Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 10, Number 11—November 2004
Policy Review

Public Health Interventions and SARS Spread, 20031

David M. Bell*Comments to Author  and World Health Organization Working Group on Prevention of International and Community Transmission of SARS
Author affiliation: *World Health Organization, Geneva, Switzerland

Main Article

Table 4

Rates of severe acute respiratory syndrome transmission on commercial aircrafta

Flight Duration Index patient(s) No. infected/
no. on plane (%)
1 90 min 1 presymptomatic 0/315 (0.0)
2 3 h 1 fever, cough 22/120 (18.3)
3 90 min 2 fever;
2 fever, cough 1/246 (0.4)

aSource: ref 19.

Main Article

  1. World Health Organization. Consensus document on the epidemiology of severe acute respiratory syndrome (SARS) WHO/CDS/CSR/GAR/2003. [monograph on the Internet] 2003 Oct 11, 17 [cited 2004 Sep 20]. Available from
  2. WHO Global Conference on Severe Acute Respiratory Syndrome (SARS). 17–18 June 2003. [cited 2004 Sep 20]. Available from
  3. Riley  S, Fraser  C, Donnelly  CA, Ghani  AC, Abu-Raddad  LJ, Hedley  AJ, Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions. Science. 2003;300:19616. DOIPubMedGoogle Scholar
  4. Lipsitch  M, Cohen  C, Cooper  B, Robins  JM, Ma  S, James  L, Transmission dynamics and control of severe acute respiratory syndrome. Science. 2003;300:196670. DOIPubMedGoogle Scholar
  5. Pang  X, Zhu  Z, Xu  F, Guo  J, Gong  X, Liu  D, Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003. JAMA. 2003;290:321521. DOIPubMedGoogle Scholar
  6. Svoboda  T, Henry  B, Shulman  L, Kennedy  E, Rea  E, Ng  W, Public health measures to control the spread of the severe acute respiratory syndrome in Toronto. N Engl J Med. 2004;350:235261. DOIPubMedGoogle Scholar
  7. Gostin  LO, Bayer  R, Fairchild  AL. Ethical and legal implications posed by the severe acute respiratory syndrome: implications for the control of severe infectious disease threats. JAMA. 2003;290:322937. DOIPubMedGoogle Scholar
  8. Cetron  M, Maloney  S, Koppaka  R, Simone  P. Isolation and quarantine: containment strategies for SARS 2003. In: Knobler S, Mahmoud M, Lemon S, Mack A, Sivitz L, Oberholtzer K, editors. Learning from SARS: preparing for the next disease outbreak. Forum on microbial threats, board of health. Institute of Medicine of the National Academies. Washington: National Academies Press; 2004. p. 71–83.
  9. Lee  ML, Chen  CJ, Su  IJ, Chen  KT, Yeh  CC, King  CC, Use of quarantine to prevent transmission of severe acute respiratory syndrome- Taiwan, 2003. MMWR Morb Mortal Wkly Rep. 2003;52:6803.PubMedGoogle Scholar
  10. Lai  CKL. Hong Kong Department of Health. Presentation at Symposium on Rethinking Quarantines: New Considerations for “Old Medicine.” Center for Strategic and International Studies. Washington, D.C. Sep17, 2003.
  11. Ou  J, Li  Q, Zeng  G, Dun  Z, Qin  A, Fontaine  RE. Efficiency of quarantine during an epidemic of severe acute respiratory syndrome in Beijing, 2003. MMWR Morb Mortal Wkly Rep. 2003;52:103740.PubMedGoogle Scholar
  12. Blendon  RJ, Benson  JM, DesRoches  CM, Raleigh  E, Taylor-Clark  K. The public’s reaction to severe acute respiratory syndrome in Toronto and the United States. Clin Infect Dis. 2004;38:92531. DOIPubMedGoogle Scholar
  13. Hawryluck  L, Gold  WL, Robinson  S, Pogorski  S, Galea  S, Styra  R, SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;7:120612.PubMedGoogle Scholar
  14. Kaydos-Daniels  SC, Olowokure  B, Chang  HJ, Barwick  RS, Deng  JF, Lee  ML, Body temperature monitoring and SARS fever hotline, Taiwan. Emerg Infect Dis. 2004;10:3736.PubMedGoogle Scholar
  15. Wu  J, Xu  F, Zhou  W, Feikin  DR, Lin  CY, He  X, Risk factors for SARS among persons without known contact with SARS patients, Beijing, China. Emerg Infect Dis. 2004;10:2106.PubMedGoogle Scholar
  16. Lau  JTF, Tsui  H, Lau  M, Yang  X. SARS transmission, risk factors, and prevention in Hong Kong. Emerg Infect Dis. 2004;10:58792.PubMedGoogle Scholar
  17. Yu  ITS, Li  Y, Wong  TW, Tam  W, Chan  AT, Lee  JHW, Evidence of airborne transmission of the severe acute respiratory syndrome virus. N Engl J Med. 2004;350:17319. DOIPubMedGoogle Scholar
  18. Update 11—WHO recommends new measures to prevent travel-related spread of SARS. Geneva. [cited 2003 Mar 27]. Available from
  19. Olsen  SJ, Chang  HL, Cheung  TYY, Tang  AFY, Fisk  TL, Ooi  SPL, et al. Transmission of the severe acute respiratory syndrome on aircraft. N Engl J Med. 2003;349:241622. DOIPubMedGoogle Scholar
  20. Desenclos  JC, Van der Werf  S, Bonmarin  I, Levy-Bruhl  D, Yazdanpanah  Y, Hoen  B, Introduction of SARS in France, March–April, 2003. Emerg Infect Dis. 2004;10:195200.PubMedGoogle Scholar
  21. Wilder-Smith  A, Paton  NI, Goh  KT. Low risk of transmission of severe acute respiratory syndrome on airplanes: the Singapore experience. Trop Med Int Health. 2003;8:10357. DOIPubMedGoogle Scholar
  22. Breugelmans  JG, Zucs  P, Porten  K, Broll  S, Niedrig  M, Ammon  A, SARS transmission and commercial aircraft. Emerg Infect Dis. 2004;10:15023.PubMedGoogle Scholar
  23. Flint  J, Burton  S, Macey  JF, Deeks  SL, Tam  TWS, King  A, Assessment of in-flight transmission of SARS-results of contact tracing, Canada. Can Commun Dis Rep. 2003;29:10510.PubMedGoogle Scholar
  24. Moser  MR, Bender  TR, Margolis  HS, Noble  GR, Kendal  AP, Ritter  G. An outbreak of influenza aboard a commercial airliner. Am J Epidemiol. 1979;110:16.PubMedGoogle Scholar
  25. Kenyon  TA, Valway  SE, Ihle  WW, Onorato  IM, Castro  KG. Transmission of multiudrug-resistant Mycobacterium tuberculosis during a long airplane flight. N Engl J Med. 1996;334:9338. DOIPubMedGoogle Scholar
  26. World Health Organization. China’s latest SARS outbreak has been contained, but biosafety concerns remain—update 7. [cited 2004 May 18].
  27. World Health Organization. WHO consultation on priority public health interventions before and during an influenza pandemic. Geneva. [cited 2004 Mar 16–18]. Available from
  28. World Health Organization Scientific Research Advisory Committee on Severe Acute Respiratory Syndrome (SARS). Report of the first meeting, Geneva, Switzerland, 20–21 Oct 2003. WHO/CDS/CSR/GAR/2004.16. [cited 2004 Sep 20]. Available from

