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• Lack of SARS Transmission among Healthcare Workers, United States

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  Healthcare workers accounted for a large proportion of persons with severe acute respiratory syndrome (SARS) during the worldwide epidemic of early 2003. This document examines an investigation conducted on healthcare workers exposed to laboratory- confirmed SARS patients in the United States to evaluate infection-control practices and possible SARS associated coronavirus (SARS-CoV) transmission. The investigation identified 110 healthcare workers with exposure within droplet range (i.e., 3 feet) to six SARS-CoV-positive patients. Forty-five healthcare workers had exposure without any mask use, 72 had exposure without eye protection, and 40 reported direct skin-to-skin contact. Potential droplet- and aerosol-generating procedures were infrequent: 5% of healthcare workers manipulated a patient's airway, and 4% administered aerosolized medication. Despite numerous unprotected exposures, there was no serologic evidence of healthcare-related SARS-CoV transmission. This document concludes that lack of transmission in the United States may be related to the relative absence of high-risk procedures or patients, factors that may place healthcare workers at higher risk for infection.

  Centers for Disease Control and Prevention (U.S.)

  Peck, Angela J.; Park, Benjamin J.; Kuehnert, Matthew J.

  2004-02
• SARS among Critical Care Nurses, Toronto

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  To determine factors that predispose or protect healthcare workers from severe acute respiratory syndrome (SARS), this document examines a study conducted among 43 nurses who worked in two Toronto critical care units with SARS patients. Eight of 32 nurses who entered a SARS patient's room were infected. The probability of SARS infection was 6% per shift worked. Assisting during intubation, suctioning before intubation, and manipulating the oxygen mask were high-risk activities. Consistently wearing a mask (either surgical or particulate respirator type N95) while caring for a SARS patient was protective for the nurses, and consistent use of the N95 mask was more protective than not wearing a mask. Risk was reduced by consistent use of a surgical mask, but not significantly. Risk was lower with consistent use of a N95 mask than with consistent use of a surgical mask. The document concludes that activities related to intubation increase SARS risk and use of a mask (particularly a N95 mask) is protective.

  Centers for Disease Control and Prevention (U.S.)

  Loeb, Mark; McGeer, Allison; Henry, Bonnie

  2004-02
• Lack of SARS Transmission among Public Hospital Workers, Vietnam

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  Vietnam was one of the first countries affected by the global severe acute respiratory syndrome (SARS) outbreak and on April 28, 2003, was the first country to be removed from the World Health Organization (WHO) list of SARS-affected countries. Sixty-one patients with laboratory- confirmed SARS were hospitalized in two hospitals, six of whom died; including the index case-patient. All case-patients were epidemiologically-linked to the index case-patient, and most outbreak amplification occurred within one hospital. This document examines an investigation into whether nosocomial transmission occurred among healthcare workers in the second hospital.

  Centers for Disease Control and Prevention (U.S.)

  Ha, Le Dang; Bloom, Sharon A.; Maloney, Susan A.

  2004-02
• Atypical SARS in Geriatric Patient

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  This document describes an atypical presentation of severe acute respiratory syndrome (SARS) in a geriatric patient with multiple coexisting conditions. Interpretation of radiographic changes was confounded by cardiac failure, with resolution of fever causing delayed diagnosis and a cluster of cases. SARS should be considered even if a contact history is unavailable, during an ongoing outbreak.

  Centers for Disease Control and Prevention (U.S.)

  Tee, Augustine K.H.

  2004-02
• Healthcare Worker Seroconversion in SARS Outbreak

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  Serum samples were obtained from healthcare workers 5 weeks after exposure to an outbreak of severe acute respiratory syndrome (SARS). This document examines a sensitive dot blot enzyme-linked immunosorbent assay, complemented by a specific neutralization test, showing that only persons in whom probable SARS was diagnosed had specific antibodies. The document suggests that subclinical SARS is not an important feature of the disease.

  Centers for Disease Control and Prevention (U.S.)

  Chow, Pierce K. H.

