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Appendix E1: Travel-Related SARS Response Matrices

Supplement E: Managing International Travel-Related Transmission Risk

Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2/3

NOTICE

Since 2004, there have not been any known cases of SARS reported anywhere in the world. The content in this Web site was developed for the 2003 SARS epidemic. But, some guidelines are still being used. Any new SARS updates will be posted on this Web site.

Matrix 1: Suggested Activities for Inbound Travelers

Level of SARS-CoV transmission activity in the United States
Suggested actions, by situation in originating location
No known SARS-CoV transmission worldwide or known SARS-CoV activity but only imported cases

Imported cases; limited transmission in location of origin

  • Distribute health alert notices to all arrivals.
  • Implement passive monitoring of all arriving passengers for development of fever or respiratory symptoms.
  • Advise persons who develop symptoms to self-report before presentation to healthcare provider.
  • Follow quarantine officer protocol for arriving ill passengers
    • Follow procedures for ill contacts
    • Collect 30-day contact information for passengers on conveyances with ill passenger
  • Consider enhanced surveillance for ill passengers.

Extensive transmission/effective control measures

  • Implement active surveillance for ill passengers.
  • Implement symptom screening for all arriving passengers.
  • Medically evaluate all passengers with symptoms.
  • Consider 10-day quarantine for asymptomatic arrivals.
  • Collect contact information on all arriving passengers.

Extensive transmission/ineffective control measures

  • Prohibit all non-essential arrivals.
  • Conduct medical screening upon arrival.
  • Implement mandatory 10-day quarantine for all asymptomatic arrivals.
  • Collect contact information on all arriving passengers.
Extensive SARS-CoV transmission in United States and community, with effective control measures

Imported cases; limited transmission in location of origin

  • Minimize non-essential travel.
  • Consider restricting travel within jurisdictions.
  • Advise arrivals to follow procedures based on situation in location of origin.

Extensive transmission/effective control measures

  • Minimize non-essential travel.
  • Consider restricting travel within jurisdictions.
  • Advise arrivals to follow procedures based on situation in location of origin.

Extensive transmission/ineffective control measures

  • Prohibit all non-essential arrivals.
  • Conduct medical screening upon arrival.
  • Implement mandatory 10-day quarantine for all asymptomatic arrivals.
  • Collect contact information on all arriving passengers.
Extensive SARS-CoV transmission in United States and community, with ineffective control measures

Imported cases; limited transmission in location of origin

  • Prohibit all non-essential arrivals.
  • Advise arrivals to follow procedures based on situation in location of origin.

Extensive transmission/effective control measures

  • Prohibit all non-essential arrivals.
  • Advise arrivals to follow procedures based on situation in location of origin.

Extensive transmission/ineffective control measures

  • Prohibit all non-essential arrivals.
  • Conduct medical screening upon arrival.
  • Implement mandatory 10-day quarantine for all asymptomatic persons.
  • Collect contact information on all arriving passengers.

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Matrix 2: Suggested Activities for Outbound Travelers

Level of SARS-CoV transmission activity in the United States
Suggested actions, by situation in originating location
No known SARS-CoV transmission worldwide
  • No special activities
SARS activity in United States and community, but only imported cases
  • Issue travel health precautions and warnings for destinations based on setting and transmission pattern
  • Prohibit non-essential travel to countries where control measures are inadequate.
  • Consider:
    • Medical screening at all exit points
    • Travel prohibition for all persons meeting case definition with epidemiologic link to transmission setting
    • Medical assessment for all with signs/symptoms without epidemiologic link
  • Prohibit travel for persons under quarantine.
Extensive SARS-CoV transmission in United States and community, with effective control measures
  • Issue international travel notifications as above.
  • Issue travel health precautions/warnings for domestic destinations based on setting and transmission pattern.
  • Initiate medical screening of departing passengers at all exit points.
  • Prohibit travel for all persons meeting case definition.
  • Prohibit travel for all persons under quarantine.
  • Require health certificate for exit.
Extensive SARS-CoV transmission in United States and community, with ineffective control measures
  • Issue international travel notifications as above.
  • Issue domestic travel health precautions/warnings as above.
  • Prohibit nonessential outbound travel.
  • Require health certificate for essential travel.
  • Implement medical screening at all exit points.
  • Prohibit travel for all persons meeting case definition.
  • Prohibit travel for all persons under quarantine.

 

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