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CDC continues to work with state and local health departments, the World
Health Organization (WHO), and other partners to investigate cases of severe
acute respiratory syndrome (SARS). This report updates SARS cases reported
worldwide and in the United States, and describes the eighth probable U.S.
SARS case with laboratory evidence of SARS-associated coronavirus (SARS-CoV)
During November 1, 2002–June 11, 2003, a total of 8,435 probable
SARS cases were reported to WHO from 29 countries, including 70 from the United
States; 789 deaths (case-fatality proportion: 9.4%) have been reported, with
no SARS-related deaths reported from the United States.1 In the
United States, a total of 393 SARS cases have been reported from 42 states
and Puerto Rico, with 323 (82%) cases classified as suspect SARS and 70 (18%)
classified as probable SARS (i.e., more severe illnesses characterized by
the presence of pneumonia or acute respiratory distress syndrome).2 Of
the 70 probable patients, 68 (97%) had traveled to areas with documented or
suspected community transmission of SARS within the 10 days before illness
onset; the remaining two (3%) patients were a health-care worker who provided
care to a SARS patient and a household contact of a SARS patient (3). Of the
68 probable SARS cases attributed to travel, 35 (51%) patients reported travel
to mainland China; 17 (25%) to Hong Kong Special Administrative Region, China;
five (7%) to Singapore; one (1%) to Hanoi, Vietnam; 14 (21%) to Toronto, Canada;
and five (7%) to Taiwan; of these, seven (10%) reported travel to more than
one of these areas.
Serologic testing for antibody to SARS-CoV has been completed for 134
suspect and 41 probable cases. None of the suspect cases and eight (20%) of
the probable cases have demonstrated antibodies to SARS-CoV, seven of which
have been described previously (3). The eighth serologically confirmed probable
SARS case occurred in a North Carolina resident who traveled to Toronto, Canada,
on May 15 and visited a relative in a health-care facility on May 16 and 17.
The relative's hospital roommate and another visitor in the room during these
visits both subsequently had SARS diagnosed. The patient returned to the United
States on May 18, and had a fever on May 24, followed by respiratory symptoms.
He was treated as an outpatient for these symptoms beginning on May 27, and
a chest radiograph on June 3 documented pneumonia. The patient has remained
in isolation at home. All of the exposed health-care workers and family contacts
are under active surveillance for SARS.
Serologic testing on this patient was negative for antibody to SARS-CoV
at day 10 of illness and positive at day 11. SARS-CoV RNA was not detected
by RT-PCR in nasopharyngeal and oropharyngeal swabs collected from the patients
11 days after onset of symptoms.
State and local health departments. SARS Investigative Team, CDC.
REFERENCES: 3 available
Update: Severe Acute Respiratory Syndrome— United States, June 11, 2003. JAMA. 2003;290(1):34. doi:10.1001/jama.290.1.34