  2004-02
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement D: Community Containment Measures, Including Non-Hospital Isolation and Quarantine

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  "Community containment strategies, including isolation and quarantine, are fundamental public health measures used to control the spread of communicable diseases. All such strategies have in common the primary goal of preventing person-to-person spread of disease by separating those with disease or at increased risk for developing disease from those at lower risk. Although the terms 'isolation' and 'quarantine' have often been used interchangeably, they actually represent distinct concepts. Isolation is a commonly used practice in modern public health. Isolation refers to the separation of ill persons with a communicable disease (e.g., SARS patients) from those who are healthy. A prototypical example is the isolation of persons with potentially infectious tuberculosis. Isolation not only prevents transmission of infection to others but also allows for the focused delivery of specialized health care to ill persons. SARS patients can be isolated in a hospital, at home, or in a designated community-based facility. […] In this document, 'quarantine' refers to interventions-either voluntary or compulsory-in which active monitoring is accompanied by a restriction on the activities of persons exposed to SARS-CoV to prevent transmission if they develop SARS-CoV disease. Quarantine may also have a specific legal definition that may differ among jurisdictions based on applicable laws. Although quarantine, by definition, restricts some personal liberties, it is a collective action implemented for the common good. Modern quarantine is predicated on the need to aid persons who are infected with or exposed to infectious agents while protecting others from the dangers of inadvertent exposure. As such, it differs substantially from the quarantine of the past."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement D: Community Containment Measures, Including Non-Hospital Isolation and Quarantine: Appendix D1: Interventions for Community Containment

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  "Contacts of SARS patients can be managed by use of a range of interventions, all of which are designed to facilitate early recognition of illness in persons at greatest risk of becoming infected and thereby to prevent transmission to others. Whereas many of these interventions are applied individually to persons identified as contacts of a person with possible or known SARS-CoV disease, others are applied to larger groups of persons, or communities, who share a similar risk of exposure." This document provides a summary and overview of these interventions.

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement D: Community Containment Measures, Including Non-Hospital Isolation and Quarantine: Appendix D3: Guidelines for Evaluating Homes and Facilities for Isolation and Quarantine

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  "Ideally, persons who meet the criteria for a confirmed or probable case of SARS-CoV disease or a SARS RUI and who do not require hospitalization for medical reasons should be isolated in their homes. The home environment is less disruptive to the patient's routine than isolation in a hospital or other community setting. Any home being considered as an isolation setting should be evaluated by the patient's physician, health department official, or other appropriate person to verify its suitability. […] When persons requiring isolation cannot be accommodated either at home or in a healthcare facility, a community-based facility for isolation will be required. The availability of a community-based facility will be particularly important during a large outbreak. Much of the work in identifying and evaluating potential sites for isolation should be conducted in advance of an outbreak as part of preparedness planning. Each jurisdiction should assemble a team to identify appropriate locations and resources for community SARS isolation facilities, establish procedures for activating them, and coordinate activities related to patient management. The team should consider the use of both existing and temporary structures. Options for existing structures include community health centers, nursing homes, apartments, schools, dormitories, and hotels. Options for temporary structures include trailers, barracks, tents, and bubble systems."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement D: Community Containment Measures, Including Non-Hospital Isolation and Quarantine: Appendix D2: Frequently Asked Questions About Use of Community Containment Measures

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  This document provides a list of frequently asked questions regarding community containment measures. It is useful for practitioners and policy makers who may become involved in non-hospital isolation and quarantine following a disease outbreak or other public health emergency.

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement I: Infection Control in Healthcare, Home, and Community Settings

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  "This new Supplement outlines the infection control recommendations for prevention of SARS-CoV transmission in healthcare, household, and community settings. During the 2003 global epidemic, SARS-CoV caused unprecedented levels of morbidity and mortality among healthcare personnel and disrupted healthcare delivery systems, leading in some instances to closure of hospitals. Rapid implementation and adherence to infection control measures proved essential for controlling transmission in healthcare settings. To assist healthcare facilities in controlling SARS-CoV transmission, CDC issued several infection control guidance documents that evolved with improved understanding of the virus and its modes of transmission. This Supplement consolidates, updates, and replaces the previous guidelines and provides new information to guide infection control practices for prevention of SARS-CoV transmission."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement C: Preparedness and Response in Healthcare Facilities

