Control of SARS in the EU: measures undertaken by member states
and accession countries
The European Commission (EC) has published a document summarising
measures undertaken by member states and accession countries to control outbreaks
of severe acute respiratory syndrome (SARS) (1). The report has been based
on the results of a questionnaire agreed by the European Union (EU) expert
group on SARS, set up under the Network for the Epidemiological Surveillance
and Control of Communicable Diseases in the Community (the Network, instituted
), to inform both the commission and the member states.
The report acknowledges the following achievements and problems:
European countries have generally adopted rapid and
consistent measures on early detection of cases, implementation of isolation
measures and guidance to health professionals and the public on the identification
of possible SARS cases. This applies also to the guidelines for infection
control and protection of hospital staff and health professionals.
A consistent approach to the guidance for health professionals
has been implemented across most countries.
Information to the public has been rapidly distributed,
using various media and channels, though the content varies throughout
Travel advice is becoming more consistent among the
Measures to inform, collect traceability information,
and screen arriving passengers are heterogeneous and lack consistency,
possibly reflecting different intensity of passenger flows directly from
affected countries, as well as different expectations of public opinion.
There is a need for a preliminary EU evaluation of measures that have
Expert European laboratories have made major contributions
to the global effort to identify the course of SARS, the SARS coronavirus,
and to develop screening tests. However, national approaches to the laboratory
diagnosis of SARS still differ among countries and the standardisation
of protocols is still far from complete.
Several countries have now included quarantine measures
in their national legal framework, and others are modifying their legislation.
Other measures adopted in some member states address
research, humanitarian assistance, anti discrimination actions, mass gathering,
and import/export of goods.
As the scientific knowledge on SARS advances, new specific diagnostic tests
are being developed. Twenty three responding countries (14 member states,
7 accession countries, and 2 European Free Trade Association (EFTA) countries)
have instituted a centralised system for SARS testing with designated national
reference laboratories, which are performing polymerase chain reaction (PCR)
tests for SARS coronavirus. Countries that do not rely on a centralised
testing are Cyprus, Estonia, Germany, and Malta. Nine responding countries
(Belgium, Germany, Greece, Italy, the Netherlands, Portugal, Romania, Spain,
Sweden, and the United Kingdom (UK)) also perform serology tests for SARS
antibodies. Seventeen responding countries (10 member states, 5 accession
countries, and 2 EFTA countries) have developed national protocols for SARS
diagnosis, with the goal of standardising the diagnostic procedures based
on laboratory tests.
Countries that have not implemented a laboratory system on SARS diagnosis
have developed links with other European reference laboratories for eventual
confirmation of SARS diagnosis.
It was also noted in the report that the Commission could provide European
added value in the networking of laboratories, standardisation of diagnostic
methodologies, and scientific collaboration in research and development
of microbiological diagnosis.
Twenty two countries (11 member states, 9 accession countries, 2 EFTA countries)
have included SARS in the list of diseases with mandatory notification.
Cyprus, Greece, Luxembourg, the Netherlands, and the United Kingdom do not
have this provision. Nineteen countries (11 member states, 6 accession countries,
2 EFTA countries) have included quarantine measures in the national legal
framework. Germany, Greece, Latvia, Lithuania, Romania, Slovakia, Sweden,
and the United Kingdom have not introduced this regulation. However, some
of these countries are reviewing their national legislation.
Community legislative actions in the area of quarantine measures, and other
measures of public health importance that affect the free movement of persons
may be considered in the revision of the International Health Regulations.
The Council of the European Union endorsed the immediate and future actions
for SARS epidemic control in Europe on 6 May (2).