SARS in Hospital Emergency Room

Abstract

Thirty-one cases of severe acute respiratory syndrome (SARS) occurred after exposure in the emergency room at the National Taiwan University Hospital. The index patient was linked to an outbreak at a nearby municipal hospital. Three clusters were identified over a 3-week period. The first cluster (5 patients) and the second cluster (14 patients) occurred among patients, family members, and nursing aids. The third cluster (12 patients) occurred exclusively among healthcare workers. Six healthcare workers had close contact with SARS patients. Six others, with different working patterns, indicated that they did not have contact with a SARS patient. Environmental surveys found 9 of 119 samples of inanimate objects to be positive for SARS coronavirus RNA. These observations indicate that although transmission by direct contact with known SARS patients was responsible for most cases, environmental contamination with the SARS coronavirus may have lead to infection among healthcare workers without documented contact with known hospitalized SARS patients.

Human Coronaviruses: Insights into Environmental Resistance and Its Influence on the Development of New Antiseptic Strategies

“…Thus, RNA of SARS-CoV was found on different environment samples, such as chair, elevator, computer mouse, etc ., and this may have contributed to contamination of health-care workers who had not been in direct contact with SARS-patients [109,110]. …”

Longitudinal Analysis of Severe Acute Respiratory Syndrome (SARS) Coronavirus-Specific Antibody in SARS Patients

“…The high mortality rate of the disease and its easy transmission to health care workers characterize its clinical importance (1,10,12,13). The clinical manifestations, laboratory findings, radiologic presentations, and outcomes of SARS for patients have been well described (3,9,12).…”

Managing Emerging Infectious Diseases with Information Systems: Reconceptualizing Outbreak Management Through the Lens of Loose Coupling

“…On April 27th, Hospital C found that a 73-year-old patient who had been kept in a regular ward for five days developed lung infiltrate. After immediate investigation, clinicians discovered that this patient had been to Hospital A on April 16th, but no agency informed them about the connection (Chen et al 2004c). By the time of discovery, a new cluster of SARS patients was already initiated by the patient.…”

“…But after mid-April, a municipal hospital in Taipei (hereafter referred to as Hospital A 2 ) reported having a SARS hospital outbreak. Six other hospitals subsequently reported incidents of hospital-acquired or nosocomial infection that were all traced back to Hospital A (Chen et al 2004c, Chu et al 2005. In this phase of hospital outbreaks, the number of SARS cases soared dramatically from the low 30s to more than 400 (Yip et al 2007).…”

“…Shortly after, prior hospital visits were incorporated as an additional epidemiological cue for SARS patient detection. On May 8th, through another contact investigation, Hospital C found that a suspect SARS patient could be traced back to its own emergency room (Chen et al 2004c). The hospital reported to the public health agency for the possibility of a hospital outbreak and suspended its emergency service on May 12th.…”