Management of inpatients exposed to an outbreak of severe acute respiratory syndrome (SARS)☆
Identifieur interne : 005651 ( Main/Merge ); précédent : 005650; suivant : 005652Management of inpatients exposed to an outbreak of severe acute respiratory syndrome (SARS)☆
Auteurs : Y.-M. Tan [Singapour] ; P. K. H. Chow [Singapour] ; B.-H. Tan [Singapour] ; A. Kurup [Singapour] ; B. K. T. Tan [Singapour] ; F. L. S. Tan [Singapour] ; J. Seldrup [Singapour] ; D. M. K. Heng [Singapour] ; B. Ang [Singapour] ; J. Green [Singapour] ; C.-Y. Wong [Singapour] ; K.-C. Soo [Singapour]Source :
- The Journal of Hospital Infection [ 0195-6701 ] ; 2004.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Femelle, Flambées de maladies, Humains, Incidence, Infection croisée (), Infection croisée (épidémiologie), Infection croisée (étiologie), Isolement du patient, Lutte contre l'infection (), Mâle, Singapour (épidémiologie), Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire aigu sévère (), Syndrome respiratoire aigu sévère (épidémiologie), Syndrome respiratoire aigu sévère (étiologie), Études de cohortes, Études prospectives.
- MESH :
- épidémiologie : Infection croisée, Singapour, Syndrome respiratoire aigu sévère.
- étiologie : Infection croisée, Syndrome respiratoire aigu sévère.
- Adulte, Adulte d'âge moyen, Femelle, Flambées de maladies, Humains, Incidence, Infection croisée, Isolement du patient, Lutte contre l'infection, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Syndrome respiratoire aigu sévère, Études de cohortes, Études prospectives.
- Wicri :
- geographic : Singapour.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Cohort Studies, Cross Infection (epidemiology), Cross Infection (etiology), Cross Infection (prevention & control), Disease Outbreaks, Female, Humans, Incidence, Infection Control (methods), Male, Middle Aged, Patient Isolation, Prospective Studies, Severe Acute Respiratory Syndrome (epidemiology), Severe Acute Respiratory Syndrome (etiology), Severe Acute Respiratory Syndrome (prevention & control), Singapore (epidemiology).
- MESH :
- geographic , epidemiology : Singapore.
- epidemiology : Cross Infection, Severe Acute Respiratory Syndrome.
- etiology : Cross Infection, Severe Acute Respiratory Syndrome.
- methods : Infection Control.
- prevention & control : Cross Infection, Severe Acute Respiratory Syndrome.
- Adult, Aged, Aged, 80 and over, Cohort Studies, Disease Outbreaks, Female, Humans, Incidence, Male, Middle Aged, Patient Isolation, Prospective Studies.
Abstract
This is a prospective observational study of a cohort of inpatients exposed to a severe acute respiratory syndrome (SARS) outbreak. Strict infection control policies were instituted. The 70 patients exposed to the SARS outbreak were isolated from the rest of the hospital. They were triaged, quarantined and cohorted in three open plan wards. Selective isolation was carried out immediately when symptoms and signs suspicious of SARS manifested clinically. The patients' ages ranged from 21 to 90 years and 56% had surgery before the quarantine. Sixteen patients with unexplained fever during the period of quarantine were isolated, seven of whom were eventually diagnosed with probable SARS. The crude incidence of SARS in our cohort was 10%. The SARS case fatality was 14%. No secondary transmission of the SARS virus within the cohort was observed. Strict infection control, together with appropriate triaging, cohorting and selective isolation, is an effective and practical model of intervention in cohorts exposed to a SARS outbreak. Such a management strategy eases the logistic constraints imposed by demands for large numbers of isolation facilities in the face of a massive outbreak.
