Sars travel advice and information. Use of this website constitutes agreement of our terms & conditions. The SARS advice contained on this website has be obtained from many sources, including information on SARS from several governments, organisations, and bodies. Sars-Advice.com does not provide any advice ourselves and information provided on these pages is provided in good faith and it is agreed by users of this website that Sars-Advice.com shall not be liable in any way for any information contained herein.
 
 Travel Advice
 SARS - UK Policy
 WHO Advice
 Deutsche - SARS
 Francais - SRAS
 FAQ's - Canada
 Links
 
About Us  |  Sponsor this site  |  Contact  

Severe acute respiratory syndrome (SARS) continues to be reported primarily among people who have travelled to affected areas. A small number of other people have become infected after being in close contact with or having cared for or lived with a SARS patient.

 

Surgical face masks for protection against SARS.

SARS FAQ's (Canadian Government)

Q. What is severe acute respiratory syndrome (SARS)?

A. SARS is an infection in which affected individuals develop a fever, followed by respiratory symptoms such as cough, shortness of breath or difficulty breathing. In some cases, the respiratory symptoms become increasingly severe, and people require oxygen support and mechanical ventilation. Other symptoms of SARS include muscle aches, headaches, and sore throat.

Currently, the cause of SARS is unknown, and no specific agents have been identified.

Q. How is SARS diagnosed?

A. In the absence of a laboratory test, doctors are using the following criteria to diagnose SARS:

  • people who have recently travelled to affected countries in Asia or who have had close contact with persons diagnosed with SARS; and

    • who develop a fever (over 38.0 degrees Celsius); and

    • have one or more of the following respiratory symptoms: cough, shortness of breath or difficulty breathing.

Q. How is SARS treated?

A. The cause of SARS is currently unknown, so doctors are presently treating patients' symptoms. With supportive care, several hospitalised individuals with SARS in Canada are recovering and some have been discharged.

Q. Does the drug Ribavirin cure SARS?

A. Health Canada's Special Access Programme (SAP) provides access to drugs that are not approved for sale in Canada for patients suffering from serious and life-threatening conditions when other marketed therapies have either failed or are unsuitable.

SAP is currently providing access to intravenous and oral Ribavirin for use in SARS. These products are not approved for sale in Canada. The efficacy of Ribavirin in treating SARS is unknown, although it has been used to treat a variety of viral illnesses including Respiratory Syncytial virus, Lassa fever, and Hanta virus.

SAP is working closely with health care professionals at each of the hospitals involved to gather information on the use of Ribavirin for SARS, and potential adverse effects.

Q. Which countries have reported cases of SARS?

A. Please consult the following link to the World Health Organization's web site for current figures:
http://www.who.int/csr/don/en/

Q. What is the difference between a "suspect" and a "probable" case?

A. A "suspect" case of SARS is a person who fits into one of the following two categories:

  • a person who develops fever and one or more respiratory symptoms, including cough, shortness of breath or difficulty breathing, within 10 days of returning from travel to areas in Asia where SARS cases are being reported; or

  • a person who develops fever and one or more respiratory symptoms, including cough, shortness of breath or difficulty breathing, within 10 days of having had close contact with a "probable" case of SARS.

"Probable" cases of SARS are similar to suspect cases, but often they have a more severe illness, with progressive shortness of breath and difficulty breathing, and in some cases, chest x-rays show signs of atypical pneumonia.

Q. Who is at risk of developing SARS?

A. At this time, the only risk factors identified are recent travel to affected countries in Asia, or close contact with a person who has SARS. Close contact includes living in the same household, providing health care to someone with SARS, or having direct contact with respiratory secretions and body fluids of a person with SARS.

Q Is there anything that can be done to help prevent the spread of SARS?

A. Practising good personal hygiene is a key to stopping the spread of this disease. Thorough hand-washing - using hot, soapy water and lathering for at least 20 seconds - is the single most important procedure for preventing infections. This is because disease-causing micro-organisms can frequently be found on the hands.

