Severe Acute Respiratory Syndrome (SARS), 2003

SARS emerged in Guangdong Province, China in November 2002. The disease spread to Hong Kong and subsequently caused outbreaks in Taiwan, Vietnam, Singapore and Canada. SARS has been shown to be caused by a novel coronavirus (SARSCoV). Minnesota Rules governing disease reporting were amended in November 2003 to include SARS. For additional information on SARS, see “SARS: Severe Acute Respiratory Syndrome” in the October/November 2003 issue (vol. 3, no. 6) of the Disease Control Newsletter.

On September 26, 2003, WHO reported a total of 8,098 SARS cases worldwide, with 774 (9.6%) deaths. The CDC reported a total 134 suspect and 19 probable cases of SARS in the United States. Eight cases had laboratory confirmation of SARS-CoV.

Eleven SARS cases were reported to MDH during 2003. According to a CDC case definition used at the time, there were 3 probable and 8 suspect cases. The cases were reported from mid- March to early May. All had a history of travel to a SARS-affected area with known community transmission (nine case-patients traveled to China, one to Hanoi, Vietnam and one to Toronto, Canada). The age range was from 8 months to 71 years. The probable cases were all children; two of them were hospitalized, none required assisted ventilation, and all cases, (probable and suspect) recovered.

MDH collaborated with clinicians by providing guidance on infection control, clinical management, and laboratory testing. Specimens were tested at MDH and sent to CDC for SARS-CoV testing. In addition, the MDH Public Health Laboratory provided viral and bacterial testing for respiratory pathogens. Results were positive for two cases for human metapneumovirus, and one each of parainfluenza 3, adenovirus, and respiratory syncytial virus.

MDH staff monitored SARS patients and their families during the infectious period to provide infection control instructions, to track symptoms and detect the possibility of transmission in close contacts.

In July 2003, applying a revised case definition to the 11 reported cases, two probable and seven suspect cases were excluded due to negative convalescent SARS-CoV serology. One probable case had an alternate diagnosis and was excluded. One suspect case did not have a convalescent serum drawn and remains as the only SARS case reported from Minnesota in 2003.

• For up to date information see>> SARS
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003