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  "The current version of Supplement C emphasizes that SARS preparedness and response planning in healthcare facilities should not occur in a vacuum but rather should build on existing preparedness activities and relationships with the public health community. Although healthcare facilities will likely play a key role in the follow-up of exposed patients and healthcare workers, it will be important to coordinate these activities with the local health department, especially for patients being discharged and for healthcare workers who live in the community. Supplement C now recommends that healthcare facilities work with health departments to coordinate this follow-up. Because activity restrictions for healthcare workers who have been exposed to SARS-CoV might depend on the level of SARS-CoV transmission in the community, Supplement C now recommends coordinating decisions on these restrictions with the health department, in accordance with the guidance in Supplement D. The recommendations for surveillance in healthcare settings have been revised for consistency with the recommendations in Supplement B. The guidance clarifies that, in patients who have epidemiologic links to SARS-CoV, the presence of either fever or lower respiratory symptoms should prompt further evaluation. In addition, in accordance with the new SARS case definition, when persons have a high risk of exposure to SARS-CoV (e.g., persons previously identified through contact tracing or self-identified as close contacts of a laboratory-confirmed case of SARS-CoV disease; persons who are epidemiologically linked to a laboratory-confirmed case of SARS-CoV disease), the clinical criteria should be expanded to include, in addition to fever or lower respiratory symptoms, the presence of two or more other early symptoms of SARS-CoV disease."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement B: SARS Surveillance

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  "This version of Supplement B includes the revised U.S. SARS surveillance case definition and an updated domestic case reporting form. The revised surveillance case definition reflects changes in the interim position statement on SARS surveillance adopted by the Council of State and Territorial Epidemiologists (CSTE) in November 2003. The current version of Supplement B clarifies and revises questions to be used by healthcare providers to screen persons requiring hospitalization for radiographically confirmed pneumonia. The screening question related to travel now includes specific geographic locations that are likely sites for a reappearance of SARS-CoV. Employment in a laboratory that contains live SARS-CoV has been added as an epidemiologic risk factor for SARS-CoV exposure. The revised Supplement clarifies that, in the absence of SARS-CoV transmission in the world, children hospitalized for radiographically confirmed pneumonia need not be screened for potential SARS-CoV disease, unless circumstances suggest that a child might be at high risk for exposure to SARS-CoV. The recommendations for surveillance in healthcare settings have been revised for consistency with the recommendations in Supplement C. The guidance clarifies that, in a setting of ongoing SARS-CoV transmission in a facility or community, the presence of either fever or lower respiratory symptoms should prompt further evaluation. In addition, in accordance with the new SARS case definition, when persons have a high risk of exposure to SARS-CoV (e.g., persons previously identified through contact tracing or self-identified as close contacts of a laboratory-confirmed case of SARS-CoV disease; persons who are epidemiologically linked to a laboratory-confirmed case of SARS-CoV disease), the clinical screening criteria should be expanded to include, in addition to fever or lower respiratory symptoms, the presence of any early symptoms of SARS-CoV disease. The current version provides some guidance for prioritization of contacts for monitoring if health department resources become overburdened during an ongoing outbreak. General reporting requirements have also been clarified."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement A: Command and Control

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  "Because of the multifaceted nature of a SARS response and the impact of a SARS outbreak on many sectors of society-political, economic, social, healthcare, and others-a well-defined command and control structure with strong leadership is required to coordinate the response, allocate resources appropriately, and ensure the dissemination of consistent information in a timely manner. Control of SARS requires policymakers, healthcare and public health professionals, community leaders, and the public to work in a coordinated manner within a well-defined collaborative framework. Emergency preparedness and response capacities at the national, state, and local levels must be harmonized to allow a seamless response. The sustained, coordinated efforts required to control SARS lend themselves to the principles and structure of incident command and management systems. These systems use a predetermined organizational structure for potential mass casualty events that addresses planning, operations, logistics, finance, and administration. They are useful in maximizing the use of limited resources, monitoring the status of an outbreak, and consolidating the control of a large number of individual resources. Legal preparedness is another key component of SARS preparedness and response. A response to an outbreak of SARS may require coordination of federal, state, and local legal authorities to impose a variety of emergency public health and containment measures, at both the individual and community levels. Experience from the 2003 SARS outbreak demonstrates how closely legal issues are intertwined with public health responses. Within days of the appearance of SARS, Canada, Hong Kong, and Singapore instituted health measures, including large-scale community-based restrictions, to prevent the further spread of SARS-CoV."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2

