SARS: Frequently Asked Questions

1. What is SARS?

SARS, or Severe Acute Respiratory Syndrome is a new disease - it is a severe infection of the lungs that has recently been reported in a number of regions, including Beijing, other parts of Asia, Europe, and North America. The course of SARS is highly variable; some people may experience only mild illness, while 3-4% will progress to respiratory failure and death.

2. What causes SARS?

Evidence strongly suggests that a new type of coronavirus, a virus in the family of those that cause common colds cause SARS.

3. How is SARS spread?

Current epidemiologic data suggest that most transmission occurs through exposure to a symptomatic patient. Most cases to date have occurred among persons with close contact to patients, i.e. health care workers and household contacts of SARS patients.

SARS is believed to be transmitted from one person to another primarily through droplets exhaled when an infected person coughs or sneezes; however, other modes of transmission, including inanimate objects such as doorknobs, telephones, etc and airborne transmission (suspension of viral particles in the air) are being investigated. A large outbreak in an apartment building in Hong Kong has raised the possibility that the virus might be transmitted through environmental sources. Recent laboratory studies have demonstrated that the SARS virus can survive after drying on plastic surfaces for up to 48 hours, highlighting the need for rigorous infection control measures.

4. How long does it take to get the disease after being exposed?

The time between exposure and getting sick is called the incubation period, and is typically 2-7 days, though it may be as long as 12 days.

5. What are the symptoms of SARS?

The illness typically begins with fever of 100.5°F (38°C) or higher, chills, general feeling of weakness or fatigue, muscle aches, and headache; and progresses to a dry cough, with shortness of breath or difficulty breathing.

6. Is there a test for the disease?

There are some diagnostic laboratory tests that are currently being developed, and several are currently being used in Beijing. The most recent addition is from Columbia University and the North East Bio-Terrorism Consortium. This test of which 3000 kits are being trialed here holds great promise.

A chest x-ray and some blood tests and throat cultures will help to determine whether another respiratory illness could be causing the symptoms.

7. How can I protect myself and my family from getting SARS?

Frequent hand washing with liquid soap and water minimizes the risk of transmission of infectious diseases, and is probably the most important precaution you can take. Use liquid soap and a disposable towel or electric hand dryer, or an alcohol gel that contains at least 60% alcohol. Wash your hands:

• If you have been in contact with a person infected with atypical pneumonia
• Before touching your eyes, nose or mouth
• After sneezing, coughing or wiping your nose
• Before putting on a face mask and after taking it off
• After going to the toilet
• After touching public installations /equipment (railings, door handles, elevator buttons, public telephones)
• When you arrive home

8. What should I do if I think I may have the disease?

You should see a health care provider at once. You should, if possible, call ahead to let them know you are coming so that they can be prepared to provide care and prevent you from infecting other persons by using the appropriate precautions. You should, if at all possible, wear a face mask when you go to see the doctor.

9. If I or one of my family members were to develop SARS in Beijing, where would we be treated?

The Beijing Municipal Government has designated 2 hospital wards for foreign nationals with SARS. The first is the Ditan Hospital, and the second is the Youdian Hospital, which is closely affiliated with the Peking Union Medical College. Beijing United Family Hospital is engaged in a dialogue with the health department regarding the co-management of foreign SARS patients who are admitted to these hospitals.

10. What is the SARS situation in Beijing?

As of May 5, 2003, Beijing has officially reported 1960 SARS cases and 107 SARS-related deaths. SARS cases in Beijing account for 44% of the total cases reported in China (1960/4409) and 50% of the deaths (107/214). Nearly 20% of cases in Beijing have occurred among health care workers in hospitals. More than 16,000 people in the capital are in quarantine. Among buildings quarantined are 27 SARS-designated hospitals, two building sites and three apartment buildings belonging to universities. In an effort to reduce the likelihood of large numbers of people congregating, many scheduled events have been postponed or cancelled, and public venues (including movie theaters, Internet cafes, libraries, and museums), as well as schools, have been closed.

11. Are there specific precautions that should be taken here in Beijing?

Persons should try to minimize opportunities for exposure. The following guidelines are based on what is currently understood about the disease:

Is it safe to travel within China?
During recent weeks, the Chinese government has taken measures to stop the spread of SARS, and has limited travel into and out of Beijing. In Admin Notice 051 (April 18, 2003), the Executive Office of the Embassy limited personal travel within China by American employees of the Mission and their family members to only that which could be accomplished using a car or other personal vehicle. Because of limitations in the quality of health care available to foreigners outside major cities, non-essential travel outside of Beijing is not recommended.

Is it safe to travel on airplanes from China?
There have been reports of transmission of SARS to persons traveling on commercial aircraft. Although neither CDC nor WHO officially recommends the use of facemasks for air travel, some infection control experts have recommended wearing facemasks during air travel, particularly when traveling from areas where transmission of SARS has occurred. Persons with fever or respiratory symptoms should not travel.

