The outbreak of SARS has been reported in many countries by the WHO. According to current available information, being in closed space increases the likelihood of virus attacks.

For those who have the symptoms of fever (above 38 C), coldness, sore muscle and cough within ten days after returning to Taiwan, please contact your physicians immediately and notify your physicians places where you have been in trips abroad. Please also ask the directors of your institution to report the situations to the Central Administration Office of Academia Sinica. Before seeking medical attention, avoid contact with family members and colleagues.

Since the SARS has been officially announced as a contagious disease, those who have contacs with the infected (such as family members and colleagues) are required to stay home instead of attending work. To prevent infections among laboratories and studies, please be on altert, and take good care of yourselves and your colleagues.

The Central Administration Office of Academia Sinica

The following Q & As are drawn from the website of the Department of Health, Taiwan, R. O. C.

Frequently Asked Questions on Severe Acute Respiratory Syndrome (SARS)

Q1¡GWhat is SARS?

A1¡GSevere Acute Respiratory Syndrome (SARS) was revised the name of Atypical Pneumonia by the World Health Organization (WHO) on 15 March, 2003. The main symptoms of SARS are high fever (> 38¢X Celsius), dry cough, shortness of breath or breathing difficulties. Changes in chest X-rays indicative of pneumonia also occur. SARS may be associated with other symptoms, including headache, muscular stiffness, loss of appetite, malaise, confusion, rash and diarrhoea.

Q2¡GHow contagious is SARS ?

A2¡GBased on currently available evidence, close contact with an infected person is needed for the infective agent to spread from one person to another. Close contact appears to be required. Close contact with aerosolized droplets and bodily secretions from an infected person appears to be important. To date, the majority of cases have occurred in hospital workers who have cared for SARS patients and the close family members of these patients. However, the amount of the infective agent needed to cause an infection has not yet been determined.

Q3¡GHow should SARS patients be managed?

A3¡GPatients should be placed in an isolation unit. Strict respiratory and mucusol barrier nursing are recommended. It is very important that suspected cases are separated from other patients and placed in their own hospital room. Health care workers and visitors should wear efficient filter masks, goggles, aprons, head covers, and gloves when in close contact with the patient. Hospital Infection Control Guidance

Q4¡GWhat is the treatment for SARS ?

A4¡GWhile some medicines have been tried, no drug can, at this time, be recommended for prophylaxis or treatment. Antibiotics do not appear to be effective. Symptoms should be treated by adequately protected health professionals. As a result of good supportive care, some patients in Hanoi have been transferred from critical care wards to regular wards. Hospital Infection Control Guidance

Q5¡GWhen will this disease be identified ?

A5¡GAn international multicenter research project to expedite identification of the causative agent was established on Monday 17 March. Eleven top labs in ten countries are consulting daily and are working together to identify the causative agent. Various specimens have been collected from cases and post-mortem examinations. Laboratory tests are ongoing and a candidate causative infectious is under investigation.

Q6¡GHow fast does SARS spread ?

A6¡GSARS appears to be less infectious than influenza. The incubation period is believed to be short, around 3-6 days. However, the speed of international travel creates a risk that cases can rapidly spread around the world.

Q7¡GWhere and when was the first case of SARS reported ?

A7¡GOn 26 February, a man was admitted to hospital in Hanoi with high fever, dry cough, myalgia (muscle soreness) and mild sore throat. Over the next four days he developed increasing breathing difficulties, severe thrombocytopenia (low platelet count) and signs of adult respiratory distress syndrome requiring ventilator support.

Q8¡GHow many cases of SARS have been reported to date ?

A8¡GFrom 1 February to 18 March, 219 cases including four deaths have been reported. In the early stages the symptoms are similar to those of many diseases including influenza. Heightened awareness about the disease, and the vigilance of health authorities around the world, have resulted in a close watch for suspected cases and rapid and thorough reporting. Not all of these suspected cases may prove to be SARS. There are many reports and rumours coming in from around the world, but quite a few of these will turn out to be normal wintertime activity of diseases like influenza whose early symptoms are similar. The cumulative number of cases and deaths is continuously updated on the WHO web site .

Q9¡GHow many countries report cases of SARS ?

A9¡GAs of 18 March, cases had been reported from nine countries. Of these, four countries have only imported cases with no documented local transmission, indicating that the disease is not spreading in these countries and residents are not at risk.

Q10¡GIs the outbreak in Guangdong Province, China linked ?

A10¡GExtensive investigation is under way to better understand the outbreak of atypical (unusual) pneumonia that began in Guangdong province in November 2002. Findings from this investigation should help clarify possible links with cases of SARS.

Q11¡GCould this result from bioterrorism ?

A11¡GThere is no indication that SARS is linked to bioterrorism.

Q12¡GDoes SARS cause severe complication and high fatality?

A12¡GThis illness can be severe and, due to global travel, has spread to several countries in a relatively short period of time. Therefore, there is cause for concern. However, SARS is not highly contagious when protective measures are used, and the percentage of cases that have been fatal is low. More than 90% of the cases as of 15 March are in health workers who can protect themselves through barrier nursing techniques. Around 10% of cases to date are close contacts of hospital workers and patients. (Close contact means having cared for, lived with or having had direct contact with respiratory secretions and body fluids of a person with SARS.) Since the WHO global alert issued on 15 March, only isolated cases have been identified and no secondary outbreaks have occurred.

Q13¡GIs it safe to travel ?

A13¡GWHO has not recommended restricting travel to any destination in the world. However, all travelers should be aware of the main symptoms and signs of SARS, as given above. People who have these symptoms and have been in close contact with a person who has been diagnosed with SARS, or have a recent history of travel to areas where cases of SARS have been spreading, should seek medical attention and inform health care staff of recent travel. Travelers who develop these symptoms are advised not to undertake further travel until fully recovered.

Q14¡GWhat is the purpose of a global travel advisory ?

A14¡GThe purpose of the advisory WHO issued on 15 March is to tell people what SARS looks like and what they need to report to a physician. The WHO alert does not recommend cancellation of, or change in, travel plans. Trade and tourism should not be restricted. The purpose of the alert is to heighten the awareness of travelers, health authorities, and physicians, not to restrict travel.

Q15¡GCould this be the next flu pandemic ?

A15¡GTests have not yet determined that the causative agent of SARS is influenza, although this was an initial concern.

Q16¡GHow to protect yourself?

A16¡GTo avoid travel to areas where cases of SARS have been spreading and reported by WHO. If your travel is absolutely necessary, please avoid visit to crowed areas, hospitals and avoid contact animals. During your recent travel, you may have been exposed to cases of severe acute respiratory syndrome. You should monitor your health for at least 7 days. If you become ill with fever accompanied by cough or difficult in breathing, you should consult a physician. To help your physician make a diagnosis, tell him or her about your recent travel history and whether you were in contact with someone who had these symptoms. If you need more information for medical service, please call 0800-024582.

• Please refer to http://www.who.int/csr/sars/sarsfaq/en/ for future information.