title: SARS in healthcare facilities, Toronto and Taiwan.
abstract: The healthcare setting was important in the early spread of severe acute respiratory syndrome (SARS) in both Toronto and Taiwan. Healthcare workers, patients, and visitors were at increased risk for infection. Nonetheless, the ability of individual SARS patients to transmit disease was quite variable. Unrecognized SARS case-patients were a primary source of transmission, and early detection and intervention were important to limit spread. Strict adherence to infection control precautions was essential in containing outbreaks. In addition, grouping patients into cohorts and limiting access to SARS patients minimized exposure opportunities. Given the difficulty in implementing several of these measures, control measures were frequently adapted to the acuity of SARS care and level of transmission within facilities. Although these conclusions are based only on a retrospective analysis of events, applying the experiences of Toronto and Taiwan to SARS preparedness planning efforts will likely minimize future transmission within healthcare facilities.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. ljm3@cdc.gov
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Simor
authors.forename: Ih-Jen
authors.initials: IJ
authors.lastname: Su
authors.forename: Susan
authors.initials: S
authors.lastname: Maloney
authors.forename: Marianna
authors.initials: M
authors.lastname: Ofner
authors.forename: Kow-Tong
authors.initials: KT
authors.lastname: Chen
authors.forename: James F
authors.initials: JF
authors.lastname: Lando
authors.forename: Allison
authors.initials: A
authors.lastname: McGeer
authors.forename: Min-Ling
authors.initials: ML
authors.lastname: Lee
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jernigan
mesh_terms: D002170:Canada; D003140:Communicable Disease Control / Q000379:methods; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000635:transmission; D004196:Disease Outbreaks; D006268:Health Facilities; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D045473:Severe acute respiratory syndrome-related coronavirus; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000635:transmission*; D013624:Taiwan