WHO case definitions of SARS in the post-outbreak period[42]

Clinical case definition requires all of the following:

  • Fever (≥38°C [100.4°F])

  • One or more symptoms of lower respiratory tract illness: cough, difficulty breathing, SOB

  • Radiological evidence of lung infiltrates consistent with pneumonia or respiratory distress syndrome

  • No alternative diagnosis that can fully explain the illness.

Laboratory case definition:

  • Positive laboratory findings of SARS coronavirus (CoV) based on either or both of the following diagnostic criteria:

    • PCR positive from at least 2 different clinical specimens or the same specimen collected on 2 or more occasions during the course of the illness

    • Seroconversion between acute and convalescent phase sera and virus isolation.

CDC updated interim case definition for SARS[21]

Clinical criteria

  • Early respiratory illness

    • Two or more of the following features: fever, chills, rigors, myalgia, headache, diarrhoea, sore throat, rhinorrhoea.

  • Mild to moderate respiratory illness

    • Fever (≥38°C [100.4°F]) plus 1 or more symptoms of lower respiratory tract illness: cough, dyspnoea, difficulty breathing.

  • Severe respiratory illness

    • Mild to moderate respiratory illness plus radiological evidence of lung infiltrates consistent with pneumonia or ARDS.

Epidemiological criteria

  • History of recent travel, within 10 days of the onset of symptoms, to a foreign or domestic location with documented or suspected recent transmission of SARS; or

  • Close contact with a person confirmed with or suspected of having SARS.

Laboratory criteria

  • Detection of serum antibodies to SARS-CoV; or

  • Isolation in cell culture of SARS-CoV from a clinical specimen; or

  • Detection of SARS-CoV RNA by reverse-transcription polymerase chain reaction (RT-PCR) testing with subsequent confirmation in a reference laboratory.

Probable case of SARS-CoV

  • Patient meets the clinical criteria for severe respiratory illness and the epidemiological criteria for likely exposure to SARS-CoV.

Confirmed case of SARS-CoV

  • Patient has a clinically compatible respiratory illness (early, mild to moderate, or severe) that is confirmed by the laboratory.

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