Guidance for Americans Living Abroad

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The primary way that SARS-CoV (the virus that causes SARS) appears to spread is by close contact*, most commonly with family members and healthcare workers. Previous research has shown that SARS can be controlled and contained through early detection, isolation of possible cases, and tracing of patients’ contacts. Guidance for the management of SARS exposures in healthcare settings and infection control precautions for SARS patients and their close contacts in household settings is provided in Supplement I, Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS).

The following recommendations are directed to embassies and to Americans living abroad in areas where SARS cases have been reported. These recommendations are based on the experiences to date and may be revised as more information becomes available. Embassies should recommend the following precautions to U.S. expatriates living in an area where SARS cases have been reported:

  • As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand washing. Cleaning your hands often using either soap and water or a waterless, alcohol-based hand rub removes potentially infectious materials from your skin and helps prevent disease transmission.
  • To minimize the possibility of infection, observe precautions to safeguard your health. This includes avoiding settings where SARS is most likely to be transmitted, such as healthcare facilities caring for SARS patients.
  • On the basis of limited available data, it would be prudent for persons in China to avoid visiting live food markets and to avoid direct contact with civets and other wildlife from these markets. Although there is no evidence that direct contact with civets or other wild animals from live food markets has led to cases of SARS, viruses very similar to SARS-CoV have been found in these animals. In addition, some persons working with these animals have evidence of infection with SARS-CoV or a very similar virus.
  • CDC does not recommend the routine use of masks or other personal protective equipment while in public areas.

Information for Persons Working in Healthcare Settings

Prevention of transmission in healthcare settings is based on adherence to appropriate infection control measures when in close contact with patients with SARS. Such close contact includes direct care of SARS patients or direct contact with the respiratory secretions and body fluids of SARS patients. For information on infection control measures, see Supplement I in Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS).

U.S. citizens, including those working for U.S. medical nongovernmental organizations (NGOs), with elective activities planned in inpatient healthcare settings in regions where SARS cases have been reported, may want to postpone activities in healthcare facilities caring for SARS patients. For additional information for healthcare providers and consular officials see this Department of State Public Announcement.

At this time, there is no Department of State (DOS) travel warning related to SARS. For a list of DOS travel warnings, see the DOS website.


  1. Close contact: A person who has cared for or lived with a person with SARS-CoV disease or had a high likelihood of direct contact with respiratory secretions and/or body fluids of a person with SARS-CoV disease. Examples of close contact include kissing or hugging, sharing eating or drinking utensils, talking within 3 feet, and direct touching. Close contact does not include activities such as walking by a person or briefly sitting across a waiting room or office.

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