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Intensive Care Medicine

Published in:

01-04-2006 | Original

Transmission of SARS to healthcare workers. The experience of a Hong Kong ICU

Authors: Charles D. Gomersall, Gavin M. Joynt, Oi Man Ho, Margaret Ip, Florence Yap, James L. Derrick, Patricia Leung

Published in: Intensive Care Medicine | Issue 4/2006

Abstract

Objective

To describe the extent and temporal pattern of transmission of severe acute respiratory syndrome (SARS) to intensive care unit staff.

Design

Retrospective observational cohort study.

Setting

University hospital intensive care unit, caring solely for patients with SARS or suspected to have SARS.

Participants

Thirty-five doctors and 152 nurses and healthcare assistants who worked in the ICU during the SARS epidemic. Interventions: Infection control measures designed to prevent transmission of disease to staff were implemented.

Measurements and results

Sixty-seven patients with SARS were admitted to the intensive care unit. Four nurses and one healthcare assistant contracted SARS, with three of these developing symptoms within 10 days of admission of the first patient with SARS. Doctors were exposed to patients with SARS for a median (IQR) of 284 (97–376) h, while nurses and healthcare assistants were exposed for a median (IQR) of 119 (57–166) h. The ICU did not meet international standards for physical space or ventilation.

Conclusions

In an ICU in which infection control procedures are rigorously applied, the risk to staff of contracting SARS from patients is low, despite long staff exposure times and a sub-standard physical environment.

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Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB, To KF, Lui SF, Szeto CC, Chung S, Sung JJY (2003) A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 348:1986–1994CrossRefPubMed

Centers for Disease Control and Prevention (2003) Cluster of severe acute respiratory syndrome cases among protected health-care workers – Toronto, Canada, April 2000. MMWR Morb Mortal Wkly Rep 52:433–436

Loeb M, McGeer A, Henry B, Ofner M, Rose D, Hlywka T, Levie J, McQueen J, Smith S, Moss L, Smith A, Green K, Walter SD (2004) SARS among critical care nurses, Toronto. Emerg Infect Dis 10:251–255PubMed

Christian MD, Loutfy M, McDonald LC, Martinez KF, Ofner M, Wong T, Wallington T, Gold WL, Mederski B, Green K, Low DE, on behalf of the SARS Investigation Team (2004) Possible SARS coronavirus transmission during cardiopulmonary resuscitation. Emerg Infect Dis 10:293–287

Gomersall CD, Joynt GM, Lam P, Li T, Yap F, Lam D, Buckley TA, Sung JJY, Hui DS, Antonio GE, Ahuja AT, Leung P (2004) Short-term of outcome of critically ill patients with severe acute respiratory syndrome. Intensive Care Med 30:381–387PubMedCrossRef

Gomersall C, Joynt G, Lam P, Li T, Yap F (2005) Protecting healthcare workers from SARS. Crit Care 9:S104–S105CrossRef

Peiris JS, Chu CM, Cheng VC, Chan KS, Hung IF, Poon LL, Law KI, Tang BS, Hon TY, Chan CS, Chan KH, Ng JS, Zheng BJ, Ng WL, Lai RW, Guan Y, Yuen KY, HKU/UCH SARS study group (2003) Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet 361:1767–1772CrossRefPubMed

Joint Faculty of Intensive Care Medicine (2003) Minimum standards for intensive care units. Joint Faculty of Intensive Care Medicine, Melbourne.

Centers for Disease Control and Prevention (2003) Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Morb Mortal Wkly Rep 52:1–46

10.

Booth CM, Matukas LM, Tomlinson GA, Rachlis AR, Rose DB, Dwosh HA, Walmsley SL, Mazzulli T, Avendano M, Derkach P, Ephtimios IE, Kitai I, Mederski BD, Shadowitz SB, Gold WL, Hawryluck LA, Rea E, Chenkin JS, Cescon DW, Poutanen SM, Detsky AS (2003) Clinical features and short-term outcomes of 144 patients with SARS in the greater Toronto area. JAMA 289:2801–2809CrossRefPubMed

11.

Chow PKH, Ooi EE, Tan HK, Ong KW, Sil BK, Teo M, Ng T, Soo KC (2004) Healthcare worker seroconversion in SARS outbreak. Emerg Infect Dis 10:249–250PubMed

12.

Ip M, Chan PKS, Lee N, Wu A, Ng TKC, Chan L, Ng A, Kwan HM, Tsang L, Chu I, Cheung JLK, Sung JJY, Tam JS (2004) Seroprevalence of antibody to severe acute respiratory syndrome (SARS)-associated coronavirus among health-care workers in SARS and non-SARS medical wards. Clin Infect Dis 38:e116–e118

13.

Tai DYH, Lew TWK, Loo S, Earnest A, Chen MIC (2003) Clinical features and predictors for mortality in a designated national SARS ICU in Singapore. Ann Acad Med Singapore 32:S34–S36PubMed

14.

Tai DYH (2004) A journey through the severe acute respiratory syndrome (SARS) crisis in Singapore—Observations of an intensivist. Critical Care & Shock 7:134–139

15.

Riley S, Fraser C, Donnelly CA, Ghani AC, Abu-Raddad LJ, Hedley AJ, Leung GM, Ho LM, Lam TH, Thach TQ, Chau P, Chan KP, Lo SV, Leung PY, Tsang T, Ho W, Lee KH, Lau EM, Ferguson NM, Anderson RM (2003) Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions. Science 300:1961–1966CrossRefPubMed

16.

Shen Z, Ning F, Zhou W, He X, Lin C, Chin DP, Zhu Z, Schuchat A (2004) Super-spreading SARS events, Beijing, 2003. Emerg Infect Dis 10:256–260PubMed

17.

Ha LD, Bloom SA, Nguyen QH, Maloney SA, Le MQ, Leitmeyer KC, Anh BH, Reynolds MG, Montgomery JM, Comer JA, Horby PW, Plant AJ (2004) Lack of SARS transmission among public health workers, Vietnam. Emerg Infect Dis 10:265–268PubMed

18.

Seto WH, Tsang D, Yung RW, Ching TY, Ng TK, Ho M, Ho LM, Peiris JS (2003) Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 361:1519–1520CrossRefPubMed

19.

Lau JTF, Fung KS, Wong TW, Kim JH, Wong E, Chung S, Ho D, Chan LY, Lui SF, Cheng A (2004) SARS transmission among hospital workers in Hong Kong. Emerg Infect Dis 10:280–286PubMed

20.

Chia SE, Koh D, Fones C, Qian F, Ng V, Tan BH, Wong KS, Chew WM, Tang HK, Muttakin Z, Emmanuel S, Fong NP, Koh G, Lim MK (2005) Appropriate use of personal protective equipment among healthcare workers in public sector hospitals and primary healthcare polyclinics during the SARS outbreak in Singapore. Occup Environ Med 62:473–477CrossRefPubMed

Title: Transmission of SARS to healthcare workers. The experience of a Hong Kong ICU
Authors: Charles D. Gomersall
Gavin M. Joynt
Oi Man Ho
Margaret Ip
Florence Yap
James L. Derrick
Patricia Leung
Publication date: 01-04-2006
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0081-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transmission of SARS to healthcare workers. The experience of a Hong Kong ICU

Abstract

Objective

Design

Setting

Participants

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Participants

Measurements and results

Conclusions

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