Main Article

1The members of the World Health Organization (WHO) Working Group are as follows: Ximena Aguilera, Ministerio de Salud, Republica de Chile; Roy Anderson, Imperial College London, United Kingdom; Dounia Bitar, Institut de Veille Sanitaire, Paris France; Martin Cetron (with Pattie Simone), Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Chew Suok Kai (with Benjamin KW Koh), Ministry of Health, Singapore; Clete DiGiovanni, Jr., Defense Threat Reduction Agency, Fort Belvoir, Virginia, USA; Arlene King, Health Canada, Ottawa, Canada; Cindy K-L Lai (with PL Ma), Department of Health, Hong Kong Special Administrative Region, China; Angus Nicoll (with Jane Leese), Communicable Disease Surveillance Centre, London, United Kingdom; Sonja Olsen, International Emerging Infections Program, Nonthaburi, Thailand; Alice Sarradet, Direction Generale de la Sante, Paris, France; Mingchang Song, General Administration of Quality Supervision, Inspection and Quarantine, (AQSIQ), Beijing, China; Ron St. John (with Susan Courage), Health Canada, Ottawa, Canada; Robert Steffen (with Leonie Prasad), University of Zurich, Switzerland; Ih-Jen Su (with SK Lai), Taiwan Center for Disease Control, Taipei, Taiwan, China; WHO Staff in the Department of Communicable Diseases Surveillance and Response (CSR): Julie Hall, Beijing, China; Emmanuel Jesuthasan, Geneva, Switzerland; Angela Merianos, Cathy Roth, Max Hardiman, Geneva, Switzerland; Hitoshi Oshitani, Western Pacific Regional Office, Manila, Philippines; and group facilitator: David Bell, WHO (CSR) Geneva, Switzerland, and Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

2The term “isolation” is applied to ill people; “quarantine” is applied to persons who have been exposed but are not ill.

Page created: May 04, 2011
Page updated: May 04, 2011
Page reviewed: May 04, 2011
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.