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  "This is an updated version of the draft guidance document issued by the Centers for Disease Control and Prevention (CDC) on November 3, 2003. CDC revised the draft based on comments received from public health partners, healthcare providers, professional organizations, and others. CDC will continue to update the document as necessary to incorporate additional comments and to reflect increased understanding of SARS-CoV transmission dynamics and the availability of improved prevention tools."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement D: Community Containment Measures

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  This is an updated version of the draft guidance document issued by the Centers for Disease Control and Prevention (CDC) on November 3, 2003. CDC revised the draft based on comments received from public health partners, healthcare providers, professional organizations, and others. CDC will continue to update the document as necessary to incorporate additional comments and to reflect increased understanding of SARS-CoVtransmission dynamics and the availability of improved prevention tools. LLIS Core Capability: Healthcare; Public Health; 2003: SARS Outbreak

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08?
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2, Supplement C: Preparedness and Response in Healthcare Facilities

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  "The goals of a preparedness and response plan in a healthcare facility are: [1] Rapidly identify and isolate all potential SARS [severe acute respiratory syndrome] patients. [2] Implement infection control practices and contract tracing to interrupt SARS-CoV transmission. [3] Ensure rapid communication within healthcare facilities and between healthcare facilities and health departments."

  Centers for Disease Control and Prevention (U.S.)

  2004-01-08
• State of New Hampshire Interim Severe Acute Respiratory Syndrome (SARS) Epidemic Preparedness Plan

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  This report "will assist health care workers and administrators, public officials and the public in appropriate activities toward preparedness and response in the event of a SARS epidemic. If this occurs, the strategies, guidelines and tools contained in this plan will help to rapidly identify SARS cases and their exposed contacts, ensure rapid information exchange and implement and coordinate effective response planning efforts."

  New Hampshire. Department of Health and Human Services

  2004-01-07
• Clark County Health District: 2004 Zoonotic Infectious Disease Surveillance Report

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  "In 2004, the Clark County Health District, Environmental Health Division (EHD), Zoonotic Infectious Disease Program conducted surveillance for several diseases in nature communicable to man, including Baylisascaris procyonis (Raccoon Roundworm), rabies, plague, West Nile Virus, Western Equine Encephalitis, and St. Louis Encephalitis. The following report details the types of animals and insects tested and the results from these surveillance activities."

  Southern Nevada Health District

  Raman, Vivek K.

  2004
• Infectious Disease Risks from Dead Bodies Following Natural Disasters

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  "Victims of natural disasters usually die from trauma and are unlikely to have acute or 'epidemic-causing' infections. This indicates that the risk that dead bodies pose for the public is extremely small. However, persons who are involved in close contact with the dead-such as military personnel, rescue workers, volunteers, and others-may be exposed to chronic infectious hazards, including hepatitis B virus, hepatitis C virus, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these persons include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis. Disposal of bodies should respect local custom and practice where possible. When there are large numbers of victims, burial is likely to be the most appropriate method of disposal. There is little evidence of microbiological contamination of groundwater from burial."

  Pan American Health Organization

  Morgan, Oliver

  2004
• Public Health Law and Ethics: Lessons from SARS and Quarantine

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  "The 2003 global outbreak of severe acute respiratory syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General W.H. Stewart had optimistically declared 'it was time to close the book on infectious diseases.' SARS proved that wrong. Outside Asia, Canada was the country hardest hit by SARS. The outbreak took 44 lives in our country, threatened many others and created numerous challenges for public health officials and the acute health care system. In particular, SARS highlighted serious deficiencies in public health infrastructure and preparedness. As in other countries, officials in Canada were required to weigh the legalities and ethics of various interventions to control the spread of the disease, including quarantine."

