Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study
Identifieur interne : 005C25 ( Main/Merge ); précédent : 005C24; suivant : 005C26Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study
Auteurs : Chow Khuan Yew ; Chien Earn Lee ; Moi Lin Ling ; Derrick Mok Kwee Heng ; Soon Ghee YapSource :
- BMJ [ 0959-8138 ] ; 2004-01-24.
English descriptors
- Teeft :
- Acute care, April, Atypical, Atypical pneumonia, Atypical presentation, Bloody stools, Centre, Clinical features, Coli bacteraemia, Diagnostic radiology, Diagnostic radiology department, Disease control, Doctor onset date, Early introduction, Epidemic curve, Epidemiological, Epidemiological link, Family members, Family wife onset date, Foot ulcer, Good surveillance system, Healthcare, Healthcare assistant urology centre onset date, Healthcare staff, Healthcare workers, Hong kong, Hospital staff, Incubation period, Index patient, Indirect contact, Infection control measures, Infectious period, Isolation procedures, Lessons learnt, Mmwr morb, National cancer centre, Neighbouring patient, Novel coronavirus, Nurse onset date, Onset date, Outbreak, Outram road, Probable case, Probable sars cases, Radiographer, Radiology, Respiratory symptoms, Respiratory syndrome, Same time, Sars, Sars infection, Sars outbreak, Sars patients, Seng, Singapore, Syndrome, Tertiary hospital, Tock, Tock seng hospital, Visitor onset date, World health organization.
Abstract
Objective To describe an outbreak of severe acute respiratory syndrome (SARS) in a tertiary hospital in Singapore, linked to an index patient with atypical presentation, and the lessons learnt from it. Design Descriptive study. Setting A tertiary hospital in Singapore. Participants Patients, healthcare workers, and visitors who contracted SARS in Singapore General Hospital. Main outcome measures Probable SARS as defined by the World Health Organization. Results The index patient presented with gastrointestinal bleeding, initially without changes to his chest radiograph. Altogether 24 healthcare workers, 15 patients, and 12 family members and visitors were infected. The incubation period ranged from three to eight days. Only 13 patients were isolated on their dates of onset. Conclusions Atypical presentation of SARS infection must be taken into consideration when managing patients with a history of contact with SARS patients. The main gap in the containment strategy in this outbreak was the failure to identify the index patient as someone who had been discharged from a ward in another hospital that managed probable SARS cases. Strict infection control measures, a good surveillance system, early introduction of isolation procedures, and vigilant healthcare professionals are essential for controlling outbreaks.
Url:
- https://api.istex.fr/ark:/67375/NVC-3CL2L672-V/fulltext.pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC318482
DOI: 10.1136/bmj.37939.465729.44
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Yew</name><affiliation><wicri:noCountry code="subField">168937</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Chien Earn" sort="Lee, Chien Earn" uniqKey="Lee C" first="Chien Earn" last="Lee">Chien Earn Lee</name><affiliation><wicri:noCountry code="subField">169854</wicri:noCountry></affiliation></author><author><name sortKey="Ling, Moi Lin" sort="Ling, Moi Lin" uniqKey="Ling M" first="Moi Lin" last="Ling">Moi Lin Ling</name><affiliation></affiliation><affiliation><wicri:noCountry code="no comma">Correspondence to: Moi Lin Ling</wicri:noCountry></affiliation></author><author><name sortKey="Heng, Derrick Mok Kwee" sort="Heng, Derrick Mok Kwee" uniqKey="Heng D" first="Derrick Mok Kwee" last="Heng">Derrick Mok Kwee Heng</name><affiliation><wicri:noCountry code="subField">169039</wicri:noCountry></affiliation></author><author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name><affiliation><wicri:noCountry code="subField">Hospital</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2004-01-24">2004-01-24</date><biblScope unit="volume">328</biblScope><biblScope unit="issue">7433</biblScope><biblScope unit="page" from="195">195</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acute care</term><term>April</term><term>Atypical</term><term>Atypical pneumonia</term><term>Atypical presentation</term><term>Bloody stools</term><term>Centre</term><term>Clinical features</term><term>Coli bacteraemia</term><term>Diagnostic radiology</term><term>Diagnostic radiology department</term><term>Disease control</term><term>Doctor onset date</term><term>Early introduction</term><term>Epidemic curve</term><term>Epidemiological</term><term>Epidemiological link</term><term>Family members</term><term>Family wife onset date</term><term>Foot ulcer</term><term>Good surveillance system</term><term>Healthcare</term><term>Healthcare assistant urology centre onset date</term><term>Healthcare staff</term><term>Healthcare workers</term><term>Hong kong</term><term>Hospital staff</term><term>Incubation period</term><term>Index patient</term><term>Indirect contact</term><term>Infection control measures</term><term>Infectious period</term><term>Isolation procedures</term><term>Lessons learnt</term><term>Mmwr morb</term><term>National cancer centre</term><term>Neighbouring patient</term><term>Novel coronavirus</term><term>Nurse onset date</term><term>Onset date</term><term>Outbreak</term><term>Outram road</term><term>Probable case</term><term>Probable sars cases</term><term>Radiographer</term><term>Radiology</term><term>Respiratory symptoms</term><term>Respiratory syndrome</term><term>Same