[Management of 90 patients presenting with suspected severe acute respiratory syndrome. Experience of a collaboration between epidemiologists and clinicians facing an emerging infectious disease health alert].
OBJECTIVE
The characteristics of patients with a suspected SARS hospitalized in a Paris hospital were studied to analyze the hypothetic differences between epidemiologic and clinical teams in the management of an epidemic emerging disease, and to gather experience for the management of the next outbreak.


METHODS
All 90 patients hospitalized between March 16 and April 30, 2003, were included. Epidemiological and clinical data were shared with the French National Institute for Health. Cases were classified according to both the official definition ("possible", "probable", "excluded") and a local one, adapted from the official definition but including an additional level of suspicion ("equivocal"), intermediate between "possible" and "excluded".


RESULTS
The initial assessment was different in 39% of the cases (n=35), according to epidemiological (n=24) or clinical (n=11) elements. The final assessment diverged in 54% of the cases (n=47). All patients were officially considered as "excluded" for epidemiologists, while 47 remained as "possible" or "equivocal" cases of SARS according to the clinicians.


CONCLUSIONS
The risk assessment was different in almost 40% of the cases, with no impact on epidemic diffusion or hospital-borne exposure as no probable case of SARS was diagnosed among these patients or their households. The confrontation of these different but complementary points of view will thus enrich the interdisciplinary management of eventual future outbreaks.
Cibrelus
L
L
Mission urgences et sécurité sanitaires, siège de l'APHP, 3, avenue Victoria, 75004 Paris, France.
Nöel
V
V
Emmanuelli
J
J
Breton
G
G
Longuet
P
P
Rigolli
B
B
Leport
C
C
Vildé
J-L
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D045169:Severe Acute Respiratory Syndrome / Q000175:diagnosis* / Q000453:epidemiology*