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      Anti–SARS-CoV Immunoglobulin G in Healthcare Workers, Guangzhou, China

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          Abstract

          Low level of immunity for SARS-CoV among well healthcare workers reinforces the need for infection control measures in hospitals to prevent epidemics.

          Abstract

          To determine the prevalence of inapparent infection with severe acute respiratory syndrome (SARS) among healthcare workers, we performed a serosurvey to test for immunoglobulin (Ig) G antibodies to the SARS coronavirus (SARS-CoV) among 1,147 healthcare workers in 3 hospitals that admitted SARS patients in mid-May 2003. Among them were 90 healthcare workers with SARS. As a reference group, 709 healthcare workers who worked in 2 hospitals that never admitted any SARS patients were similarly tested. The seroprevalence rate was 88.9% (80/90) for healthcare workers with SARS and 1.4% (15/1,057) for healthcare workers who were apparently healthy. The seroprevalence in the reference group was 0.4% (3/709). These findings suggest that inapparent infection is uncommon. Low level of immunity among unaffected healthcare workers reinforces the need for adequate personal protection and other infection control measures in hospitals to prevent future epidemics.

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          Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study.

          J S M Peiris, C M Chu, V Cheng … (2003)
          We investigated the temporal progression of the clinical, radiological, and virological changes in a community outbreak of severe acute respiratory syndrome (SARS). We followed up 75 patients for 3 weeks managed with a standard treatment protocol of ribavirin and corticosteroids, and assessed the pattern of clinical disease, viral load, risk factors for poor clinical outcome, and the usefulness of virological diagnostic methods. Fever and pneumonia initially improved but 64 (85%) patients developed recurrent fever after a mean of 8.9 (SD 3.1) days, 55 (73%) had watery diarrhoea after 7.5 (2.3) days, 60 (80%) had radiological worsening after 7.4 (2.2) days, and respiratory symptoms worsened in 34 (45%) after 8.6 (3.0) days. In 34 (45%) patients, improvement of initial pulmonary lesions was associated with appearance of new radiological lesions at other sites. Nine (12%) patients developed spontaneous pneumomediastinum and 15 (20%) developed acute respiratory distress syndrome (ARDS) in week 3. Quantitative reverse-transcriptase (RT) PCR of nasopharyngeal aspirates in 14 patients (four with ARDS) showed peak viral load at day 10, and at day 15 a load lower than at admission. Age and chronic hepatitis B virus infection treated with lamivudine were independent significant risk factors for progression to ARDS (p=0.001). SARS-associated coronavirus in faeces was seen on RT-PCR in 65 (97%) of 67 patients at day 14. The mean time to seroconversion was 20 days. The consistent clinical progression, shifting radiological infiltrates, and an inverted V viral-load profile suggest that worsening in week 2 is unrelated to uncontrolled viral replication but may be related to immunopathological damage.
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            Cluster of severe acute respiratory syndrome cases among protected health-care workers--Toronto, Canada, April 2003.

            (2003)
            Infections among health-care workers (HCWs) have been a common feature of severe acute respiratory syndrome (SARS) since its emergence. The majority of these infections have occurred in locations where infection-control precautions either had not been instituted or had been instituted but were not followed. Recommended infection-control precautions include the use of negative-pressure isolation rooms where available; N95 or higher level of respiratory protection; gloves, gowns, and eye protection; and careful hand hygiene. This report summarizes a cluster of SARS cases among HCWs in a hospital that occurred despite apparent compliance with recommended infection-control precautions.
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              Severe acute respiratory syndrome--Singapore, 2003.

              Mark Chen (2003)
              The Singapore Ministry of Health (MOH), with assistance from the World Health Organization (WHO), has been investigating an outbreak of severe acute respiratory syndrome (SARS). This is a novel condition caused by the SARS-associated coronavirus (SARS-CoV) and is characterized by both an atypical pneumonia and efficient nosocomial transmission. This report summarizes epidemiologic features of this outbreak in Singapore, including the influence of super spreaders and the national prevention and control strategy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging 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): January 2005
                Volume: 11
                Issue: 1
                Pages: 89-94
                Affiliations
                [* ]Sun Yat-Sen University, Guangzhou, People’s Republic of China
                [† ]Chinese University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China
                Author notes
                Address for correspondence: Wei-Qing Chen, School of Public Health, Zhongshan Rd II 74, Guangzhou 510080, The People’s Republic of China; fax: 86-20-87330446; email: wqchen@ 123456gzsums.edu.cn
                Article
                Publisher ID: 04-0138
                DOI: 10.3201/eid1101.040138
                PMC ID: 3294349
                PubMed ID: 15705328
                SO-VID: f6865f4c-1aa7-408e-80b1-28e1f19c0066
                History
                Categories
                Subject: Research
                Subject: Research

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: research,china,healthcare workers,seroprevalence,sars
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: research, china, healthcare workers, seroprevalence, sars

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