  Health Law Review

  Ries, Nola M.

  2004-01-01?
• Fatal Infectious Disease Surveillance in a Medical Examiner Database

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  "Increasing infectious disease deaths, the emergence of new infections, and bioterrorism have made surveillance for infectious diseases a public health concern. Medical examiners and coroners certify approximately 20% of all deaths that occur within the United States and can be a key source of information regarding infectious disease deaths. We hypothesized that a computer-assisted search tool (algorithm) could detect infectious disease deaths from a medical examiner database, thereby reducing the time and resources required to perform such surveillance manually. We developed two algorithms, applied them to a medical examiner database, and verified the cases identified against the opinion of a panel of experts. The algorithms detected deaths with infectious components with sensitivities from 67% to 94%, and predictive value positives ranging from 8% to 49%. Algorithms can be useful for surveillance in medical examiner offices that have limited resources or for conducting surveillance across medical examiner jurisdictions."

  Centers for Disease Control and Prevention (U.S.)

  Wolfe, Mitchell I.; Nolte, Kurt B.; Yoon, Steven S.

  2004-01
• Serial No. 108-210: Beneficial or Critical? The Heightened Need for Telework Opportunities in the Post-9/11 World: Hearing before the Committee on Government Reform, House of Representatives, One Hundred Eighth Congress, Second Session, July 8, 2004

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  From the opening statement of Tom Davis: "Good morning, and I want to welcome everybody to today's oversight hearing on the Status of Telework Programs and Policies in the Federal Government. We are here to determine why many Federal supervisors have been slow to implement telework across all levels of the Government work force. For years now, many of us have recognized that telework offers significant benefits to managers, employees, and society. More recently, and perhaps more importantly, we now realize that telework needs to be an essential component of any continuity of operations plan. Something we once considered advantageous and beneficial has evolved into a cornerstone of emergency preparedness. The innovations of the information age, laptop computers, broadband Internet service, blackberries and so forth, continue to make location less relevant in a working world. Telework capitalizes on these advances, offering a broad range of benefits to employers and employees, and the public." Statements, letters, and materials submitted for the record include those of the following: Pamela J. Gardiner, Scott J. Cameron, J. Christopher Mihm, James A. Kane, Steve DuMont, Eric Richert, Carol Goldberg, Stephen Perry, Kay Coles James, Elijah E. Cummings, Tom Davis, Danny K. Davis, Dennis J. Kucinich, Henry A. Waxman, and Frank Wolf.

  United States. Government Printing Office

  2004
• Quarantine and Police Powers: The Role of Law Enforcement in a Biomedical Crisis

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  This document provides guidance to senior law enforcement officials in instances of biological terrorism.

  Police Executive Research Forum

  Richards, Edward P.; Goodman, Richard; Milligan, Stacy

  2004-01
• S. Hrg. 108-367: SARS: Is Minnesota Prepared? Hearing before the Permanent Subcommittee on Investigations of the Committee on Governmental Affairs, United States Senate, One Hundred Eighth Congress, First Session, Field Hearing in Minneapolis, Minnesota, October 8, 2003

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  This hearing focuses on how Minnesota officials are preparing for a possible outbreak of SARS in the upcoming flu season. In the first outbreak of SARS, there were 8,098 cases in 28 countries. The United States experienced 29 total probable cases of SARS-with the median age being 33-and thankfully no fatalities. Throughout the world, however, 916 people died of SARS-related complications. This hearing discusses what can be done to ensure that the next outbreak of SARS isn't summarized with statistics of who got sick and died-but rather a case study that illustrates how lives can be saved when government and the health care communities- at every level-work together, not just hoping for the best, but being prepared for the worst. "Today's hearing gives us an excellent opportunity to assess our preparedness. We will hear from two of Minnesota's leaders in the area of public health and infectious disease. We will also hear from local officials, and, in particular school, officials who represent the front line of our effort to contain any future outbreak." Statements, letters, and materials submitted for the record include those of the following: Dianne Mandernach, Michael T. Osterholm, Jeff Spartz, Mary Quinn Crow, Ann Hoxie, Debra Herrmann, Rob Benson, and Donna J. Spannaus-Martin.

