title: Viral load and outcome in SARS infection: the role of personal protective equipment in the emergency department.
abstract: This study was conducted to evaluate the effectiveness of personal protective equipment (PPE) against severe acute respiratory syndrome (SARS). Sixteen patients in a SARS cluster, including 4 health care workers (HCWs) and 12 non-HCWs were studied. We compared the initial viral load by nasopharyngeal swabs, clinical progression, and outcome of this cluster. The HCWs had a lower viral load. The non-HCWs had a higher mean C-reactive protein, lower oxygen saturation, and a higher incidence of intubation and death. Secondary household transmission developed in three of the non-HCWs' families. One month after discharge, non-HCWs had more signs of fibrosis on high resolution computed tomography (HRCT) scan and an impaired pulmonary function test. Although most of the PPE do not confer absolute protection against SARS, it seems that they may lower exposure to the virus, leading to a lower risk of secondary transmission, and be associated with relatively mild disease and a better early outcome.
authors.affiliation: Division of Chest, Medical Department, Mackay Memorial Hospital, and Department of Respiratory Care, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Lu
authors.forename: Pei-Jan
authors.initials: PJ
authors.lastname: Chen
authors.forename: Chin-Yin
authors.initials: CY
authors.lastname: Sheu
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003428:Cross Infection / Q000517:prevention & control*; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000295:instrumentation / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011482:Protective Devices; D012129:Respiratory Function Tests; D020133:Reverse Transcriptase Polymerase Chain Reaction; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D013624:Taiwan / Q000453:epidemiology; D019562:Viral Load