Should I wear a facemask when I go out?
Based on currently available data, it is unlikely that you would be exposed or infected during casual contact when walking outdoors.

SARS patients should limit interactions outside the home and should not go to work, school, out-of-home childcare, or other public areas until ten days after resolution of fever and respiratory symptoms. During this time, infection control precautions should be used, as described below, to minimize the potential for transmission. If contact with others is expected in the home or elsewhere then patients should wear a mask.

Can I go shopping?
Current data suggest that transmission during casual contact such as shopping is unlikely. Avoid overly crowded places with poor ventilation, and wash your hands after handling merchandise and as soon as you return home.

12. What are the international schools doing to protect children and staff?

Most of the schools have regularly updated information regarding SARS on their web sites, with links to CDC and WHO websites.

Western Academy of Beijing (WAB)
WAB has hired a special duty nurse to evaluate all children and visitors with any illnesses and to monitor children in their classrooms on an ongoing basis; and established a screening station at the entrance to the school (hand washing required prior to entering the building). Field trips have been cancelled. The spring break occurred as scheduled, and when children return to school on May 12th, all children will be required to have their temperatures taken and documented by a parent each day before school, and will have their temperatures taken at school by a nurse each morning. All persons entering the school will be required to have their temperatures taken. The school curriculum is available online at www.wab.edu for those students who have left post, or who will not return to the classroom. Students may contact the school at jhu@westernacademy.com to obtain a password to access the curriculum.

International School of Beijing (ISB)
ISB has hired 2 extra nurses to evaluate any student showing any signs of illness, and to screen all visitors. Nurses go room to room to monitor students in the classroom. Service contractors have been instructed about infection control. ISB cancelled its spring break and expects to finish the school year 2 weeks earlier than originally scheduled. Students may access the curriculum at https://www.edline.net/InterstitialLogin.page. Instructions for accessing this service are available at ISB’s web site http://www.isb.bj.edu.cn/.

International Montessori School of Beijing (MSB)
School was closed from April 28th through May 7th. Upon resumption of class on May 8th, attendance is considered voluntary, and students electing to continue their studies at home may do so through the school’s “cyber-school” program. Beginning on May 8th, teachers will check the children’s temperatures with an aural (ear) thermometer twice daily. The school is limiting access to the building to students, teachers and staff only. Children will be met by a teacher or staff member at the door and will be escorted to and from class.

13. What precautions should be taken regarding our domestic helpers/Ayis

It is important that Ayis are aware of the nature of SARS, and have an understanding of how it is believed to be transmitted, so that they can work effectively with you to prevent transmission to your household.

The following guidelines for Ayis, adapted from the Hong Kong Department of Health Recommendations, are provided:

• Wash hands frequently with liquid soap and water, and use a paper towel, especially before handling food or taking care of children, before touching eyes, mouth or nose, and after using toilet
• Do not visit crowded places or large gatherings on days of
• Travel to and from their workplace by taxi, rather than by bus
• If cough, fever, or other respiratory symptoms develop
• Do NOT come to work
• Contact your employer by telephone to inform them you are ill
• Consult a doctor promptly
• Remain at home, except to visit a doctor
• Cover the mouth and nose with tissue paper when sneezing or coughing
• Clean hands with liquid soap immediately after sneezing or coughing
• Wear a face mask around family members and if you need to go out
• Do not spit
• Do not smoke

给阿姨的几点建议：

用洗手液或肥皂经常洗手，用纸巾擦干。特别在处理食物及料理小孩之前，及触摸眼睛，嘴巴和鼻子之前要洗手。如厕后要洗手。

不要在休息日时到人口稠密的地方，不要参与大型聚会。

上下班最后乘坐出租汽车，不要坐公共汽车。

如阿姨出现呼吸道受感染的病征，例如咳嗽或发烧等，请阿姨做到以下几点：

• 不要来上班
• 打电话告诉雇主自己生病了
• 立即去看医生
• 除看医生外，其余时间均呆在家里
• 打喷嚏或咳嗽时用纸巾捂住口鼻，然后立即洗手
• 和家庭成员接触时，或你必须外出时，必须带口罩
• 不要随地吐痰
• 不要吸烟

Information about SARS is continually being updated as new data are received and analyzed. These recommendations are subject to change as more information becomes available.

Useful links for more information:
http://www.info.gov.hk/dh/ap.htm - Hong Kong Department of Health (English and Chinese)
http://www.beijingunited.com/beijing/scc/n_news_Sarsnews06.htm - Beijing United Family Hospital (English and Chinese) - NOTE check home page for daily SARS updates
http://www.cdc.gov - CDC website with LOTS of SARS information, most relevant to persons living in the U.S.
http://www.who.int/csr/don/2003_04_08/en/ - WHO official website, with case counts. Check for daily updates.
http://www.bjfao.gov.cn - Beijing Foreign Affairs Office website has detailed Beijing information, but was a few days out of date.