title: Lack of SARS transmission among healthcare workers, United States.
abstract: Healthcare workers accounted for a large proportion of persons with severe acute respiratory syndrome (SARS) during the worldwide epidemic of early 2003. We conducted an investigation of healthcare workers exposed to laboratory-confirmed SARS patients in the United States to evaluate infection-control practices and possible SARS-associated coronavirus (SARS-CoV) transmission. We identified 110 healthcare workers with exposure within droplet range (i.e., 3 feet) to six SARS-CoV-positive patients. Forty-five healthcare workers had exposure without any mask use, 72 had exposure without eye protection, and 40 reported direct skin-to-skin contact. Potential droplet- and aerosol-generating procedures were infrequent: 5% of healthcare workers manipulated a patient's airway, and 4% administered aerosolized medication. Despite numerous unprotected exposures, there was no serologic evidence of healthcare-related SARS-CoV transmission. Lack of transmission in the United States may be related to the relative absence of high-risk procedures or patients, factors that may place healthcare workers at higher risk for infection.
authors.affiliation: Mycotic Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Park
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Peck
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kuehnert
authors.forename: Claire
authors.initials: C
authors.lastname: Newbern
authors.forename: Chad
authors.initials: C
authors.lastname: Smelser
authors.forename: James A
authors.initials: JA
authors.lastname: Comer
authors.forename: Daniel
authors.initials: D
authors.lastname: Jernigan
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
mesh_terms: D000328:Adult; D016358:Contact Tracing; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000635:transmission*; D014481:United States / Q000453:epidemiology