Q. Are the Canadian cases linked to the outbreak in Asia?

A. Yes. The first cases of SARS identified in Canada are people who had travelled to Hong Kong. Subsequent cases have been in their close contacts and travellers to Asia.

Q. Is this disease spreading through or being spread by the Asian community only?

A. While identifying the cause of the disease has been difficult, time has shown that its spread is not limited to any one geographic region, nor is it linked to a particular ethnic group. SARS can be contracted and passed on by any individual, regardless of their cultural identity or background. The only requirement to becoming infected is by direct, close contact with a SARS affected individual.

Q. Are the people who travelled through Toronto and Vancouver airports at risk?

A. It is unlikely that someone who has not had close contact with someone with SARS will develop it. Being in the Toronto or Vancouver airports is not considered to be an at risk activity. Measures have been put in place to identify travellers with symptoms of SARS or travellers at risk of developing SARS.

Q. What should I do if I develop symptoms of SARS?

A. If you have recently travelled to Asia or have had close contact with someone who has SARS, and develop symptoms within 10 days, you should call ahead to your physician or your local public health unit/department. They can provide information about the appropriate Emergency Department or established SARS Centre you should visit for medical assessment. The symptoms for SARS are the following:

  • a fever of more than 38 degrees Celsius; and

  • a cough, shortness of breath or difficulty breathing.

Q. What do we know about the cause of SARS?

A. The National Microbiology Laboratory (NML) in Winnipeg continues to do extensive research into the cause of SARS. In many of the specimens from Canadian cases, there is evidence of a previously unrecognized form of coronavirus. There is also some evidence of human metapneumovirus. Although the cause of SARS is not certain, there is a strong indication that it is linked to the coronavirus, with the possibility that other factors also contribute.

Q. What can you tell us about coronavirus?

A. Normally, coronaviruses cause mild to moderate upper-respiratory illness such as the common cold. When viewed under a microscope, the coronavirus has a halo or crown-like appearance. Coronaviruses can also be found in animals.

Q. What can you tell us about metapneumovirus?

A. Metapneumovirus is part of the paramyxovirus family. Viruses in the paramyxo family can be responsible for mumps, measles, pneumonia and the common cold. The metapneumovirus was only recently identified in humans and has been proven to be very common. It causes respiratory symptoms that are not usually as severe as those evidenced in the current outbreak.

Q. What are the next steps?

A. Research at the NML is ongoing into the cause of SARS. In addition, researchers are working on the development of an antibody test. This test detects whether the patient has developed an antibody to SARS. The presence of this antibody could indicate whether or not the patient has contracted SARS. It is not known, however, whether this will be suitable for a screening test. Research is also ongoing to determine the stage of the illness at which the antibody is developed in the body.

Q. Is NML working with other international labs?

A. Under the direction of the World Health Organization, the NML continues to work in collaboration with a network of laboratories from around the world. With the hope that this collaboration will contribute to a more speedy determination of the cause and more effective treatment of SARS, information is shared via regular conference calls as well as a secure website.

Q. How close are you to finding the cause of SARS?

A. It's difficult to say how close we are to finding the cause. We feel we're on the right track and that these findings will help pinpoint what we should be focussing on, but it's impossible to say when we may have more answers.

Q Should members of the general public wear a mask as protection against SARS?

A. At this present time, masks are not recommended for use by the general public.

The only exception would be under special circumstances, whereby a person has come into close contact with a SARS affected individual.

Close contact means contact is close enough to have the person's respiratory secretions or saliva on you. Close contact includes living in the same household as a SARS affected person, providing care to someone who has SARS, or having direct contact with respiratory secretions and body fluids of a person with SARS.

To date, all evidence indicates that individuals affected by SARS are not contagious until they begin to exhibit the symptoms associated with SARS, including fever over 38.0 degrees Celsius and one or more of the following symptoms: cough, shortness of breath or difficulty breathing.

