Public Health Guidance for Community-Level Preparedness and Response to
Severe Acute Respiratory Syndrome (SARS) Version 3

Supplement E: Managing International Travel-Related Transmission Risk

VIII\. Preparedness Planning

**A. Legal authority for restricting movement**

In advance of the possible reappearance of SARS-CoV, public health
officials should:

-   Work closely with their legal counterparts to ensure that the legal
    authority for movement restrictions at the local, state, and federal
    levels is known and understood and to establish boundaries of
    authority and processes to address multi-jurisdictional issues (See
    Supplement A).

-   Develop plans for making decisions on movement restrictions, such
    as: 1) requirements for pre-departure screening, 2) requirements for
    arrival screening and/or quarantine, 3) travel prohibitions on cases
    and contacts, 4) restrictions related to use of mass transit
    systems, and 5) cancellation of non-essential travel.

-   Work closely with local, state, and federal law enforcement to
    develop plans for enforcement of these restrictions.

**B. Engagement of key partners**

In advance of the possible reappearance of SARS-CoV, public health
officials should:

-   Begin preparedness planning by identifying key partners
    representing: 1) law enforcement (local, state, federal), 2) legal
    community, 3) emergency medical services (for evaluation of ill
    arriving passengers and transportation to the hospital), 4) hospital
    personnel, 5) transportation industry personnel, and 6) other
    emergency management personnel. The partners should be involved in
    the planning process.

-   Develop plans for the training, mobilization, and deployment of
    pertinent public health and other staff.

-   Conduct training programs and drills.

-   Provide respirator fit-testing and training in use of PPE for
    persons at risk for exposure to possible SARS cases.

-   Plan for the diversion of conveyances carrying supplies for
    maintenance of critical infrastructure around key transportation
    hubs that may be affected by SARS-CoV.

**C. Protocols for management of ill arriving passengers**

> Public health officials and CDC quarantine staff, in collaboration
> with legal and law enforcement authorities, should develop protocols
> for the management of ill arriving passengers at ports of entry,
> including provisions for:

-   Meeting flights with a reported ill passenger

-   Establishing notification procedures and communications links

-   Separating the ill passenger during assessment

-   Assessing the ill passenger and referring for evaluation and care

-   Transporting the ill passenger to a designated healthcare facility
    (see Supplement D.)

-   Collecting locating information on other passengers and crew

-   Collecting the flight manifest, customs declarations, and other
    information for contact tracing

-   Identifying any other ill passengers and separating them from well
    passengers

-   Quarantining contacts if necessary, including transportation to a
    quarantine facility

-   Providing enforcement for uncooperative ill passengers or contacts

> See Supplement A.

D.  **Memoranda of agreement (MOA) with healthcare facilities, transport
    services, emergency medical systems, and physicians**

-   State and local public health officials should work with federal
    quarantine staff to develop MOAs with hospitals near ports of entry;
    these facilities must be equipped to isolate, evaluate, and manage
    possible SARS patients (see Supplement C).

-   Agreements should include arrangements with a designated emergency
    medical service for on-site assessment of ill passengers and
    transportation to a hospital for evaluation.

See Supplement A.

**E. Designation of quarantine facility**

> State and local public health officials should identify a facility for
> travelers who are designated as contacts and who require quarantine
> but cannot be quarantined at home.

**F. Roles and responsibilities**

> Roles and responsibilities should be outlined for the various partners
> and the various levels of jurisdiction (local, state, and federal) for
> each component of the response.

For additional information and material on prevention of SARS
travel-related risks,

see <http://www.cdc.gov/ncidod/sars/travel.htm>.

For more information, visit
[www.cdc.gov/ncidod/sars](http://www.cdc.gov/ncidod/sars/) or call the
CDC public response hotline\
at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646
(TTY)