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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

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