While the number of Severe Acute Respiratory Syndrome (SARS) cases around the world has decreased over the past few months from epidemic levels earlier this year, it is too early to close the book completely on SARS. With the weather turning cool in the northern hemisphere, authorities believe SARS may re-emerge. Researchers say the deadly coronavirus that causes SARS still lurks in animals and could again make the leap into humans. SARS remains an infectious virus for which there is no vaccine.

Both the World Health Organization (WHO) and United States Centers for Disease Control and Prevention (CDC) have issued recommendations on infection control procedures in hospitals to protect against SARS (the CDC recommendations are considered "interim guidelines"). Each organization recommends healthcare providers and public health professionals stay current on procedures for both outpatient/triage and inpatient settings.

The WHO and CDC recommendations are summarized below. These recommendations are current as of September 30, 2003 and will be revised as additional information about the illness becomes available.

Outpatient/Triage Setting

Both the WHO and CDC recommend the following for hospitals treating patients in an outpatient/triage setting:

• The hospital should move patients who require assessment for SARS to a separate area to minimize transmission to others.
• Those patients should be given a facemask to wear, preferably one that provides filtration of their expired air.
• Staff involved in the triage process should wear an at least an N95 face mask (which seals off the nose and mouth from the air), eye protection and wash hands before and after contact with any patient, after activities likely to cause contamination and after removing gloves.
• Healthcare professionals should follow universal precautions and wear eye protection for all patient contact.

Inpatient Setting

In an inpatient setting, both the WHO and CDC recommend:

• Placing patients in an isolation room with negative pressure relative to the surrounding area.
• Hand washing with clean water before and after contact with any patient, after activities likely to cause contamination and after removing gloves. Alcohol-based skin disinfectants may be used if there is no obvious organic material contamination
• Wearing personal protective equipment (PPE) if accessing the isolation unit. The PPE worn in this situation should include:
  
  • A face mask providing appropriate respiratory protection
  • Single pair of gloves
  • Eye protection
  • Disposable gown
  • Apron
  • Footwear that can be decontaminated

Both organizations stress isolation of patients under investigation for SARS and implementation of universal precautions in both triage and inpatient settings. While the WHO and CDC recommend similar infection control procedures in some areas, different protective measures are stressed in other instances. The full scope of recommendations published by WHO and CDC are available at: http://www.who.int/csr/sars/infectioncontrol/en/ and http://www.cdc.gov/ncidod/sars/ic.htm