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July 18, 2003


Discounted Rates Draw Travelers to SARS-Affected Areas; Emory Physician Says Education is Key Before Traveling

ATLANTA - After months of posting travel advisories and alerts for areas affected by Severe Acute Respiratory Syndrome (SARS), the U.S. Centers for Disease Control and Prevention (CDC) lifted its last travel alert on Tuesday. The areas hit hardest by SARS are reporting no ongoing transmission of the disease, allowing the CDC to lift all alerts. Now, tourism officials and airlines are offering low-budget travel packages to these areas to help boost the economy and bring in travelers once again, according to an Emory University travel medicine expert. "Educating these travelers about SARS before they head to these destinations is still very important, even as the epidemic wanes," says Phyllis Kozarsky, MD, professor of medicine and medical director of the TravelWell clinic at Emory.

"We discuss the illness with our patients traveling to areas that have had SARS," says Dr. Kozarsky. "At this point, we feel comfortable in advising our travelers that they are safe to venture into these regions. As typical, we also urge our travelers to let us know on their return if they develop any illness that may be of concern to them."

Taiwan was the last area under a CDC travel alert. That alert was removed Tuesday, July 15. Travel alerts for Toronto, Beijing and Hong Kong were removed last week. A travel alert does not advise against travel, but informs travelers of a health concern and provides advice about specific precautions; a travel advisory recommends that nonessential travel be postponed. Advisories are downgraded to alerts when more than 20 days (or two SARS incubation periods) have elapsed since the date of onset of symptoms of the last case. Travel alerts are lifted when more than 30 days (or three SARS incubation periods) have elapsed since the date of onset of symptoms for the last case.

As advisories and alerts have been lifted in SARS-affected areas over the past weeks and months, the staff at TravelWell has been seeing more travelers heading to these destinations. At Emory's TravelWell, patients receive pre-travel care and health advice before traveling abroad. The staff conducts personal travel assessments and physical exams while dispensing prescriptions, immunizations and education about the patient's destination. If patients are planning a trip to an area previously affected by SARS, some of the consult is spent discussing SARS and various prevention methods, such as washing hands regularly or using alcohol-based hand gels.

"Washing your hands often is the best public health message we can offer to the general public," says Dr. Kozarsky, an infectious disease specialist in the Emory University School of Medicine. Wearing masks or other personal protective equipment in public areas, even during the outbreak, is not recommended as an effective way of preventing the illness.

"We're seeing mostly business travelers going to places in Asia like Beijing, Singapore and Hong Kong, and not so many leisure travelers right now," says Dr. Kozarsky. "Tourism officials are trying to lure people back into their cities by offering reduced travel expenses and amenities. Five-star hotels are drastically dropping their rates. Pricey tourism packages are being reduced and are now affordable for many people. Airlines that cancelled flights to these areas at the height of the SARS epidemic are resuming service with really low fares."

As these Asian cities try to recover from the overwhelming impact of SARS, Dr. Kozarsky says the airline industry is also trying to recuperate from its losses. "SARS affected the airline industry more so than 9/11 and the terrorist attacks. It will be a while before the airlines recover," she says.

CDC officials are still on alert monitoring and surveying the SARS-affected areas, reports Dr. Kozarsky, who is Chief of Travelers' Health at CDC. Specialists there continue to work with the World Health Organization in assisting public health officials in those regions to monitor for any new SARS cases.

"People should get out there and be adventuresome. The best advice for those traveling to these areas is to stay educated on the changing status of all illnesses and outbreaks, and use common sense," says Dr. Kozarsky, who is also one of the editors of the recently revised CDC Health Information for International Travel, often referred to as the "Yellow Book." The travel health manual can better assist travelers in planning safer trips abroad and is a valuable resource for both health care providers as well as the public. The book is considered by many to be the gold standard on travel health information. To find out more about the Yellow Book, visit or purchase it directly from the Public Health Foundation at

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