Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 3

Supplement E: Managing International Travel-Related Transmission Risk

Summary
May 3, 2005

Goals

• Prevent the introduction of SARS-CoV (and spread from an introduction) into the United States from SARS-affected areas.
• Prevent exportation of SARS-CoV from the United States if domestic transmission presents an increased risk of exportation.
• Reduce the risk of SARS-CoV disease among outbound travelers to SARS-affected areas.
• Prevent the transmission of SARS-CoV to passengers on a conveyance with a SARS patient, and evaluate and monitor other passengers to detect SARS-like illness and prevent further spread.

• SARS-CoV can spread rapidly on a global scale through international travel if control measures are not implemented.
• SARS-CoV transmission usually involves close contact and is often limited to healthcare settings or households; the risk of SARS to travelers visiting an affected area is low unless travelers are exposed to these settings.
• Travelers visiting SARS-affected areas can reduce their risk by following recommended guidelines and can help prevent transmission by monitoring their health during and for 10 days after travel.
• SARS patients can transmit SARS-CoV to other passengers on conveyances and should postpone travel until they are no longer infectious.
• Active follow-up of passengers on conveyances with SARS cases can help prevent further spread by informing passengers of their exposure and providing instructions for monitoring health and seeking medical evaluation if symptoms develop.
• Transmission of SARS-CoV on conveyances can occur only if an undetected case boards. Therefore, the primary preventive strategy is to prevent symptomatic persons from traveling.

• Screen incoming travelers from SARS-affected areas for SARS, and provide guidance about monitoring their health and reporting illness.
• Provide guidance to outbound travelers about active SARS-affected areas and measures to reduce the risk of acquiring SARS-CoV disease during travel.
• If SARS-CoV transmission in the United States presents an increased risk of exporting SARS-CoV to other countries, then screen outbound travelers to prevent such exportation.
• Ensure the appropriate evaluation and management of SARS cases and potentially exposed passengers and crew members on conveyances.