The CDC and the Council of State and Territorial Epidemiologists (CSTE) have developed an interim surveillance case definition for SARS. For a complete description of the case definition, please refer to the CDC website: (http://www.cdc.gov/ncidod/sars/).

For conditions of public health importance such as SARS-CoV infections, disease-control activities should be initiated as soon as possible after a potential case is recognized, even though information sufficient to determine case status may be lacking.

SARS Case Classification:

Classification is based on a combination of the clinical, epidemiologic and laboratory criteria as described below.

     Probable case: meets the clinical criteria for severe respiratory illness and the epidemiologic 

     criteria for likely exposure to SARS-CoV

     Confirmed case of SARS-CoV disease: clinically compatible illness (i.e., early, mild-to moderate,

     or severe) that is laboratory confirmed

Clinical Criteria

Early illness

·         Presence of two or more of the following features: fever (might be subjective), chills, rigors, myalgia, headache, diarrhea, sore throat, or rhinorrhea

Mild-to-moderate respiratory illness

·         Temperature of >100.4° F (>38° C)* and

·         One or more clinical findings of lower respiratory illness (e.g., cough, shortness of breath, or difficulty breathing)

Severe respiratory illness

·         Meets clinical criteria of mild-to-moderate respiratory illness and

·         One or more of the following findings:

o        Radiographic evidence of pneumonia, or

o        Acute respiratory distress syndrome, or

o        Autopsy findings consistent with pneumonia or acute respiratory distress syndrome without an identifiable cause

Epidemiologic Criteria

Possible exposure to SARS-CoV

One or more of the following exposures in the 10 days before onset of symptoms:

·         Travel to a foreign or domestic location with documented or suspected recent transmission of SARS-CoV or

·         Close contact with a person with mild-to-moderate or severe respiratory illness and history of travel in the 10 days before onset of symptoms to a foreign or domestic location with documented or suspected recent transmission of SARS-CoV

Likely exposure to SARS-CoV

One or more of the following exposures in the 10 days before onset of symptoms:

·         Close contact with a person with confirmed SARS-CoV disease or

·         Close contact with a person with mild-to-moderate or severe respiratory illness for whom a chain of transmission can be linked to a confirmed case of SARS-CoV disease in the 10 days before onset of symptoms

Laboratory Criteria

Tests to detect SARS-CoV are being refined and their performance characteristics assessed; therefore, criteria for laboratory diagnosis of SARS-CoV are changing. The following are general criteria for laboratory confirmation of SARS-CoV:

·         Detection of serum antibody to SARS-CoV by a test validated by CDC (e.g., enzyme immunoassay), or

·         Isolation in cell culture of SARS-CoV from a clinical specimen, or

·         Detection of SARS-CoV RNA by a reverse transcription polymerase chain reaction test validated by CDC and with subsequent confirmation in a reference laboratory (e.g., CDC).

Comments:

A case may be excluded as a suspect or probable SARS case if an alternative diagnosis can explain the illness, or the case has a convalescent-phase serum sample (obtained >28 days after symptom onset) testing negative for SARS-CoV antibodies, or the case was reported on the basis of contact with an index case that was subsequently excluded as a case of SARS, provided other possible epidemiologic exposure criteria are not present.