Severe Acute Respiratory Syndrome (SARS) first appeared in Chinas Guangzhou province and has been spreading throughout the world with clusters found in certain locations. The main purpose of this circular is to provide general information about SARS, relay recommendations made by the various health authorities and give advice about dealing with the practical consequences.
The symptoms of SARS are said to be similar to pneumonia and influenza. In addition to a fever in excess of 38°C and respiratory symptoms, SARS may be associated with other symptoms such as headaches, muscular stiffness, loss of appetite, malaise, confusion, rash, and diarrhoea.
To date, 5th April.2003 2,416 people are reported to have been infected. 89 people have died. The areas most affected so far are China (1,220 cases/20 deaths), Hong Kong (842/22), Singapore (101/6), USA (115/0), Vietnam (59/4), Canada (74/7), Taiwan (17/0), and Thailand (7/2). See below.
Fighting the disease
Anybody infected with SARS will normally be treated with antibiotics, although this treatment is not yet shown to be effective. There are no vaccines developed to date. On the other hand, WHO reports success in controlling the disease once preventive measures have been taken.
Tests for identifying the disease are being developed, and should, according to our sources, be available at major hospitals globally in a few weeks. However, there is little point in testing people other than those who have already manifested clinical symptoms of the disease. This is due to the diseases possible long incubation period (believed to be between 2-10 days) and the difficulty in diagnosing people without clinical symptoms.
Who is at risk
Cases of SARS continue to be reported mainly among those who have had direct or close contact with SARS patients and health care workers who did not use infection control procedures. Most of the deaths were individuals who had a history of chronic disease or patients who sought treatment at a relatively late stage of infection.
According to the World Health Organization (WHO), SARS is not only spread by close contact from person to person. A recent WHO press briefing states: It appears that there is something in the environment that is transferring virus, which is serving as a vehicle to transfer the virus from one person to another. It is possibly an object that people are touching and getting infected from, where there has been a SARS person who has coughed, or possibly a sewage or water system or some type of environmental vehicle.
Recommendations: Measures to prevent infection
Prevention against the disease is highly recommended. It is suggested that, as a minimum, the following should be considered:
· Hospitalise under isolation or cohort with other probable SARS cases (see WHOs Hospital Infection Control Guidance at http://www.who.int/csr/sars/infectioncontrol/en/).
· Seek advise from local authorities as to whether SARS is a particular concern for that port of call. This can normally be done via the companys ship agent.
· Restrict shore leave in affected areas.
· Limit contact with shore side personnel in affected areas.
· Impose heightened personal hygiene routines
· Establish contingency plans in case SARS related symptoms are found among shipboard personnel.
Recommendations: Guidelines to handle infections
It is important to mitigate the effects of SARS on affected crew members as well as to protect the health of those onboard who are not affected.
· Make immediate arrangements to disembark the sick crew member, if there is suspicion of SARS infection. The following symptoms may be indications thereof: 1) high fever in excess of 38°C, 2) respiratory symptoms and/or other symptoms, see above, 3) and recent history of travel to/from affected areas. Seek advice from the company and/or local port and/or medical authorities on any particular procedures to be followed in order to disembark potentially sick personnel.
· If the vessel is at sea, isolate the sick crew member(s) from other personnel not responsible for the care of the sick crew member. Shipboard crews should contact the company office to seek guidance on the treatment and care of the sick crew member(s).
· Before arrival in port, notify local health authorities if any crew member who may have SARS symptoms.
· Fully co-operate with any requests made by local health and port State authorities.
The Hong Kong Marine Department has issued a notice regarding reporting of arrival in Hong Kong. For further information, please refer to their website at http://www.info.gov.hk/mardep/notices/mdn03044.pdf. Other ports in Asia have also imposed reporting regimes in this regard. Contact your local agent for further details.
Further information and Links
The WHO has the most updated and co-ordinated website containing information on SARS. For more information, guidance and recommendations regarding the SARS virus, please refer to the WHO website at www.who.org.
Disclaimer: The information contained herein is conveyed for the benefit of the reader, and is collected in good faith from available information. We do not guarantee the correctness or accuracy of the content, and we waive any liability for any losses incurred due to the content herein. Please note that the information about SARS is being continuously updated. It is advisable to refer to www.who.org as the main and most updated source of information.