Activities at airports

Q. What is Health Canada doing to monitor incoming passengers for SARS at airports?

A. At the Vancouver and Pearson airports, Quarantine Officers are meeting direct flights from Hong Kong, Singapore and Beijing. Quarantine Officers are also present at Montreal's Dorval airport. They are passing out Health Alert Notices (yellow cards) to incoming passengers. These cards ask travellers to see a physician if they begin to have any symptoms related to SARS.

In addition, Health Canada has placed Health Alert Notices with accompanying posters in all terminals for distribution to passengers from all other international flights (i.e., those flights that do not arrive directly from Hong Kong, Singapore and Beijing) who are not being met by a Quarantine Officer.

Several thousand Health Alert Notices and Health Canada posters have been set up in airports in Halifax, St. John's, Montreal (Mirabel), Toronto, Ottawa, Winnipeg, Edmonton, Calgary and Vancouver.

Starting April 10, some airlines began a phased-in distribution of yellow Health Alert Notice forms and traveller contact information on direct flights coming into Canada from Hong Kong, Singapore and Beijing. More airlines are expected to follow shortly.

There is active participation of Quarantine Officers on Airport Authority Emergency Protocols as required.

Q. What is Health Canada doing to monitor outgoing passengers for SARS at airports?

A. On April 1, 2003, Health Canada began using Health Alert Notices (cherry cards) to inform all passengers departing from Pearson International Airport about symptoms and contact with persons with SARS.

The local airport authorities have placed the Health Alert Notices and posters at strategic locations at Pearson, informing travellers who meet certain criteria (ie., they have SARS symptoms, they have been in contact with a SARS infected person in the last 10 days) to defer their flights.

Airline staff are also asking passengers checking in if they have seen and read the information on the Health Alert Notices.

A Health Canada SARS team of health professionals has been sent to Pearson to provide information to airline and airport staff. In very limited cases, this team will assist the individual traveller and, if necessary, arrange for the transportation of individuals to local medical facilities.

These activities meet the World Health Organization's recommendations on new measures to prevent travel-related spread of SARS, which include screening of air passengers departing from affected areas.

Health Canada will be continually monitoring the situation at Pearson International Airport to evaluate the efficacy of the measures being implemented. Health Canada is asking for the cooperation of local public health officials, the airline industry and the travelling public on this plan.

Q. Why is it so difficult to get travel manifests?

A. All airlines that have carried passengers who have become ill with SARS have been asked to provide lists of passengers and contact information so that provincial and territorial public health personnel can contact them to see if they have become ill with the same disease. Although simple in concept, there is no standardized, internationally accepted system for recording this information by international airlines. Some airlines are better prepared to provide the data than others. It is often difficult for a company to aggregate the data in a timely fashion. The information is often a mixture of coded data that requires considerable personnel time to decipher and organize.

To date, Health Canada has completed 17 flights for which information was made available and has forwarded this information to the provincial/territorial public health authorities. Other passenger manifests are being forwarded by the involved airlines

Travel advisories:

Q. I have planned an upcoming trip to Asia. Should I still go?

A. Due to the mounting concern about transmission of the SARS agent in non-hospital and community settings in the City of Hanoi, Vietnam; the People's Republic of China including the Hong Kong Special Administrative Region; Singapore and Taiwan, Health Canada recommends that persons planning to travel to these areas should defer all travel until further notice.

Also, Health Canada recommends alternate routing be considered, when possible, if a traveller is transiting through City of Hanoi, Vietnam; the People's Republic of China including the Hong Kong Special Administrative Region; Singapore or Taiwan.

Health Canada is monitoring the international situation and the most up-to-date information is available at the Travel Medicine Program website.
http://www.hc-sc.gc.ca/pphb-dgspsp/tmp-pmv/index.html

Q. Earlier advisories indicated that the risk to travellers was low. You seem to now be saying that the risk is not low. What is the risk?

A. The risk is probably still low, but we have increasing evidence for transmission of this illness in the community, meaning outside the hospital and family setting. It is a prudent public health measure to use the revised travel advisory.

