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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

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Matrix 1: Suggested Activities for Inbound Travelers

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

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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