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
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 They have not been superseded.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:
High fever (>38°C) AND cough or breathing difficulty
AND one or more of the following exposures in the 10 days before symptom onset:
Close contact2 with a person who is a suspect or probable case of SARS
History of travel to an area with recent local transmission of SARS
Residing in an area with recent local transmission of SARS
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
A suspect case with radiographic evidence of infiltrates consistent with pneumonia or respiratory distress syndrome (RDS) on chest X-ray.
A suspect case positive for SARS-CoV by one or more assays.
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. 2Close contact: having cared for, lived with, or had direct contact with respiratory secretions or body fluids of a suspect or probable case of SARS.
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.
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.
A Cluster of Cases of Severe Acute Respiratory Syndrome in Hong Kong. N Engl J Med. 2003 Apr 1 [epub]. Tsang KW, Ho PL, Ooi GC, Yee WK, Wang T et al. [PubMed]
Identification of Severe Acute Respiratory Syndrome in Canada. N Engl J Med. 2003 Mar 31 [epub]. Poutanen SM, Low DE, Henry B et al. [PubMed]
Case Clusters of the Severe Acute Respiratory Syndrome. N Engl J Med. 2003 Apr 1 [epub]. Drazen JM. [PubMed]
Pneumonia causes panic in Guangdong province. BMJ. 2003 Feb 22;326(7386):416. Rosling L, Rosling M. [PubMed]
Respiratory protection
The chest roentgenogram in SARS typically shows diffuse bilateral infiltrates consistent with ARDS. (Source: The Internet Journal of Emergency and Intensive Care Medicine)
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 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.
Situation report on Severe Acute Respiratory Syndrome — 13 May 2003 ARCHIVE(13 May bulletin listed in index but PDF link missing)
Situation report on atypical pneumonia — 19 April 2003 ARCHIVE
Situation report on atypical pneumonia — 14 April 2003 ARCHIVE
Situation report on atypical pneumonia — 7 April 2003 ARCHIVE
Health Surveillance for airline passengers — 25 March 2003 ARCHIVE
Source of pneumonia cases found — 19 March 2003 ARCHIVE
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.
Beijing Municipal Government SARS Updates (beijing.gov.cn/english/englishsars) ARCHIVE
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:
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.
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.
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.
MOH Malaysia SARS site (webjka.dph.gov.my/sars) ARCHIVE
NSTP e-Media / New Straits Times SARS coverage (emedia.com.my) ARCHIVE
The Star Online SARS updates (thestar.com.my/SARS) ARCHIVE
Bernama SARS news archive (bernama.com) ARCHIVE
United Kingdom
UK Health Security AgencyFIXED(successor to PHLS, which was dissolved in 2003, replaced by HPA, then PHE, now UKHSA)
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.
PHLS: Case definitions and follow-up procedures; guidance for hospitals, schools, primary care, infection control in the community; travel advice; daily case count ARCHIVE
UK DOH SARS site (doh.gov.uk/sars) ARCHIVE
BBC: Spread of Severe Acute Respiratory Syndrome — In Pictures ARCHIVE
France Ministry of Health — Pneumopathie et Asie du Sud Est (sante.gouv.fr, in French) ARCHIVE
NZ MOH: Questions and Answers about SARS — 24 March 2003; SARS Updates 24, 18, 17 March 2003 ARCHIVE
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
Yahoo: WHO trebles SARS death rate as more provinces declared no-go zones (AFP) — 9 May 2003 ARCHIVE
Yahoo: WHO pinpoints SARS virus, reveals true scale of China crisis (AFP) — 17 April 2003 ARCHIVE
Yahoo: Labs close in on deadly SARS virus — WHO (Reuters) — 7 April 2003 ARCHIVE
MSNBC: WHO — SARS outbreak nearly over — 12 June 2003 ARCHIVE
Washington Post: SARS News (wp-dyn/health/conditioncenter/sars) ARCHIVE
CNN Special Report: Severe Acute Respiratory Syndrome (cnn.com/SPECIALS/2003/sars) ARCHIVE
TimesOnline: Surgical masks have little effect against virus (Peter Hodsman, Singapore) — 2 April 2003 ARCHIVE
USA Today: Taiwan SARS mission ends for ill U.S. scientist — 22 May 2003 ARCHIVE
Open Directory Links on SARS (dmoz.org) (Thanks to Aliza R Panitz, Canada) ARCHIVE
Communicable disease control, surveillance and other resources
National Electronic Telecommunications System for Surveillance (NETSS) (cdc.gov/epo/dphsi/netss.html) ARCHIVE(superseded by NEDSS/NNDSS; see CDC NEDSS page)
Interstate Shipment of Etiologic Agents (cdc.gov/od/ohs/biosfty) ARCHIVE
Glossary of Terms (outbreak.org/cgi-unreg/dynaserve.exe) ARCHIVE