L.A. County SARS Update: Written Advisory, Info On Seven Suspected SARS Cases

Los Angeles County Department of Health Services officials have identified seven suspected cases of Severe Acute Respiratory Syndrome (SARS), an atypical respiratory illness recently reported in persons in several nations in Southeast Asia.

Five of the seven cases have recovered. One person remains hospitalized in good condition. Six of the seven individuals have a history of travel to at least one of the affected areas. The remaining case occurred in a child whose parent had traveled. To date all laboratory specimens sent to the Centers for Disease Control and Prevention (CDC) for analysis have been negative for both viral and bacterial pathogens.

The health department continues to work closely with CDC quarantine authorities to increase awareness of SARS at LAX and the port and to alert and help identify any passengers who may be experiencing symptoms of this illness. In addition, the health department alerts emergency departments and physicians in Los Angeles County to updates from the CDC regarding case definition or appropriate triage and the isolation procedures to help reduce SARS transmission.

"Respiratory illnesses are very common in Los Angeles County at this time of the year," said Jonathan Fielding, M.D., M.P.H., Director of Public Health and County Health Officer. "For many of these, a specific diagnosis is never obtained. Therefore, the mere presence of these symptoms should not be a cause of heightened concern."

To avoid confusion with other respiratory illnesses at this time of the year, Dr. Fielding emphasizes that there are specific conditions that must be met to be considered as SARS. CDC recently updated their case definition of SARS to include:

Documented fever (greater than 38 degrees C or 100.5 degrees F);

AND one or more signs or symptoms of respiratory illness including cough, shortness of breath, difficulty breathing, or abnormal chest x-ray;

AND one or more of the following:

History of travel to Hong Kong; the People’s Republic of China; Hanoi, Vietnam; or Singapore, within ten days of symptom onset;

Close contact with persons with respiratory illness having the above travel history. Close contact includes having cared for, having lived with, or having had direct contact with respiratory secretions and body fluids of a person with SARS.

Currently cases of possible SARS have been reported from those visiting mainland China; Hong Kong; Hanoi, Vietnam; and Singapore. As of March 28, CDC advises that people planning elective or nonessential travel to these areas may wish to postpone their trips until further notice. The CDC website periodically updates these travel advisories (www.cdc.gov).

Health officials advise that, in the unlikely event a traveler experiences this combination of symptoms AND has traveled to these countries in the last 7 days, they should seek medical attention and inform the health care staff about their recent travel. Physicians should report any suspect case of SARS in a person who has recently traveled to these locations or has had close contact with someone who has recently traveled to these locations by calling the Acute Communicable Disease Control (ACDC) unit at 213-240-7941during the day or 213-974-1234 before 9:00 a.m. on weekdays and during nights or weekends.

For more information about SARS, please see the CDC’s and WHO’s websites at www.cdc.gov/ncidod/sars and www.who.int. The health department also posts updates regarding SARS at www.lapublichealth.org/acd/sars.htm.