SARS Transmission among Hospital Workers in Hong Kong

Abstract

Despite infection control measures, breakthrough transmission of severe acute respiratory syndrome (SARS) occurred for many hospital workers in Hong Kong. We conducted a case-control study of 72 hospital workers with SARS and 144 matched controls. Inconsistent use of goggles, gowns, gloves, and caps was associated with a higher risk for SARS infection (unadjusted odds ratio 2.42 to 20.54, p < 0.05). The likelihood of SARS infection was strongly associated with the amount of personal protection equipment perceived to be inadequate, having <2 hours of infection control training, and not understanding infection control procedures. No significant differences existed between the case and control groups in the proportion of workers who performed high-risk procedures, reported minor protection equipment problems, or had social contact with SARS-infected persons. Perceived inadequacy of personal protection equipment supply, infection control training <2 hours, and inconsistent use of personal protection equipment when in contact with SARS patients were significant independent risk factors for SARS infection.

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters

“…The key learning points from the SARS epidemics [26,27], particularly those concerning infection control, are summarised in table 1.…”

“…In addition to staff absence due to personal infection, quarantine and caring duties, high stress levels may impact Data taken from [26,27].…”

Contamination of Health Care Personnel During Removal of Personal Protective Equipment

“…[4][5][6][7] Contamination of the skin and clothing of health care personnel contributes to transmission of pathogens and places personnel at risk for infection with potentially fatal pathogens, such as Ebola virus, severe acute respiratory syndrome, and Middle East respiratory syndrome coronaviruses. 1,[8][9][10][11] Moreover, personnel frequently acquire norovirus infections during health care facility outbreaks and are at risk of acquiring CDI if they receive antibiotics. [12][13][14] The risk of inadvertent contamination of skin and clothing despite use of PPE may be particularly high during removal of contaminated equipment.…”

Reply to the comments on “in vivo protective performance of N95 respirator and surgical facemask”

“…We understand that the purpose of a surgical mask is the prevention of surgical wound contamination and subsequent patient infection, not personal protection. However, these guidelines and test standards did not stop the widespread practices of health care workers and domestic users in the community to wear surgical and other facemasks as a key personal protective device during the SARS outbreak in Hong Kong, Taiwan, and Toronto [Seto et al, 2003;Lau et al, 2004;Loeb et al, 2004;Chen et al, 2005]. Seto et al [2003] reported that surgical facemasks did provide significant protection for health care workers taking care of SARS patients.…”