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      SARS in Three Categories of Hospital Workers, Hong Kong

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          Abstract

          The SARS attack rate for hospital workers in Hong Kong was 1.20% and was significantly higher in nonmedical support staff.

          Abstract

          We analyzed attack rates for severe acute respiratory syndrome (SARS) in three categories of hospital workers (nurses, nonmedical support staff, and other technical or medical staff) in all public hospitals in Hong Kong that had admitted SARS patients. Of 16 such hospitals, 14 had cases. The overall attack rate was 1.20%. Nonmedical support staff had the highest attack rate (2.73%). The odds ratios of group nonmedical support staff versus those of nurses and of nonmedical support staff versus other technical or medical staff were 2.30 (p < 0.001) and 9.78 (p < 0.001), respectively. The number of affected staff and attack rates were significantly correlated with the number of SARS patients admitted (r = 0.914 and 0.686, respectively). Affected patients were concentrated in three hospitals and in the earlier phase of the epidemic. Cleaning and clerical staff on hospital wards were at a much higher risk.

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          Most cited references6

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          An outbreak of severe acute respiratory syndrome among hospital workers in a community hospital in Hong Kong.

          During outbreaks, hospital workers are at high risk for nosocomial infection with severe acute respiratory syndrome (SARS)-associated coronavirus. To examine how hospital workers became infected and whether they transmit the virus to their families. Retrospective descriptive study. 529-bed community hospital in Hong Kong. 40 hospital workers infected with SARS-associated coronavirus over a 6-week period (25 March through 5 May 2003). Percentage of infected hospital workers according to job category. The cumulative incidence was highest among health care assistants, followed by physicians and nurses (8%, 5%, and 4%, respectively). Most hospital workers were infected from direct contact with patients with SARS, who primarily were in general wards and had unsuspected infection. At the time of contact, all hospital workers had used masks but not necessarily other protective devices. Affected hospital workers did not infect their families. Before isolation of all patients with clinically confirmed or suspected SARS, routine use of several protective devices, and training of staff in infection control, many health care workers were infected with SARS from patients with unsuspected cases.
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            Ventilation of wards and nosocomial outbreak of severe acute respiratory syndrome among healthcare workers.

            To identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units. Architectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed. Four types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m(2)/m(3)) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1:95 and 1:40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance. Isolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.
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              [Epidemiological study on severe acute respiratory syndrome in Guangdong province].

              To understand the epidemiological characteristics of severe acute respiratory syndrome (SARS) outbreaks in some areas of Guangdong province and to provide scientific basis for prevention and control measures against it. Standardized questionnaire was used on individual cases. Data on the epidemiological characteristics as time, place, persons and aggregation status of SARS cases, development of the epidemics, were analyzed with software EPI 6.0. The incidence of SARS in Guangdong province was 1.72/100,000 with case fatality rate as 3.64%. Most cases of SARS occurred between the last ten days of January and the first ten days of February with the peak (61.88% of the patients) occurred in the first ten days of February. As to the distribution of place, Pearl river delta region-economically developed with great number of mobile population-was heavily affected areas (account for 96.66% of the total patients). The majority of patients were young adults and medical staff seemed to be the most affected subgroup (account for 24.9% of the patients in total). Family and hospital aggregation of patients comprised the another two important characteristics of SARS (account for 37.1% of the total patients). Current knowledge on SARS suggested that it was an air-borne infectious disease with human beings served as the source of infection. The incubation period of the disease was from 1 to 12 days with a median of 4 days. Respiratory secretions and close contact contributed to person-to-person transmission. Most cases were distributed in Pearl river delta region, an area famous for its economic development and heavy flow of mobile population.
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                Author and article information

                Journal
                Emerg Infect Dis
                Emerging Infect. Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                August 2004
                : 10
                : 8
                : 1399-1404
                Affiliations
                [* ]The Chinese University of Hong Kong, Hong Kong, China
                Author notes
                Address for correspondence: Joseph T.F. Lau, Centre for Epidemiology and Biostatistics, 5/F, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong Special Administration Region, China; fax: 852-2645-3098; email: jlau@ 123456cuhk.edu.hk
                Article
                04-0041
                10.3201/eid1008.040041
                3320402
                15496240
                616b0cfe-6509-4e41-b531-6e970ebfa729
                History
                Categories
                Research
                Research

                Infectious disease & Microbiology
                healthcare workers,research,sars,nosocomial infection,hong kong,chinese,hospital infection,incidence study

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