Health Canada's role:

Q. What is Health Canada doing to protect Canadians?

A. The Government of Canada is taking all the necessary precautions to protect the health and safety of individuals in the fight against SARS. At Health Canada, there is an unprecedented level of activity going on in six key areas - investigation, laboratory diagnosis, infection control, treatment, travel and emergency response. This includes 24/7 surveillance and monitoring, laboratory testing to find the cause of SARS, emergency measures and support at Canadian airports to stop the spread of SARS in Canada and abroad, epidemiological and infection control and support, coordination and collaboration with inter-governmental jurisdictions and non-governmental organizations, and international consultation with partners including the World Health Association (WHO) and the U.S. Centers for Disease Control and Prevention.

More specifically:

Investigation: Health Canada has deployed 14 epidemiological experts to assist Toronto's public health unit and the Ontario Ministry of Health with the investigation of the SARS cases. An outreach investigation and response team in Ottawa is in constant contact with the Toronto team.

Laboratory diagnosis: Health Canada staff - including those in the National Microbiology Laboratory in Winnipeg, the Centre for Emergency Preparedness and Response, the Centre for Infectious Disease Prevention and Control, and the Workplace Health and Public Safety Programme - are working around the clock in collaboration with our provincial and international partners to address this worldwide issue.

Samples from across the country have been sent to Health Canada's National Microbiology Laboratory in Winnipeg to conduct tests in an effort to determine the cause of the pneumonia-like cases. As results become available, the National Microbiology Laboratory will convey the results to the attending physicians.

Infection control: Health Canada has directed blood operators to temporarily defer from donating blood (for a period of 10 days) persons who have:

  • travelled within the previous 10 days to an affected area outside Canada (currently, the affected areas are: China, including the Special Administrative Regions of Hong Kong; Hanoi, Vietnam; Singapore and Taiwan);

  • been a patient, worked in or visited a facility that is under quarantine for SARS.

Infection control guidelines for, for example, airflight cabin crew, airport staff and health care workers have been developed. You can find these guidelines at
http://www.hc-sc.gc.ca/pphb-dgspsp/sars-sras/prof_e.html

Treatment: Health Canada's Special Access Program is currently providing access to intravenous and oral Ribavirin for use in SARS. These products are not approved for sale in Canada. Ribavirin is not indicated in the treatment of SARS, although it has been used to treat a variety of viral illnesses including Respiratory Syncytial virus, Lassa fever, and Hanta virus. SAP is working closely with health care professionals at each of the hospitals involved to gather information on the use of Ribavirin for SARS, and potential adverse effects.

Travel: On March 18, Health Canada sent two Quarantine Officers to Pearson International Airport and three to Vancouver International Airport. Another arrived at Dorval International Airport on March 30. These health professionals are monitoring passengers arriving on direct flights from Hong Kong, Singapore and Beijing; passing out Health Alert Notices to incoming passengers; and supporting airport staff.

To date, Health Canada Quarantine Officers have met approximately 90 flights and distributed approximately 25,000 Health Alert Notices to passengers in Toronto and Vancouver.

In addition, several thousand Health Alert Notices and Health Canada posters have been sent to terminals at the airports in Halifax, St John's, Montreal (Dorval and Mirabel), Ottawa, Toronto, Winnipeg, Edmonton, Calgary and Vancouver.

On April 10, some airlines began a phased-in distribution of yellow Health Alert Notice forms and traveller contact information on direct flights coming into Canada from Hong Kong, Singapore and Beijing. More airlines are expected to follow shortly.

April 1, 2003, Health Canada launched an initiative to inform all departing travellers from Pearson International Airport about symptoms and contact with persons with SARS through the Health Alert Notice.

The local airport authorities will place the Health Alert Notices and posters at strategic locations at Pearson International Airport, informing travellers who meet certain criteria to defer their flights.

Emergency measures: On March 15, Health Canada activated its Emergency Operation Centre. It is currently is being staffed by approximately 30 employees and is operating at a Level 3, which means the Department has activated its Emergency Response Plan.

