Low prevalence of subclinical severe acute respiratory syndrome-associated coronavirus infection among hospital healthcare workers in Hong Kong

Abstract

We recruited 688 hospital healthcare workers who cared for patients with severe acute respiratory syndrome (SARS) and did not develop the disease in the Hong Kong outbreak in 2003. A questionnaire survey was conducted and serum samples were collected for SARS-associated coronavirus (SARS-CoV) antibody. The high-risk procedures performed and the types of unprotected exposures were recorded for analysis. Only 1 asymptomatic nurse had positive serological test. The result demonstrates the low rate of subclinical SARS-CoV infection in hospital healthcare workers and that the infection control practice against SARS in Hong Kong's hospitals during the outbreak was highly effective.

Extremely Low Exposure of a Community to Severe Acute Respiratory Syndrome Coronavirus: False Seropositivity due to Use of Bacterially Derived Antigens

“…This is not surprising in view of the high morbidity and mortality seen with SARS (http://www.who.int/csr/sars) and is also consistent with the behavior of a new emergent infectious agent. A similar conclusion was reached previously when health care workers who attended to SARS patients or their family members were examined for exposure to the virus, although the asymptomatic seropositive rates observed here, except for one study (19), were considerably higher (0.14% to 4.60%) than ours (6,9,13,16,31). The high rates observed in these studies may be due to the use of whole viral antigens or, as discussed below, the use of bacterially produced N fragments (31).…”

“…Investigations conducted thus far are conflicting regarding the prevalence of individuals in a community who were seropositive but who did not have overt SARS previously (defined according to WHO guidelines). Based on this definition-which considers subclinical or nonpneumonic manifestations as asymptomatic-some studies found high exposure rates (0.48% to 4.60%) (9,27,31,32,34) while others found low (0.14% to 0.19%) (13,16) to nil (1,6,9,30) rates. Such differences may be due to the assay method used (for example, Vero cell immunofluorescence [IFA] versus enzyme-linked immunosorbent assay [ELISA]), the type of antigen used for detection (for example, crude viral lysate versus recombinant nucleocapsid [N] antigen), or the population size sampled (87 to 1,621 people).…”

Cuidados enfermeros orientados a mitigar la transmisión del coronavirus en casos positivos: una revisión narrativa

“…El 72,3% reclamó capacitación en el manejo de enfermedades contagiosas ante nuevos brotes, percibiendo más ansiedad. Lai et al 16 encuestaron profesionales hospitalarios (62% enfermeras) tras el brote de SARS-CoV-1, identificando los procedimientos de mayor riesgo.…”

The lessons of SARS in Hong Kong

“…Asymptomatic infection of hospital-based healthcare workers was distinctly rare. 6 A dedicated team was formed to work in SARS wards of PMH in order to avoid exposure of all staff to SARS and minimise the number infected. Temporary accommodations from within PMH and external sources were offered to all staff, especially those of the SARS team, so that they can have the choice to stay away from home after duty.…”