  United States. Government Printing Office

  2004
• Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2: Supplement G: Communication and Education

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  "During the 2003 SARS response, health communications figured prominently among the tools used to contain the outbreak. The response to outbreaks and the threat of outbreaks necessitated extensive communications activities. Experience showed that, although a media/communications plan cannot alleviate the threat of SARS-CoV or solve associated public health problems, good communication can guide the public, the media, and healthcare providers in responding appropriately and complying with exposure-control measures as required. This document describes the communication plans and activities that are suggested to prepare for a possible reappearance of SARS-CoV and activities that would be needed to respond to a SARS outbreak. This plan identifies information necessary for major planning, preparedness, and communication response activities of state and local health departments and provides guidance for coordinating efforts with CDC and other entities."

  Centers for Disease Control and Prevention (U.S.)

  2003-12-29
• Public Law 108-195: Defense Production Act Reauthorization of 2003

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  "An Act to reauthorize the Defense Production Act of 1950, and for other purposes."

  United States. Government Printing Office

  2003-12-19
• Early Warning Infectious Disease Surveillance (EWIDS) Guidance

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  This guidance outlines ways to decrease the time needed to detect chemical, biological, radiological agents in tissue, food or environmental samples that cause threats to the public's health; improve the timeliness of information regarding threats to the public's health, and; decrease the time to identify causes, risk factors, and appropriate interventions for those affected by threats to the public's health.

  Centers for Disease Control and Prevention (U.S.)

  2004
• Quarantine and Isolation: Lessons Learned from SARS

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  "This report uses the experience with Severe Acute Respiratory Syndrome (SARS) to highlight the broad legal and policy challenges in preparing for an outbreak of infectious disease or similar public health emergency. Based on an analysis of the history of quarantine and isolation, relevant U.S. law, and the roles of various governmental bodies in infectious disease control, as well as lessons learned from detailed case studies of the six jurisdictions at the center of the SARS epidemic (Canada, China, Hong Kong, Singapore, Taiwan, and Vietnam), we identified twelve key issues for public health officials and other policy makers within three broad categories [....]."

  University of Louisville. Institute for Bioethics, Health Policy, and Law

  Rothstein, Mark A.; Alcalde, Gabriela M.; Elster, Nanette R. . . .

  2003-11
• SARS: When a Global Outbreak Hits Home [webcast]

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  This program was originally broadcast October 23, 2003. The archived program includes links to an overview of the program, related resources, an archived discussion, and the webcast of the program. "Early in 2003, a previously unknown, but highly communicable disease was reported in Asia. First identified as atypical pneumonia, it became known as Severe Acute Respiratory Syndrome (SARS). By July 2003, more than thirty countries worldwide had reported cases of SARS. Most of us do not remember the exact moment that we heard about this new, potentially fatal disease, but the public health leaders of Toronto remember the day, time, and where they were. Toronto, in the Ontario province of Canada, suffered the worst outbreak outside of Asia. Because it is a city known for its diversity, it is not surprising that SARS was spread to Toronto by an international traveler. It is precisely this aspect of the outbreak that makes all communities vulnerable and emphasizes the need for increased surveillance, communication, and preparedness. Join us as we discuss the tremendous efforts of Canada's public health professionals, health care workers, and civic leaders to contain the outbreak and protect the health of their citizens now and in the future."

  University of North Carolina at Chapel Hill. School of Public Health

  2003-10-23
• Risk Communication Recommendations for Infectious Disease Outbreaks

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  Scholars in risk communication sometimes distinguish three paradigms. (1) When people are insufficiently alarmed about a serious hazard, the task is to increase their concern and motivate them to take appropriate actions. (2) When people are excessively alarmed about a small hazard, the task is to diminish their concern and deter them from unnecessary and potentially harmful actions. (3)When people are justifiably alarmed about a serious hazard, the task is to harness their concern and guide their actions.

  New York (State). Department of Health

  2003-10-20