The week of April 7, Health Canada sent Toronto health officials 10,000 masks from the Department's national emergency stockpile system.

Finally, we and many other partners fighting SARS are meeting Canadians' demand for up to date information. Health Canada has answered thousands of enquiries through the 1-800 O Canada information line. Updates, fact sheets, Qs and As, and travel advisories are posted regularly on Health Canada's website for the public and health care providers.

Q. What is Health Canada doing to assist Ontario?

A. Health Canada has deployed six staff to assist Toronto's public health unit and the Ontario Ministry of Health with the investigation of the SARS cases. The department has also provided guidelines for infection control and recommendations on actions for public health settings. Health Canada then deployed an additional eight personnel to Ontario the week of March 31, and sent two mobile x-ray machines and processors to Toronto for two isolation units being set up in non-hospital facilities. The week of April 7, Health Canada sent Toronto health officials 10,000 masks from the Department's national emergency stockpile system.

Health Canada is ready to respond to requests for support from provinces and territories on the SARS issue.

Q. What kinds of powers does Health Canada have under the Federal Quarantine Act?

A. Under the Quarantine Act, Health Canada has the power to detain persons, goods or conveyances on suspicion that the persons, goods and conveyances might introduce a dangerous communicable disease into Canada. The authority permits detention without due process for a period of 48 hours in order to undertake a medical examination of persons, analysis of goods or inspection of conveyances. If detention is required beyond 48 hours, Health Canada must present evidence for a continuation of the detention in a federal court. These powers also apply to persons and conveyances leaving Canada for another country. This Act would only be invoked if necessary and Health Canada is not considering that at this time.

Q. What is the Emergency Operations Centre?

A. In a national health emergency or disaster, Health Canada's Office of Emergency Services is responsible for supporting emergency health and social services nationally and in the provinces, territories or abroad. The office is responsible for the Emergency Operations Centre (EOC) which responds to calls for emergency assistance from provincial and territorial governments and from other parts of the Government of Canada. The EOC can operate at four levels:

  • Level 1 - on standby (the EOC generally operates on this level when there is no emergency)

  • Level 2 - EOC staff begin monitoring an evolving situation with a limited number of personnel

  • Level 3 - Health Canada's Emergency Response Plan is activated

  • Level 4 - the number of staff in the EOC is expanded and provides 24/7 support

The EOC was activated on March 15 in response to the SARS outbreak. It is currently being staffed by approximately 30 employees and is operating at a Level 3, which means the Department has activated its Emergency Response Plan.

Q. Where can I find up to date information on SARS?

A. Health Canada website www.sars.gc.ca
Information for the public: 1-800-454-8302

Workplace health

Q. How is Health Canada supporting federal employees with respect to SARS?

A. Health Canada's Workplace Health and Public Safety Programme is providing advice to federal employers in Canada and abroad on occupational health and safety matters. As of March 17, Health professionals from Health Canada's Workplace Health and Public Safety Programme were on site at the Pearson, Vancouver and Dorval airports to provide information sessions for federal employees. They continue to provide information sessions to employers and employees at workplaces across the country, and answer daily enquiries from employers.

The Workplace Health and Safety Programme has issued advisories and Qs and As, and has spoken to or met with representatives of a number of federal departments to provide them with information and advice they can use in determining what health and safety measures they deem appropriate for their employees. WHPSP officials participated in a videoconference with employees working in seven missions in affected areas overseas to provide information about respiratory protection and to discuss other general health concerns about SARS.

Q. Why is Health Canada not recommending the use of masks by federal workers, such as Customs agents at Pearson and Vancouver airports?

A. The role of Health Canada's Workplace Health and Public Safety Programme (WHPSP) is to provide advice to federal employers on occupational health and safety matters.

It is Health Canada's position that Government of Canada workers are unlikely to become ill because employees' encounters with passengers/clients are of reasonably short duration and not considered to be close contact. Therefore, Health Canada advises that the use of masks is not necessary.

Employers can use this information and advice in determining what health and safety measures they deem appropriate for their employees.