Url:
DOI: 10.1016/j.jhin.2004.06.013
PubMed: 15501336
PubMed Central: 7124218
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Tan</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author><author><name sortKey="Chow, P K H" sort="Chow, P K H" uniqKey="Chow P" first="P. K. H." last="Chow">P. K. H. Chow</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author><author><name sortKey="Tan, B H" sort="Tan, B H" uniqKey="Tan B" first="B.-H." last="Tan">B.-H. Tan</name><affiliation wicri:level="1"><nlm:aff id="AFF2">Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Internal Medicine, Singapore General Hospital, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Kurup, A" sort="Kurup, A" uniqKey="Kurup A" first="A." last="Kurup">A. Kurup</name><affiliation wicri:level="1"><nlm:aff id="AFF2">Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Internal Medicine, Singapore General Hospital, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Tan, B K T" sort="Tan, B K T" uniqKey="Tan B" first="B. K. T." last="Tan">B. K. T. Tan</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author><author><name sortKey="Tan, F L S" sort="Tan, F L S" uniqKey="Tan F" first="F. L. S." last="Tan">F. L. S. Tan</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author><author><name sortKey="Seldrup, J" sort="Seldrup, J" uniqKey="Seldrup J" first="J." last="Seldrup">J. Seldrup</name><affiliation wicri:level="1"><nlm:aff id="AFF3">Clinical Trials and Epidemiology Research Unit, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Clinical Trials and Epidemiology Research Unit, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Heng, D M K" sort="Heng, D M K" uniqKey="Heng D" first="D. M. K." last="Heng">D. M. K. Heng</name><affiliation wicri:level="1"><nlm:aff id="AFF3">Clinical Trials and Epidemiology Research Unit, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Clinical Trials and Epidemiology Research Unit, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Ang, B" sort="Ang, B" uniqKey="Ang B" first="B." last="Ang">B. Ang</name><affiliation wicri:level="1"><nlm:aff id="AFF4">Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Green, J" sort="Green, J" uniqKey="Green J" first="J." last="Green">J. Green</name><affiliation wicri:level="1"><nlm:aff id="AFF4">Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore</wicri:regionArea><wicri:noRegion>Singapore</wicri:noRegion></affiliation></author><author><name sortKey="Wong, C Y" sort="Wong, C Y" uniqKey="Wong C" first="C.-Y." last="Wong">C.-Y. Wong</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author><author><name sortKey="Soo, K C" sort="Soo, K C" uniqKey="Soo K" first="K.-C." last="Soo">K.-C. Soo</name><affiliation wicri:level="1"><nlm:aff id="AFF1">Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore</nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea>Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608</wicri:regionArea><wicri:noRegion>Singapore 169608</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Journal of Hospital Infection</title><idno type="ISSN">0195-6701</idno><idno type="eISSN">1532-2939</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Cross Infection (epidemiology)</term><term>Cross Infection (etiology)</term><term>Cross Infection (prevention & control)</term><term>Disease Outbreaks</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Infection Control (methods)</term><term>Male</term><term>Middle Aged</term><term>Patient Isolation</term><term>Prospective Studies</term><term>Severe Acute Respiratory Syndrome (epidemiology)</term><term>Severe Acute Respiratory Syndrome (etiology)</term><term>Severe Acute Respiratory Syndrome (prevention & control)</term><term>Singapore (epidemiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Flambées de maladies</term><term>Humains</term><term>Incidence</term><term>Infection croisée ()</term><term>Infection croisée (épidémiologie)</term><term>Infection croisée (étiologie)</term><term>Isolement du patient</term><term>Lutte contre l'infection ()</term><term>Mâle</term><term>Singapour (épidémiologie)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Syndrome respiratoire aigu sévère ()</term><term>Syndrome respiratoire aigu sévère (épidémiologie)</term><term>Syndrome respiratoire aigu sévère (étiologie)</term><term>Études de cohortes</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Singapore</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cross Infection</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cross Infection</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Infection Control</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Cross Infection</term><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infection croisée</term><term>Singapour</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Infection