Severe Acute Respiratory Syndrome (SARS)

Rhode Island Department of Health
Guidelines for School Departments Related to SARS

June 2003

BACKGROUND:   To date, all reported patients with Severe Acute Respiratory Syndrome (SARS) in the United States have been exposed and infected either through previous foreign travel to countries with community transmission of SARS or close contact (e.g., household members or healthcare workers) with SARS patients.  The main geographic locations (and this will change with time), which are listed as SARS, affected areas are:  China, Hong Kong, Taiwan, Hanoi, Singapore and Toronto.  Casual contact with a SARS patient at schools, other institutions, or public gatherings (e.g., attending the same class or public gathering) has not resulted in reported transmission in the United States. People without symptoms cannot transmit SARS.

Guidelines:

1. Travelers returning from SARS affected areas are routinely given written instructions (from the Division of Quarantine at CDC) at disembarkation on what procedures to follow should they become ill.  Students, teachers and other school personnel who are known to have returned from one of the above SARS related areas and who are not exhibiting any signs of illness (fever of 100.4 or greater, cough, shortness of breath) should have no restrictions on their activities or school attendance. 

2. If school health personnel become aware of illness (fever of 100.4 or greater, cough, or shortness of breath) developing in the 10 day period after return from a SARS affected location, they should exclude the person from school pending medical and public health recommendations. If the illness develops during the course of the school day isolate the individual from other persons in the school environment (in a room or outdoors) and recommend that a health care provider evaluate them immediately.  The parent or person affected must be advised to call ahead to the health care provider to inform them of the referral. At the same time the school health authorities (school nurse or school physician) should make a report to the Office of Communicable Diseases at 401 222 2577 (day), or 401 272 5952 (after hours).   The Office of Communicable Diseases staff will provide expert guidance and support all aspects of the school response when such a report is made.  Such a response includes assessment of the case, assessment of risk for persons exposed, management of the case (including recommendations for mask use and isolation), management of close contacts identified in the school, and risk communication messages to parents, staff and the press.  It is important that the school authorities coordinate their media/public information responses with the Department of Health.

3. In preparation for in-school management of cases pending pick up or transportation, it is advisable that school nurses offices are stocked with a few surgical masks and thermometers.  Masks generally are to be used after the health department recommends how and by who they should be used on a case-by-case basis.  Emergency contact information for students should be kept up to date.  Exclusion from school of children and staff who are running fevers should be routinely enforced.

4. It is important to reinforce basic hygienic practices (cover nose/mouth while sneezing or coughing with a tissue rather than a bare hand, wash hands frequently and avoid sharing utensils).  School rest rooms should be kept stocked with a supply of paper towels, soap and running hot water.  Hand washing posters should be posted in rest rooms.  On field trips and other situations where access to running water is a problem a supply of alcohol hand gels for dry cleaning is advisable.  Classrooms should have a supply of tissues, and receptacles for their proper disposal.  The school environment, including cafeteria and bathrooms should be cleaned regularly.

5. School authorities should keep up to date their knowledge of the most current Federal travel advisories and alerts in order to make informed decisions about scheduling school trips.  See http://www.cdc.gov/ncidod/sars/basics.htm for updates or http://www.health.ri.gov/

6. Parents with questions can be referred to the CDC hotlines: 888-246-2675 (English) or 888-246-2857 (Spanish) or to the RI HEALTH Family Health Information Line at 1 800 942 7434.

NOTE:    The above guidelines can be adapted for all congregate environments where children are cared for during the day such as camps, after school programs, day care programs, summer programs etc.