SARS in Taiwan: an overview and lessons learned

Chen, Kow-Tong; Twu, Shiing-Jer; Chang, Hsiao-Ling; Wu, Yi-Chun; Chen, Chu-Tzu; Lin, Tao; Olsen, Sonja J.; Dowell, Scott F.; Su, Ih‐Jen

doi:10.1016/j.ijid.2004.04.015

Cited by 106 publications

(97 citation statements)

References 12 publications

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“…Soon, Taipei became the centre of a SARS outbreak that spread over the entirety of Taiwan in the span of six weeks. 7 By late June, SARS had caused 73 fatalities in Taiwan, affecting physicians and nurses as well. 8 SARS was a highly contagious, emerging infectious disease (EID) that, just like influenza, was spread through droplet aerosols and contact transmission.…”

Section: Sars Backgroundmentioning

confidence: 99%

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From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic

Yen

Chiu

Schwartz

et al. 2014

Journal of Hospital Infection

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In anticipation of a future pandemic potentially arising from H5N1, H7N9 avian influenza or Middle East Respiratory Syndrome, and in large part in response to severe acute respiratory syndrome (SARS) in 2003, the city of Taipei, Taiwan, has developed extensive new strategies to manage pandemics. These strategies were tested during the 2009 H1N1 outbreak. This article assesses pandemic preparedness in Taipei in the wake of recent pandemic experiences in order to draw lessons relevant to the broader international public health community. Drawing on Taiwan and Taipei Centers for Disease Control data on pandemic response and control, we evaluated the effectiveness of the changes in pandemic response policies developed by these governments over time, emphasizing hospital and medical interventions with particular attention paid to Traffic Control Bundling. SARS and H1N1 2009 catalysed the Taiwan and Taipei CDCs to continuously improve and adjust their strategies for a future pandemic. These new strategies for pandemic response and control have been largely effective at providing interim pandemic containment and control, while development and implementation of an effective vaccination programme is underway. As Taipei's experiences with these cases illustrate, in mitigating moderate or severe pandemic influenza, a graduated process including Traffic Control Bundles accompanied by hospital and medical interventions, as well as school- and community-focused interventions, provides an effective interim response while awaiting vaccine development. Once a vaccine is developed, to maximize pandemic control effectiveness, it should be allocated with priority given to vulnerable groups, healthcare workers and school children.

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Section: Sars Backgroundmentioning

confidence: 99%

“…The consequence was a total of 347 casualties, of whom 70% were from healthcare-associated infections and 30% were of healthcare workers (HCWs). 7,9,10 Lessons from the post-SARS evaluation of pandemic response…”

Section: Sars Backgroundmentioning

confidence: 99%

From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic

Yen

Chiu

Schwartz

et al. 2014

Journal of Hospital Infection

View full text Add to dashboard Cite

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“…The Taiwan SARS outbreak began with a businessman who went to Guangdong Province, China, from February 5th to the 21st, 2003 (Chen et al 2005a, Twu et al 2003. He developed a fever and dry cough shortly after his return and was hospitalized in Hospital C on March 8th.…”

Section: Effective Central Guidelines Tightening Coordination For Manmentioning

confidence: 99%

“…On April 12th, a laundry worker in Hospital A, who often spent time in the emergency room, developed a fever and diarrhea (Chen et al 2005a). Because he did not have any travel history and clinicians were not aware of any SARS patient appearing in the hospital, the worker did not receive special attention and he remained on duty and interacted with people as usual.…”

Section: Low Local Sensitivity Triggeringmentioning

confidence: 99%

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

Chen

Brown

et al. 2011

Information Systems Research

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I ncreasing global connectivity makes emerging infectious diseases (EID) more threatening than ever before.Various information systems (IS) projects have been undertaken to enhance public health capacity for detecting EID in a timely manner and disseminating important public health information to concerned parties. While those initiatives seemed to offer promising solutions, public health researchers and practitioners raised concerns about their overall effectiveness. In this paper, we argue that the concerns about current public health IS projects are partially rooted in the lack of a comprehensive framework that captures the complexity of EID management to inform and evaluate the development of public health IS. We leverage loose coupling to analyze news coverage and contact tracing data from 479 patients associated with the severe acute respiratory syndrome (SARS) outbreak in Taiwan. From this analysis, we develop a framework for outbreak management. Our proposed framework identifies two types of causal circles-coupling and decoupling circles-between the central public health administration and the local capacity for detecting unusual patient cases. These two circles are triggered by important information-centric activities in public health practices and can have significant influence on the effectiveness of EID management. We derive seven design guidelines from the framework and our analysis of the SARS outbreak in Taiwan to inform the development of public health IS. We leverage the guidelines to evaluate current public health initiatives. By doing so, we identify limitations of existing public health IS, highlight the direction future development should consider, and discuss implications for research and public health policy.

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“…I n 2003, the Severe Acute Respiratory Syndrome (SARS) epidemic presented countries with the challenge of detection and quarantine of persons with a communicable febrile illness and this experience has helped shape strategies for an influenza pandemic. Some countries, including Australia, 1 implemented visual inspection to detect SARS, whereas others such as Hong Kong, 2 Singapore, 3 Taiwan 4 and Canada 5 made use of infrared thermal imaging to detect febrile passengers. The Australian approach, which was based on symptom screening, missed most travellers with suspected and probable SARS, 1 whereas thermal cameras had some success detecting SARS in visitors and outpatients entering a hospital in Taiwan 6 .…”

mentioning

confidence: 99%

Investigation of febrile passengers detected by infrared thermal scanning at an international airport

McBride

Buikstra

Fitzgerald

2010

Australian and New Zealand Journal of Public Health

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Objective: To determine the best approach for the evaluation of fever, detected by infrared thermal scanning, at an international airport. Methods: Arriving passengers with fever were divided into three groups: community evaluation by a GP, with or without cost compensation, or evaluation at the airport by a health practitioner. Uptake of offered evaluations was measured, diagnoses were recorded, and region‐specific rates of fever measured. Observations were made on practical aspects of thermal screening. Results: Over a six‐month period, 181,759 passengers were screened for fever at the Cairns international airport, Queensland, Australia. Fever was identified in 118 (0.06%) of the arriving passengers and 76 were enrolled in the study. Only 19 of these passengers (25%) voluntarily underwent further evaluation. No differences were observed in the three approaches. Conclusions: Public health surveillance of febrile passengers arriving at an international airport should not rely on voluntary passenger participation for the detection of imported contagious diseases.

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SARS in Taiwan: an overview and lessons learned

Abstract: In this outbreak, an emergency plan consisted of patient isolation and strict hospital infection control.

Cited by 106 publications

References 12 publications

From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic

From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic

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

Investigation of febrile passengers detected by infrared thermal scanning at an international airport

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