croisée</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Disease Outbreaks</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Patient Isolation</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Flambées de maladies</term><term>Humains</term><term>Incidence</term><term>Infection croisée</term><term>Isolement du patient</term><term>Lutte contre l'infection</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Syndrome respiratoire aigu sévère</term><term>Études de cohortes</term><term>Études prospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Singapour</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>This is a prospective observational study of a cohort of inpatients exposed to a severe acute respiratory syndrome (SARS) outbreak. Strict infection control policies were instituted. The 70 patients exposed to the SARS outbreak were isolated from the rest of the hospital. They were triaged, quarantined and cohorted in three open plan wards. Selective isolation was carried out immediately when symptoms and signs suspicious of SARS manifested clinically. The patients' ages ranged from 21 to 90 years and 56% had surgery before the quarantine. Sixteen patients with unexplained fever during the period of quarantine were isolated, seven of whom were eventually diagnosed with probable SARS. The crude incidence of SARS in our cohort was 10%. The SARS case fatality was 14%. No secondary transmission of the SARS virus within the cohort was observed. Strict infection control, together with appropriate triaging, cohorting and selective isolation, is an effective and practical model of intervention in cohorts exposed to a SARS outbreak. Such a management strategy eases the logistic constraints imposed by demands for large numbers of isolation facilities in the face of a massive outbreak.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tsang, K W" uniqKey="Tsang K">K.W. Tsang</name></author><author><name sortKey="Ho, P L" uniqKey="Ho P">P.L. Ho</name></author><author><name sortKey="Ooi, G C" uniqKey="Ooi G">G.C. Ooi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ksiazek, T G" uniqKey="Ksiazek T">T.G. Ksiazek</name></author><author><name sortKey="Erdman, D" uniqKey="Erdman D">D. Erdman</name></author><author><name sortKey="Goldsmith, C S" uniqKey="Goldsmith C">C.S. Goldsmith</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuiken, T" uniqKey="Kuiken T">T. Kuiken</name></author><author><name sortKey="Fouchier, R A" uniqKey="Fouchier R">R.A. Fouchier</name></author><author><name sortKey="Schutten, M" uniqKey="Schutten M">M. Schutten</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tan, Y M" uniqKey="Tan Y">Y.M. Tan</name></author><author><name sortKey="Chow, P K" uniqKey="Chow P">P.K. Chow</name></author><author><name sortKey="Soo, K C" uniqKey="Soo K">K.C. Soo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hsu, L Y" uniqKey="Hsu L">L.Y. Hsu</name></author><author><name sortKey="Lee, C C" uniqKey="Lee C">C.C. Lee</name></author><author><name sortKey="Green, J A" uniqKey="Green J">J.A. Green</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lee, N" uniqKey="Lee N">N. Lee</name></author><author><name sortKey="Hui, D" uniqKey="Hui D">D. Hui</name></author><author><name sortKey="Wu, A" uniqKey="Wu A">A. Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ho, W" uniqKey="Ho W">W. Ho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abdullah, A S" uniqKey="Abdullah A">A.S. Abdullah</name></author><author><name sortKey="Tomlinson, B" uniqKey="Tomlinson B">B. Tomlinson</name></author><author><name sortKey="Cockram, C S" uniqKey="Cockram C">C.S. Cockram</name></author><author><name sortKey="Thomas, G N" uniqKey="Thomas G">G.N. Thomas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wu, W" uniqKey="Wu W">W. Wu</name></author><author><name sortKey="Wang, J" uniqKey="Wang J">J. Wang</name></author><author><name sortKey="Liu, P" uniqKey="Liu P">P. Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Varia, M" uniqKey="Varia M">M. Varia</name></author><author><name sortKey="Wilson, S" uniqKey="Wilson S">S. Wilson</name></author><author><name sortKey="Sarwal, S" uniqKey="Sarwal S">S. Sarwal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lipsitch, M" uniqKey="Lipsitch M">M. Lipsitch</name></author><author><name sortKey="Cohen, T" uniqKey="Cohen T">T. Cohen</name></author><author><name sortKey="Cooper, B" uniqKey="Cooper B">B. Cooper</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Rainer, T H" uniqKey="Rainer T">T.H. Rainer</name></author><author><name sortKey="Cameron, P A" uniqKey="Cameron P">P.A. Cameron</name></author><author><name sortKey="Smit, D" uniqKey="Smit D">D. Smit</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hoey, J" uniqKey="Hoey J">J. Hoey</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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