Rapid creation of a temporary isolation ward for patients with severe acute respiratory syndrome in Taiwan.
OBJECTIVE
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.


METHODS
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.


METHODS
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.
Fung
Chang-Phone
CP
Section of Infectious Diseases, Department of Emergency Service, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
Hsieh
Tsorng-Liu
TL
Tan
Kuang-Huan
KH
Loh
Chin-Hui
CH
Wu
Jiunn-Sheng
JS
Li
Chien-Chung
CC
Chang
Feng-Yee
FY
Siu
L K
LK
Yen
Moh-Yun
MY
Wang
Lih-Shinn
LS
Wong
Wing-Wai
WW
Kao
Wei-Fong
WF
Hsu
Jia-Hui
JH
Lin
Ting-Hsiang
TH
Huang
Fu-Yuan
FY
Lee
Chen-Hsen
CH
D004196:Disease Outbreaks; D006772:Hospitals, Military; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010356:Patient Isolation; D016730:Program Development; D020133:Reverse Transcriptase Polymerase Chain Reaction; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control* / Q000635:transmission*; D013624:Taiwan; D013997:Time Factors; D014187:Transportation of Patients; D014691:Ventilation