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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


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.


  • 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.

Key concepts

  • 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.

Priority activities

  • 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.


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