Israeli guidelines for investigation and management of SARS cases and their contacts

As the first emerging epidemic of the 21st century, SARS has raised much interest and fear among statesmen, economists, and the general public, as well as within the medical community. This new disease is characterized by several daunting challenges, including person-to-person transmission, an environmentally resistant agent, a nonspecific clinical presentation, and a high fatality rate among high risk individuals. In Israel, as elsewhere, public health authorities were forced to quickly design appropriate measures to confront this new threat. The Israeli guidelines for surveillance, epidemiologic investigation and intervention in the event of a SARS outbreak were drafted in the absence of complete data on some of the most basic epidemiologic characteristics of the disease. Discrepancies between published guidelines from several countries made the decision-making process even more complicated. We describe the epidemiologic guidelines for SARS drafted by the Israeli working group, as well as the considerations on which they are based. The recent experience with this new outbreak has already provided several valuable lessons on policy making which may help future planning for emerging and re-emerging infectious diseases.