the way to another destination, port health authorities may refer the passenger to a local health authority for assessment and care.

If I am on an airplane or ship with someone suspected of having SARS, will I be allowed to continue to my destination?
CDC does not currently recommend restricting the onward travel of healthy passengers in the event that a passenger or crew member suspected of having SARS is removed from the ship or airplane by port health authorities. All passengers and crew members exposed to SARS are requested to provide locating information and are advised to seek medical attention if they develop SARS-like symptoms.

What does a quarantine official do if a passenger is identified as having possible SARS?
Quarantine officials arrange for appropriate medical assistance, including medical isolation, to be available when the airplane lands or the ship docks. Isolation is important not only for the sick passenger's comfort and care but also for the protection of members of the public. Isolation is recommended for travelers with possible cases of SARS until SARS can be ruled out or until they are no longer infectious. Quarantine officials will request locating information from the other passengers. CDC, with the help of state and local health authorities, will follow up with any close contacts of the ill passenger for 10 days to ensure that persons who develop symptoms during this period are identified promptly and managed appropriately.

What does a quarantine official do if a passenger with possible SARS refuses to be isolated?
Many levels of government (federal, state, and local) have the authority to compel the isolation of sick persons to protect the public. CDC will work with appropriate state and local officials if it is necessary to compel the isolation of a sick passenger.

CDC has recommended guidelines for medical aircraft that transport SARS patients. Should commercial airlines also follow these guidelines?
No. This guidance is intended specifically for air medical transport (AMT) service providers who use specialized and/or specially equipped aircraft to transport SARS patients. It should not be generalized to commercial passenger aircraft. The recommendations for AMT are based on standard infection control practices, AMT standards, and epidemiologic information from investigations of SARS, including experience from air transport of patients during the 2003 outbreak. Specific guidance for airline flight crews, cargo and cleaning personnel, and personnel interacting with arriving passengers is provided.

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