Intended for healthcare professionals

Editorials

Severe acute respiratory syndrome revisited

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7394.831 (Published 19 April 2003) Cite this as: BMJ 2003;326:831

SARS Checklist

EDITOR,

I would like to share the SARS checklist below, which I have designed for busy general practitioners and hospital doctors. Colleagues inform me that they have found it useful. The checklist is based on WHO case definitions as well as the UK case definitions¹ updated on 10th April 2003.

¹ www.phls.co.uk/topics/SARS/case-definitions.htm

UPDATED DECISION MAKING LIST FOR SARS

Case Name ........................

Case Definition based on PHLS update 10th April 2003.

A	Presenting after 1st Feb 2003 date       ? A
                  
B	History of Sudden Onset High Fever       ? B       
           >38 degrees C                           

C	Cough				         ? C
	  or
	Sore Throat	    		         ? C
	  or
	Shortness of breath		         ? C
	  or
	Dyspnoea			         ? C

D	Travelled to an area in which there is   ? D
        more than limited local transmission 
        in 10 days before onset	                 

E	Close contact 10 days before onset:
	Cared for SARS patient		         ? E
	  or
	Lived with SARS patient		         ? E
	  or
	Direct contact with respiratory          ? E
        secretion				 
          or
	Direct contact with body fluid	         ? E

F	CXR = Pneumonia and no response to       ? F
        standard antimicrobial treatment	 	     or 
	Respiratory distress, sudden             ? F
        deterioration or fast progression	 
             or
        Death due to an unexplained              ? F
        respiratory illness, autopsy shows 
        signs of RDS of unidentifiable cause 
        and history of travel to SARS area 
        within 10 days prior to illness	

Suspected LOW Case = A + B + one of C + D

Suspected HIGH Case = A + B + one of C + one of E

Probable Case = A + B + one of C + D + one of F

Probable Case = A + B + one of C + one of E + one of F

Please note:

i) Ideally the patient should be examined at home rather than being brought to the surgery.

ii) If the case warrants hospital admission, please discuss this with the consultant physician on call, so that precautions can be taken to prevent spread of infection in hospital.

iii)Ideally transport to hospital should be organised with the ambulance service after ensuring at the time of booking, ambulance control is aware of the possibility of SARS so that precautions can be taken.

iv) Information regarding SARS can be found on http://www.phls.org.uk/topics_az/SARS/menu.htm

v) If you feel you have a case, suspect or probable please do not forget to inform Public Health, so that contact tracing can be arranged.

Competing interests:  
None declared

Competing interests: UPDATED DECISION MAKING LIST FOR SARSCase Name ........................Case Definition based on PHLS update 10th April 2003.A Presenting after 1st Feb 2003 date ? A B History of Sudden Onset High Fever ? B >38 degrees C C Cough ? C or Sore Throat ? C or Shortness of breath ? C or Dyspnoea ? CD Travelled to an area in which there is ? D more than limited local transmission in 10 days before onset E Close contact 10 days before onset: Cared for SARS patient ? E or Lived with SARS patient ? E or Direct contact with respiratory ? E secretion or Direct contact with body fluid ? EF CXR = Pneumonia and no response to ? F standard antimicrobial treatment or Respiratory distress, sudden ? F deterioration or fast progression or Death due to an unexplained ? F respiratory illness, autopsy shows signs of RDS of unidentifiable cause and history of travel to SARS area within 10 days prior to illness

24 April 2003
Madhu Bardhan
Consultant in Public Health Medicine
Christchurch House, Coventry, CV1 2GQ