A) CONFIRMED * CASE OF SARS

A person with:

Early clinical presentation of SARS, i.e.:
• Fever (over 38 degrees Celsius) AND cough or breathing difficulty
  
AND    Radiographic evidence consistent with SARS*, i.e.:
• Radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS)
  
AND    Laboratory evidence** of SARS-associated coronavirus (SARS-CoV) infection, i.e.:
• PCR positive results or seroconversion or virus isolation (see CPHLN: Laboratory Evidence of SARS-CoV infection).

OR

A deceased person with:

A History of early clinical presentation of SARS, i.e.:
• Fever AND cough or difficulty breathing resulting in death
  
AND    Autopsy findings consistent with SARS, i.e.:
• Evidence of pneumonia or RDS without an alternate identifiable cause
  
AND    Laboratory evidence** of SARS coronavirus infection, i.e.:
• PCR positive results or seroconversion or virus isolation (see CPHLN: Laboratory Evidence of SARS-CoV infection).

B) PROBABLE CASE OF SARS

A person with:

Early clinical presentation of SARS, i.e.:
• Fever (over 38 degrees Celsius) AND cough or breathing difficulty
  
AND    Radiographic evidence consistent with SARS, i.e.:
• Radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS)
  
AND    Epidemiologically linked to a person or place linked to SARS, i.e.:
• Close contact*** with a confirmed SARS case, within 10 days of onset of symptoms.
OR  
• Close contact with a symptomatic person who has laboratory evidence of SARS-CoV infection, within 10 days of onset of symptoms.
OR
• Residence, recent travel or visit to an “Area with recent local transmission of SARS”**** within the 10 days prior to onset of symptoms OR close contact (including health care providers) with a probable case who has been to an “Area with recent local transmission of SARS” within the 10 days prior to onset of symptoms.

OR

A deceased person with:

A history of early clinical presentation of SARS, i.e.:
• Fever AND cough or difficulty breathing resulting in death
  
AND    Autopsy findings consistent with SARS, i.e.:
• Consistent with the pathology of RDS without an identifiable cause
  
AND    Epidemiologically linked to a person or place linked to SARS, i.e.:
• Close contact with a confirmed SARS case, within 10 days of onset of symptoms.
OR  
• Close contact with a symptomatic person who has laboratory evidence of SARS-CoV infection, within 10 days of onset of symptoms.
OR
• Residence, recent travel or visit to an “Area with recent local transmission of SARS”**** within the 10 days prior to onset of symptoms OR close contact (including health care providers) with a probable case who has been to an “Area with recent local transmission of SARS” within the 10 days prior to onset of symptoms.

OR

A deceased person with:

A history of early clinical presentation of SARS, i.e.:
• Fever AND cough or difficulty breathing resulting in death
  
AND    Laboratory evidence** of SARS coronavirus infection, i.e.:
• PCR positive results or seroconversion or virus isolation (see CPHLN: Laboratory Evidence of SARS-CoV infection).

 TABLE 1: Areas with recent local transmission of SARS

† Areas are listed as “affected” based on having recent local transmission as per the WHO definition (see link below). Some modification of the list has been made as per Canadian surveillance objectives/recommendations of the Canadian Respiratory Infection Surveillance Committee.

For further details and updates see: <http://www.who.int/csr/sars/areas/en/>

_____________________

* During the outbreak period, persons without x-ray changes (i.e. those who are not severely ill) may have laboratory evidence of SARS Coronavirus (SARS-CoV) infection if tested as part of an outbreak. These individuals will be considered as “confirmed SARS-CoV infections”, while not meeting the clinical criteria for confirmed cases of “Severe Acute Respiratory Syndrome (SARS)”.

** Refer to CPHLN: Laboratory Evidence of SARS-CoV infection in the SARS Post-Outbreak Period. Laboratory results must be verified by a provincial Public Health Laboratory and/or the National Microbiology Laboratory

*** Close contact means having cared for, lived with or had face-to-face (within 1 metre) contact with, or having had direct contact with respiratory secretions and/or body fluids of a person with SARS.

**** “Areas with recent local transmission” of SARS (see Table 1)