Severe Acute Respiratory Syndrome (SARS-CoV)

VADS CORNER — Coronavirus · SARS-CoV · Outbreak 2003
Online since 18 March 2003 · Comprehensively revised 9 September 2026

This page covers the SARS outbreak of 2003, caused by a novel coronavirus (SARS-CoV), first identified in late 2002 in Guangdong Province, China, and subsequently spreading to Canada, Hong Kong, Singapore, Taiwan, Vietnam, and other countries. The page was first posted on 18 March 2003 and updated through July 2025. Initial reports in early 2003 suggested a possible paramyxovirus origin; this was subsequently confirmed to be incorrect — SARS-CoV is a coronavirus.

For COVID-19 (SARS-CoV-2), see the dedicated COVID-19 page. For Middle East Respiratory Syndrome (MERS), see CDC: MERS.

About this revision. This page was first posted in March 2003 and updated through July 2025. Most of the original links pointed to WHO and government SARS situation-update URLs from the outbreak period (March–June 2003). Dead links of historical interest are retained, clearly labelled, and grouped into archive blocks. CDC SARS pages have migrated to archive.cdc.gov; all sub-page links updated accordingly. Nothing has been deleted. The page as it stood before this revision is preserved at oldsarspage.html.

NEW added or confirmed in this revision   FIXED URL corrected or source replaced   ARCHIVE link dead, retained for the record   VERIFY could not be confirmed — check before relying on it

Resource sites

Case definition — WHO

The suspect and probable case definitions below were published by WHO on 30 April 2003 (revised 1 May 2003) and remain the current WHO clinical/epidemiological surveillance definitions. They have not been superseded. WHO subsequently published updated surveillance guidelines in October 2004 (WHO/CDS/CSR/ARO/2004.1) which added a confirmed case category based on laboratory criteria, and a phased surveillance framework for the post-outbreak period. Both documents are linked at the foot of this box.

Suspect case

A person presenting after 1 November 20021 with history of:

Also: a person with an unexplained acute respiratory illness resulting in death after 1 November 2002, on whom no autopsy has been performed, with one or more of the above exposures.

Probable case

  1. A suspect case with radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS) on chest X-ray.
  2. A suspect case positive for SARS-CoV by one or more assays.
  3. A suspect case with autopsy findings consistent with the pathology of RDS without an identifiable cause.

Confirmed case — added October 2004

The October 2004 WHO surveillance guidelines introduced a confirmed case category, defined as a person in whom SARS-CoV infection is confirmed by laboratory testing meeting quality assurance criteria. This category recognises that laboratory diagnostics (PCR, serology, virus isolation) had matured sufficiently by late 2004 to support a laboratory-confirmed classification alongside the clinical/epidemiological suspect and probable categories.

Exclusion

A case should be excluded if an alternative diagnosis can fully explain the illness. A suspect case who dies, on whom no autopsy is conducted, should remain classified as “suspect” unless identified as part of a chain of SARS transmission, in which case it should be reclassified as “probable”.

1 The surveillance period begins 1 November 2002 to capture cases of atypical pneumonia in China now recognised as SARS. International transmission was first reported in March 2003 for cases with onset in February 2003.
2 Close contact: having cared for, lived with, or had direct contact with respiratory secretions or body fluids of a suspect or probable case of SARS.

Sources:
Case definitions for surveillance of severe acute respiratory syndrome (SARS) — WHO, 30 April 2003 (revised 1 May 2003). Suspect and probable categories.
WHO Guidelines for the Global Surveillance of SARS: updated recommendations, October 2004 (WHO/CDS/CSR/ARO/2004.1). Confirmed case category and phased surveillance framework. Replaces the August 2003 interim document.

WHO — situation updates 2003

WHO SARS situation updates are now accessible through the WHO Disease Outbreak News archive. All links below confirmed live at who.int/emergencies/disease-outbreak-news.

CDC guidance documents

The CDC SARS website is preserved at archive.cdc.gov for historical purposes; it is no longer maintained or updated.

