Questions and Answers on SARS: Travel and Quarantine

BG0312E | Date: 2003-05-22

Are there any travel restrictions related to SARS?

At this time there are no travel restrictions in place that are directly related to SARS. However, a Centers for Disease Control and Prevention (CDC) travel advisory recommends that individuals who are planning nonessential or elective travel to mainland China, Hong Kong and Taiwan may wish to postpone their trip until further notice. CDC also has issued travel alerts for Singapore and Toronto, Canada, to recommend that U.S. travelers to any of these places observe precautions to safeguard their health.

What are CDC's quarantine officials doing to prevent and control the spread of SARS?

CDC's quarantine inspectors or their designees are distributing health alert cards to air passengers returning in airplanes either directly or indirectly to the United States from mainland China; Hong Kong; Taiwan; Singapore; and Toronto, Canada. The notices inform travelers about SARS and its symptoms and asks them to monitor their health for 10 days and to see a doctor if they get a fever with a cough or have difficulty breathing. CDC distributes more than 20,000 health alert notices each day to air travelers returning from the affected regions. Inspectors also are boarding airplanes if a traveler has been reported with symptoms matching the case definition of SARS.

WHO has recommended procedures for pre-departure screening of airline passengers from some countries for respiratory illnesses or other symptoms of SARS.

What information about SARS is being provided to people traveling on ships?

SARS information contained on CDC's health alert cards is being provided by the major shipping associations and the International Council of Cruise Lines to people traveling on cargo ships and cruise ships at U.S. ports. Inspectors also are boarding ships if a passenger or crew member has been reported with symptoms matching the case definition of SARS.

What does a quarantine inspector do?

Quarantine inspectors serve as important guardians of health at borders and ports of entry into the United States. They routinely respond to illness in arriving passengers and ensure that the appropriate medical action is taken.

What is considered routine health inspections of airplanes or ships versus what is happening now?

Routine health inspections consist of working with airline, cargo ship, and cruise ship companies to protect passengers and crew from certain infectious diseases. Quarantine inspectors meet arriving aircraft and ships reporting ill passengers and/or crew (as defined in the foreign quarantine regulations) and assist them in getting appropriate medical treatment.

What is the risk to individuals who may have shared a plane or boat trip with a suspected SARS patient?

Cases of SARS continue to be reported primarily among people who have had direct close contact with an infected person, such as those sharing a household with a SARS patient and health-care workers who did not use infection control procedures while attending to a SARS patient. SARS also has occurred among air travelers, primarily travelers to and from Hong Kong, Hanoi, Singapore, and mainland China.

CDC is requesting locating information from travelers who are on flights with people suspected of having SARS. CDC, with the help of state and local health authorities, is attempting to follow-up with these travelers for 14 days to make sure no one develops symptoms consistent with SARS.

Who actually notifies quarantine officials of potential SARS cases? Is it the crew of the airplane or ship? The passengers?

Under foreign quarantine regulations, the master of a ship or captain of an airplane coming into the United States from a foreign port is required by law to report certain illnesses among passengers. The illness must be reported to the nearest quarantine official. If possible, the crew of the airplane or ship will try to relocate the ill passenger or crew member away from others. If the passenger is only passing through a port of entry on his/her way to another destination, port health authorities may refer the passenger to a local health authority for assessment and care.

If I'm on board an airplane or ship with someone suspected of having SARS, will I be allowed to continue to my destination?

CDC does not currently recommend that the onward travel of healthy passengers be restricted in the event that a passenger or crew member suspected of having SARS is removed from the ship or airplane by port health authorities. All passengers and crew members may be advised by port health authorities to seek medical attention if they develop SARS symptoms.

What does a quarantine official do if a passenger is identified as meeting the case definition for suspected SARS?

Quarantine officials arrange for appropriate medical assistance to be available when the airplane lands or the ship docks, including medical isolation. Isolation is important not only for the sick passenger's comfort and care but also for the protection of members of the public. Isolation is recommended for travelers with suspected cases of SARS until appropriate medical treatment can be provided or until they are no longer infectious.

What does a quarantine official do if a passenger identified as meeting the case definition for suspected SARS refuses to be isolated?

Many levels of government (Federal, State, and local) have basic authority to compel isolation of sick persons to protect the public. In the event that it is necessary to compel isolation of a sick passenger, CDC will work with appropriate State and local officials to ensure that the passenger does not infect others.

The Outbreak

What is the status of the SARS outbreak in the United States?

In the United States, cases of SARS continue to be reported primarily among people who traveled to affected areas; a small number of other people have gotten sick after being in close contact with (that is, having cared for or lived with) a SARS patient while in the United States. Currently, there is no evidence that SARS is spreading more widely in the community in the United States.

To minimize the risk for SARS among U.S. residents, the public health system is taking careful and thorough precautions to stop the spread of SARS. People who are suspected of having SARS are being isolated from others and getting care. People arriving from affected parts of the world (who might have been exposed to SARS) are receiving information about SARS and instructions on what they should do if they become ill. SARS patients and their contacts are being monitored to help prevent spread of the disease.

The CDC website has a list of frequently asked questions on travel and quarantine procedures currently in place in the United States for persons entering the United States from SARS infected countries: http://www.cdc.gov/ncidod/sars/faq.htm#travel.