No Person-to-Person Transmission of SARS in the World

In the absence of SARS-CoV transmission anywhere in the world, screen all patients hospitalized for radiographically confirmed pneumonia or Acute Respiratory Distress Syndrome (ARDS) of unknown etiology for the three following characteristics that might indicate a higher index of suspicion for SARSCoV infection:

1.	In the 10 days before illness onset, travel to or close contact with other ill persons who recently traveled to mainland China, Hong Kong, or Taiwan, or
2.	Employment in an occupation at particular risk for SARS-CoV exposure, including a healthcare worker with direct patient contact or a worker in a laboratory that contains live SARS-CoV, or
3.	Part of a cluster of cases of atypical pneumonia without an alternative diagnosis

Report to Public Health - Seattle & King County at 206-296-4774:

1.	All cases of hospitalized pneumonia for whom the answer to at least one of the above three screening questions is "yes"
2.	Any clusters of unexplained pneumonia

• For patients with at least one exposure risk factor but no travel to Mainland China: Use droplet precautions.
• Treat for common causes of community-acquired pneumonia
• Perform diagnostic work-up (alert clinical lab of possible SARS case) including:
  • CBC with differential
  • Pulse oximetry
  • Blood cultures
  • Sputum Gram's stain and culture
  • Testing for Influenza A and other viral respiratory pathogens
  • Urinary antigen testing: legionella and pneumococcal
  • Other tests: CPK, transaminase levels, LDH, aPTT, C-reactive protein