BMJ  2003;326 (21 June), doi:10.1136/bmj.326.7403.0

WHO guidelines for detecting SARS need to be reconsidered

The WHO guidelines for diagnosing SARS have an 83% accuracy in detecting suspected cases. In an observational study of 556 people screened for SARS in Hong Kong, Rainer and colleagues (p 1354) found that the best predictor of SARS was radiological evidence of pneumonic change, which often preceded the onset of fever. The main discriminatory symptoms in the early stages of the disease were fever, chills, malaise, myalgia, and rigor—not respiratory tract symptoms, as stated in the WHO guidelines. The guidelines had a specificity of 95% and a sensitivity of 26% for detecting SARS.

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Evaluation of WHO criteria for identifying patients with severe acute respiratory syndrome out of hospital: prospective observational study

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