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Volume 10, Number 2—February 2004
THEME ISSUE
2004 SARS Edition
SARS Transmission

Lack of SARS Transmission and U.S. SARS Case-Patient

Angela J. Peck*Comments to Author , E. Claire Newbern*†, Daniel R. Feikin*, Elmira T. Isakbaeva*, Benjamin J. Park*, Jason T. Fehr‡, Ashley C. LaMonte*, Thong P. Le§, Terry L. Burger¶, Luther V. Rhodes¶#, Andre Weltman**, Dean D. Erdman*, Thomas G. Ksiazek*, Jairam R. Lingappa*, and the SARS Pennsylvania Case Investigation Team
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA; ‡Penn State College of Medicine, Hershey, Pennsylvania, USA; §Infectious Diseases Service, Bethlehem, Pennsylvania, USA; ¶Lehigh Valley Hospital and Health Network, Allentown and Bethlehem, Pennsylvania, USA; #Allentown Infectious Diseases Services, Allentown, Pennsylvania, USA; and; **Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA

Main Article

Table

Characteristics of contacts of SARS case-patient—Pennsylvania, 2003

Prediagnosisa
Variable
All contacts (N = 41) (%)
Healthcare workers
(n = 17) (%)
Household contacts
(n = 4) (%)
Otherb
(n = 5) (%)
Postdiagnosisa healthcare workers
(n = 15) (%)
Age (y)





>50
9 (22)
4 (24)
0 (0)
3 (60)
2 (13)
18–49
31 (76)
13 (77)
3 (75)
2 (40)
13 (87)
<18
1 (2)
0
1 (25)
0
0






Male
10 (24)
4 (24)
1 (25)
2 (40)
3 (20)






No. minutes of total contact per person, median (range)
28 (1–741)
7.5 (1–30)
459 (241–741)
30 (10–150)
110 (10–280)






Types of contact,





Within 3 feet
38 (93)
17 (100)
4 (100)
2 (40)
15 (100)
Skin to object
17 (41)
12 (71)
4 (100)
1 (20)
0
Skin to skin
13 (32)
9 (53)
2 (50)
1 (20)
1 (7)






Use of PPEc
13 (32)
0
0
0
13 (87)






Postexposure symptomsd





Fever
4 (10)
0 (0)
1 (25)
1 (20)
2 (13)
Respiratory symptoms
11 (27)
7 (41)
1 (25)
2 (40)
1 (7)
Met case definition (suspect case)
2 (5)
0
1 (25)
0
1 (7)






Furloughed from work, no. (%)
11 (27)
7 (41)
2 (50)
1 (20)
1 (7)






Total no. of specimens collected (average/person)





Serum
125 (3)
63 (3.7)
14 (3.5)
9 (1.8)
39 (2.6)
Nasopharyngeal swab
35 (0.9)
17 (1)
4 (1)
4 (0.8)
10 (0.7)
Oropharyngeal swab
124 (3)
64 (3.8)
14 (3.5)
12 (2.4)
34 (2.3)
Stool
21 (0. 5)
10 (0. 6)
3 (0. 8)
5 (1)
3 (0.2)
Urine
4 (0.1)
0
4 (1)
0
0






No. of days from last contact to last serum collection, median (range)e 28 (8–37) 28 (8–29) 29 (28–37) 16.5 (11–28)e 25 (22–30)

aPrediagnosis contacts were those exposed to the case-patient after his onset of symptoms (April 3, 22003) but before his diagnosis with probable severe acute respiratory syndrome (SARS) (April 14). Postdiagnosis contacts were those exposed only after the diagnosis was made and infection control precautions were in effect.
bOther, 4 contacts with healthcare–related exposure and 1 community exposure.
cN95 respirator, gown, gloves. To be counted as having worn personal protective equipment (PPE), contact had to have worn it for every interaction with the case-patient.
dSymptoms occurring during the 10-day period after contact with the case-patient.
eMedian and range for “other” category is for 4 contacts, since 1 contact did not provide any serum specimens.

Main Article

1Members of the Pennsylvania SARS Investigation Team: Marc-Alain Widdowson, Nino Khetsuriani, L. Clifford McDonald, Stephan S. Monroe, Suxiang Tong, James A. Comer, Daniel Jernigan, Matthew J. Kuehnert, Joseph S. Bresee, Sara A. Lowther, and Larry J. Anderson (CDC); Mary Theresa Temarantz, John P. Bart, William S. Miller, Mary Jo Lampart, and Carol Yozviak (Pennsylvania Department of Health); Shana Stites, (Bethlehem Bureau of Health); Susan Oliver, Debra Wilson, Carol Guanowsky, and Beverly Wasko (Lehigh Valley Hospital); Corwin A. Roberston (CDC and New Jersey Department of Health and Senior Services); and Diane Krolikowski, Jeff Bomboy, and Reynaldo C. Guerra.

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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