Coronaviridae — background

Transmission electron micrograph of a SARS-CoV coronavirus particle, showing spheroid shape with large knobby surface projections (spikes) imparting the corona appearance. CDC PHIL ID 3467.
Transmission electron micrograph of a SARS-CoV coronavirus particle showing the characteristic surface spike projections that give the coronavirus its name. Credit: CDC/C.D. Humphrey; T.G. Ksiazek, 2003. Public domain — CDC PHIL ID 3467.

Dead Coronaviridae links — retained for the record

Medical publications — journal articles

The Lancet — key 2003 papers

New England Journal of Medicine

British Medical Journal

MMWR — Morbidity and Mortality Weekly Report

MMWR 2003 SARS updates FIXED

Original cdc.gov/mmwr/preview/mmwrhtml/ URLs confirmed live.

Reference texts

PubMed searches

MEDLINE abstracts — core cluster papers

Respiratory protection

Chest roentgenogram showing diffuse bilateral infiltrates typical of ARDS. Source: The Internet Journal of Emergency and Intensive Care Medicine.
The chest roentgenogram in SARS typically shows diffuse bilateral infiltrates consistent with ARDS. (Source: The Internet Journal of Emergency and Intensive Care Medicine)

Country coverage — 2003 outbreak

Where the original government URL still exists, it is linked directly. Where it has been restructured, the current equivalent is given. Where neither exists, the entry is in the archive block below.

Hong Kong

Selected bulletins with direct links:

Hong Kong 2003 situation reports — earlier series (March–April), archived

The daily situation reports from the HKSAR Department of Health from March and early April 2003 (the info.gov.hk/dh/new/bulletin/ series) are no longer accessible. The headlines below are retained from the original page for the record. From 17 April onwards, bulletins are available via the SARS Bulletin index above.

China

China 2003 coverage — archived

The Beijing Municipal Government's 2003 English SARS section (beijing.gov.cn/english/englishsars/) and People's Daily's 2003 SARS special (english.peopledaily.com.cn/zhuanti/Zhuanti_335.shtml) are both dead with no live equivalents. The current NHC and Beijing government English portals do not preserve 2003 content. A third-party data archive of Chinese official SARS figures is available at sars2003.com — content verified, provenance unattributed.

Singapore

Singapore MOH 2003 SARS press releases FIXED

The original series (app.moh.gov.sg) has been fully migrated to moh.gov.sg/newsroom/. Selected releases covering the outbreak from first detection through containment:

Singapore 2003 — partially archived

Canada

Canada 2003 coverage — partially restored

The Health Canada 2003 SARS warning series (hc-sc.gc.ca/english/protection/warnings/sars/), the Ontario Ministry of Health SARS update archive, Vancouver Coastal Health, and Toronto Public Health pages from 2003 are all dead. The following live resources replace or supplement them.

Australia

Australia 2003 updates — partially restored

The original health.gov.au/sars/ sub-pages (sara1.htm through sara43.htm and associated PDF leaflets) are no longer accessible as live pages. The following live resources cover Australia's 2003 response.

Malaysia

Malaysia 2003 coverage — archived

The MOH Malaysia 2003 SARS site (webjka.dph.gov.my/sars) is dead with no successor. The NSTP/NST, The Star, and Bernama 2003 SARS archives are also inaccessible. Malaysia had one confirmed probable SARS death (a pilot, imported case from China) and no sustained local transmission; contemporary academic analysis of the Malaysian response can be found in peer-reviewed literature but the original government and media pages from 2003 have not been preserved online.

United Kingdom

UK 2003 coverage — archived

The original Public Health Laboratory Service (PHLS) SARS pages (phls.co.uk/topics_az/SARS) are completely gone. The guidance documents listed below were among the most comprehensive published during the outbreak.

France, Taiwan, New Zealand, Eurosurveillance

France, New Zealand 2003 coverage — archived

News online — international media archive (2003)

Individual links to Yahoo, MSNBC, Washington Post, CNN, USA Today, Herald Sun and other media from 2003 no longer resolve. Headlines retained as a record of contemporaneous coverage.

2003 media coverage — archived headlines

Communicable disease control, surveillance and other resources

Related articles

Dead resource links — retained for the record

Virology sites

Medline search, medical journals and search engines


First posted 18 March 2003 · Last updated 16 July 2025 · Comprehensively revised 9 September 2026
Disclaimer · cyberdoc@vadscorner.com · View original 2003–2025 page