Transmission from children to adults is uncommon. 3,10 The attack rate for children was found to be lower than adults among quarantined close contacts in Beijing (5% in children <10 years of age, 11.4% in those between 30 and 39 years of age and 27.6% in those aged between 60 and 69 years) 11 There was no report of SARS transmission in schools both in Hong Kong and China where the outbreak was most extensive. A cluster of nine mild paediatric patients had been reported in a private boarding school for 820 students. All lived in the same building and ate daily meals together in the school canteen. 12 Congenital and perinatal infection have not been documented in the 12 pregnancies reported in Hong Kong, 13 nine in China 14 and one in the USA. 15 In hospital settings, aerosolised respiratory secretions and direct contact with patients' secretion, excreta and fomites are other amplifying events. The role of faecal-oral transmission is unknown but is probably of some significance as profuse watery diarrhoea is common and large amounts of virus are found in stool. There have been no reports of food or waterborne transmission. The role of contaminated fomites in transmission is uncertain but must not be under estimated as the virus can survive for days at room temperature on most surfaces.