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Rapid Creation of a Temporary Isolation Ward for Patients With Severe Acute Respiratory Syndrome in Taiwan

Published online by Cambridge University Press:  02 January 2015

Chang-Phone Fung
Affiliation:
Section of Infectious Diseases, Taipei Veterans General Hospital andNational Yang-Ming University, Taipei, Taiwan
Tsorng-Liu Hsieh
Affiliation:
Department of Internal Medicine, Sung-Shan Military Hospital, Taipei, Taiwan
Kuang-Huan Tan
Affiliation:
Committee of Infection Control, Sung-Shan Military Hospital, Taipei, Taiwan
Chin-Hui Loh
Affiliation:
Division of Infectious Diseases, Tri-Service General Hospital, Taipei, Taiwan
Jiunn-Sheng Wu
Affiliation:
Department of Internal Medicine, Sung-Shan Military Hospital, Taipei, Taiwan
Chien-Chung Li
Affiliation:
Department of Internal Medicine, Sung-Shan Military Hospital, Taipei, Taiwan
Feng-Yee Chang
Affiliation:
Division of Infectious Diseases, Tri-Service General Hospital, Taipei, Taiwan
L. K. Siu
Affiliation:
Division of Clinical Research, National Health Research Institute, Taipei, Taiwan
Moh-Yun Yen
Affiliation:
Department of Emergency Service, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Lih-Shinn Wang
Affiliation:
Division of Infectious Diseases, Buddhist Tzu Chi General Hospital, Hwalien, Taiwan
Wing-Wai Wong
Affiliation:
Section of Infectious Diseases, Taipei Veterans General Hospital andNational Yang-Ming University, Taipei, Taiwan
Wei-Fong Kao
Affiliation:
Department of Emergency Service, Taipei Veterans General Hospital andNational Yang-Ming University, Taipei, Taiwan
Jia-Hui Hsu
Affiliation:
Committee of Infection Control, Sung-Shan Military Hospital, Taipei, Taiwan
Ting-Hsiang Lin
Affiliation:
Division of Laboratory Research and Development, Center for Disease Control, Department of Health, Taipei, Taiwan
Fu-Yuan Huang
Affiliation:
MacKay Memorial Hospital, Taipei, Taiwan
Chen-Hsen Lee*
Affiliation:
Department of Emergency Service, Taipei Veterans General Hospital andNational Yang-Ming University, Taipei, Taiwan
*
Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei, 11217, Taiwan
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Abstract

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Objectives:

To rapidly establish a temporary isolation ward to handle an unexpected sudden outbreak of severe acute respiratory syndrome (SARS) and to evaluate the implementation of exposure control measures by healthcare workers (HCWs) for SARS patients.

Design:

Rapid creation of 60 relatively negative pressure isolation rooms for 196 suspected SARS patients transferred from 19 hospitals and daily temperature recordings of 180 volunteer HCWs from 6 medical centers.

Setting:

A military hospital.

Results:

Of the 196 patients, 34 (17.3%) met the World Health Organization criteria for probable SARS with positive results of serologic testing for SARS-associated coronavirus (SARS-CoV), reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal or throat swabs for SARS-CoV, or both. Seventy-four patients had suspected SARS based on unprotected exposure to SARS patients; three of them had positive results on RT-PCR but negative serologic results. The remaining 88 patients did not meet the criteria for a probable or suspected SARS diagnosis. Of the 34 patients with probable SARS, 13 were transferred to medical centers to receive mechanical ventilation due to rapid deterioration of chest x-ray results, and three patients died of SARS despite intensive therapy in medical centers. During the study period, one nurse developed probable SARS due to violation of infection control measures, but there was no evidence of cross-transmission to other HCWs.

Conclusions:

Despite the use of full personal protection equipment, the facility failed to totally prevent exposures of HCWs to SARS but minimized the risk of nosocomial transmission. Better training and improvements in infection control infrastructure may limit the impact of SARS.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

References

1.World Health Organization. Acute respiratory syndrome China, Hong Kong Special Administrative Region of China, and Viet Nam. Wkly Epidemiol Rec 2003;78:7374.Google Scholar
2.Tsang, KW, Ho, PL, Ooi, GC, et al.A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:19771985.CrossRefGoogle ScholarPubMed
3.Lee, N, Hui, D, Wu, A, et al.A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:19861994.CrossRefGoogle Scholar
4.Centers for Disease Control and Prevention. Severe acute respiratory syndrome: Singapore, 2003. MMWR 2003;52:405411.Google Scholar
5.Poutanen, SM, Low, DE, Henry, B, et al.Identification of severe acute respiratory syndrome in Canada. N Engl J Med 2003;348:19952005.CrossRefGoogle ScholarPubMed
6.Twu, SJ, Chen, TJ, Chen, CJ, et al.Control measures for severe acute respiratory syndrome (SARS) in Taiwan. Emerg Infect Dis 2003;9:718720.Google Scholar
7.World Health Organization. Cumulative Number of Reported Probable Cases of SARS From 1st November 2002 to 4th July 2003. Geneva: World Health Organization; 2003. Available at www.who.int/csr/sars/country2003_07_04/en/.Google Scholar
8.Centers for Disease Control and Prevention. Severe acute respiratory syndrome: Taiwan, 2003. MMWR 2003;52:461466.Google Scholar
9.World Health Organization. Case Definitions for Surveillance of Severe Acute Respiratory Syndrome (SARS); 2003. Geneva: World Health Organization; 2003. Available at www.who.int/csr/sars/casedefinition/en/. Accessed April 20, 2003.Google Scholar
10.Rainer, TH, Cameron, PA, Smit, D, et al.Evaluation of WHO criteria for identifying patients with severe acute respiratory syndrome out of hospital: prospective observational study. Br Med J 2003;326:13541358.Google Scholar
11.Pang, X, Zhu, Z, Xu, F, et al.Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003. JAMA 2003;290:32153221.Google Scholar
12.Donnelly, CA, Ghani, AC, Leung, GM, et al.Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet 2003;361:17611766.CrossRefGoogle ScholarPubMed
13.Riley, S, Fraser, C, Donnelly, CA, et al.Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions. Science 2003;300:19611966.CrossRefGoogle Scholar
14.World Health Organization. Hospital Infection Control Guidance for Severe Acute Respiratory Syndrome (SARS) (Revised 24 April 2003). Geneva: World Health Organization; 2003. Available at www.who.int/csr/sars/infectioncontrol/en/print.html.Google Scholar
15.Huang, KY. The lessons of SARS. J Microbiol Immunol Infect 2003;36:7780.Google ScholarPubMed
16.World Health Organization. Summary of Probable SARS Cases With Onset of Illness From 1 November 2002 to 31 July 2003 (Revised 26 Septembr 2003). Geneva: World Health Organization; 2003. Available at www.who.int/csr/sars/country/table2003_09_23/en/.Google Scholar
17.Seto, WH, Tsang, D, Yung, RW, et al.Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003;361:15191520.Google Scholar