Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak

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Abstract

TOC Summary Line: Healthcare workers in hospitals affected by SARS experience increased psychological stress 1–2 years after the outbreak.

Abstract

Healthcare workers (HCWs) found the 2003 outbreak of severe acute respiratory syndrome (SARS) to be stressful, but the long-term impact is not known. From 13 to 26 months after the SARS outbreak, 769 HCWs at 9 Toronto hospitals that treated SARS patients and 4 Hamilton hospitals that did not treat SARS patients completed a survey of several adverse outcomes. Toronto HCWs reported significantly higher levels of burnout (p = 0.019), psychological distress (p<0.001), and posttraumatic stress (p<0.001). Toronto workers were more likely to have reduced patient contact and work hours and to report behavioral consequences of stress. Variance in adverse outcomes was explained by a protective effect of the perceived adequacy of training and support and by a provocative effect of maladaptive coping style and other individual factors. The results reinforce the value of effective staff support and training in preparation for future outbreaks.

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Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome

Christian Drosten, Stephan Günther, Wolfgang Preiser … (2003)

The severe acute respiratory syndrome (SARS) has recently been identified as a new clinical entity. SARS is thought to be caused by an unknown infectious agent. Clinical specimens from patients with SARS were searched for unknown viruses with the use of cell cultures and molecular techniques. A novel coronavirus was identified in patients with SARS. The virus was isolated in cell culture, and a sequence 300 nucleotides in length was obtained by a polymerase-chain-reaction (PCR)-based random-amplification procedure. Genetic characterization indicated that the virus is only distantly related to known coronaviruses (identical in 50 to 60 percent of the nucleotide sequence). On the basis of the obtained sequence, conventional and real-time PCR assays for specific and sensitive detection of the novel virus were established. Virus was detected in a variety of clinical specimens from patients with SARS but not in controls. High concentrations of viral RNA of up to 100 million molecules per milliliter were found in sputum. Viral RNA was also detected at extremely low concentrations in plasma during the acute phase and in feces during the late convalescent phase. Infected patients showed seroconversion on the Vero cells in which the virus was isolated. The novel coronavirus might have a role in causing SARS. Copyright 2003 Massachusetts Medical Society

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Characterization of a novel coronavirus associated with severe acute respiratory syndrome.

P Rota (2003)

In March 2003, a novel coronavirus (SARS-CoV) was discovered in association with cases of severe acute respiratory syndrome (SARS). The sequence of the complete genome of SARS-CoV was determined, and the initial characterization of the viral genome is presented in this report. The genome of SARS-CoV is 29,727 nucleotides in length and has 11 open reading frames, and its genome organization is similar to that of other coronaviruses. Phylogenetic analyses and sequence comparisons showed that SARS-CoV is not closely related to any of the previously characterized coronaviruses.

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Coronavirus as a possible cause of severe acute respiratory syndrome.

V Cheng, A. Yung, J. S. Malik Peiris … (2003)

An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients. We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe disease and investigated the causal agents by chest radiography and laboratory testing of nasopharyngeal aspirates and sera samples. We compared the laboratory findings with those submitted for microbiological investigation of other diseases from patients whose identity was masked. Patients' age ranged from 23 to 74 years. Fever, chills, myalgia, and cough were the most frequent complaints. When compared with chest radiographic changes, respiratory symptoms and auscultatory findings were disproportionally mild. Patients who were household contacts of other infected people and had older age, lymphopenia, and liver dysfunction were associated with severe disease. A virus belonging to the family Coronaviridae was isolated from two patients. By use of serological and reverse-transcriptase PCR specific for this virus, 45 of 50 patients with SARS, but no controls, had evidence of infection with this virus. A coronavirus was isolated from patients with SARS that might be the primary agent associated with this disease. Serological and molecular tests specific for the virus permitted a definitive laboratory diagnosis to be made and allowed further investigation to define whether other cofactors play a part in disease progression.

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Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): December 2006

Volume: 12

Issue: 12

Pages: 1924-1932

Affiliations

[* ]Mount Sinai Hospital, Toronto, Ontario, Canada;

[† ]University of Toronto, Toronto, Ontario, Canada;

[‡ ]Saint Michael's Hospital, Toronto, Ontario, Canada;

[§ ]The Scarborough Hospital, Toronto, Ontario, Canada;

[¶ ]Hamilton Health Sciences Centre, Hamilton, Ontario, Canada;

[# ]McMaster University, Hamilton, Ontario, Canada;

[** ]Centre for Addiction and Mental Health, Toronto, Ontario, Canada;

[†† ]Sunnybrook and Women's Health Sciences Centre, Toronto, Ontario, Canada;

[‡‡ ]Rouge Valley Health System, Toronto, Ontario, Canada;

[§§ ]Whitby Mental Health Centre, Whitby, Canada;

[¶¶ ]North York General Hospital, Toronto, Ontario, Canada

Author notes

Address for correspondence: Robert Maunder, Department of Psychiatry, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario M5G 1X5; email: rmaunder@ 123456mtsinai.on.ca

Article

Publisher ID: 06-0584

DOI: 10.3201/eid1212.060584

PMC ID: 3291360

PubMed ID: 17326946

SO-VID: 826ee61b-1ba2-4aae-896a-3b0fc49d51e0

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Long-term Psychological and Occupational Effects of Providing Hospital Healthcare during SARS Outbreak

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Microbiology Society: Coronaviruses

Most cited references 16

Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome

Characterization of a novel coronavirus associated with severe acute respiratory syndrome.

Coronavirus as a possible cause of severe acute respiratory syndrome.

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Cited by 530

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