time</term><term>Sars</term><term>Sars infection</term><term>Sars outbreak</term><term>Sars patients</term><term>Seng</term><term>Singapore</term><term>Syndrome</term><term>Tertiary hospital</term><term>Tock</term><term>Tock seng hospital</term><term>Visitor onset date</term><term>World health organization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To describe an outbreak of severe acute respiratory syndrome (SARS) in a tertiary hospital in Singapore, linked to an index patient with atypical presentation, and the lessons learnt from it. Design Descriptive study. Setting A tertiary hospital in Singapore. Participants Patients, healthcare workers, and visitors who contracted SARS in Singapore General Hospital. Main outcome measures Probable SARS as defined by the World Health Organization. Results The index patient presented with gastrointestinal bleeding, initially without changes to his chest radiograph. Altogether 24 healthcare workers, 15 patients, and 12 family members and visitors were infected. The incubation period ranged from three to eight days. Only 13 patients were isolated on their dates of onset. Conclusions Atypical presentation of SARS infection must be taken into consideration when managing patients with a history of contact with SARS patients. The main gap in the containment strategy in this outbreak was the failure to identify the index patient as someone who had been discharged from a ward in another hospital that managed probable SARS cases. Strict infection control measures, a good surveillance system, early introduction of isolation procedures, and vigilant healthcare professionals are essential for controlling outbreaks.</div></front></TEI><double doi="10.1136/bmj.37939.465729.44"><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study</title><author><name sortKey="Khuan Yew, Chow" sort="Khuan Yew, Chow" uniqKey="Khuan Yew C" first="Chow" last="Khuan Yew">Chow Khuan Yew</name></author><author><name sortKey="Lee, Chien Earn" sort="Lee, Chien Earn" uniqKey="Lee C" first="Chien Earn" last="Lee">Chien Earn Lee</name></author><author><name sortKey="Ling, Moi Lin" sort="Ling, Moi Lin" uniqKey="Ling M" first="Moi Lin" last="Ling">Moi Lin Ling</name></author><author><name sortKey="Heng, Derrick Mok Kwee" sort="Heng, Derrick Mok Kwee" uniqKey="Heng D" first="Derrick Mok Kwee" last="Heng">Derrick Mok Kwee Heng</name></author><author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:0D14268C4AC76BA14731FC3B5D16155033DC06C5</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1136/bmj.37939.465729.44</idno><idno type="url">https://api.istex.fr/ark:/67375/NVC-3CL2L672-V/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">000975</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000975</idno><idno type="wicri:Area/Istex/Curation">000975</idno><idno type="wicri:Area/Istex/Checkpoint">001E57</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">001E57</idno><idno type="wicri:doubleKey">0959-8138:2004:Khuan Yew C:outbreak:of:severe</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study</title><author><name sortKey="Khuan Yew, Chow" sort="Khuan Yew, Chow" uniqKey="Khuan Yew C" first="Chow" last="Khuan Yew">Chow Khuan Yew</name><affiliation><wicri:noCountry code="subField">168937</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Chien Earn" sort="Lee, Chien Earn" uniqKey="Lee C" first="Chien Earn" last="Lee">Chien Earn Lee</name><affiliation><wicri:noCountry code="subField">169854</wicri:noCountry></affiliation></author><author><name sortKey="Ling, Moi Lin" sort="Ling, Moi Lin" uniqKey="Ling M" first="Moi Lin" last="Ling">Moi Lin Ling</name><affiliation></affiliation><affiliation><wicri:noCountry code="no comma">Correspondence to: Moi Lin Ling</wicri:noCountry></affiliation></author><author><name sortKey="Heng, Derrick Mok Kwee" sort="Heng, Derrick Mok Kwee" uniqKey="Heng D" first="Derrick Mok Kwee" last="Heng">Derrick Mok Kwee Heng</name><affiliation><wicri:noCountry code="subField">169039</wicri:noCountry></affiliation></author><author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name><affiliation><wicri:noCountry code="subField">Hospital</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2004-01-24">2004-01-24</date><biblScope unit="volume">328</biblScope><biblScope unit="issue">7433</biblScope><biblScope unit="page" from="195">195</biblScope></imprint><idno type="ISSN">0959-8138</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Acute care</term><term>April</term><term>Atypical</term><term>Atypical pneumonia</term><term>Atypical presentation</term><term>Bloody stools</term><term>Centre</term><term>Clinical features</term><term>Coli bacteraemia</term><term>Diagnostic radiology</term><term>Diagnostic radiology department</term><term>Disease control</term><term>Doctor onset date</term><term>Early introduction</term><term>Epidemic curve</term><term>Epidemiological</term><term>Epidemiological link</term><term>Family members</term><term>Family wife onset date</term><term>Foot ulcer</term><term>Good surveillance system</term><term>Healthcare</term><term>Healthcare assistant urology centre onset date</term><term>Healthcare staff</term><term>Healthcare workers</term><term>Hong kong</term><term>Hospital staff</term><term>Incubation period</term><term>Index patient</term><term>Indirect contact</term><term>Infection control measures</term><term>Infectious period</term><term>Isolation procedures</term><term>Lessons learnt</term><term>Mmwr morb</term><term>National cancer centre</term><term>Neighbouring patient</term><term>Novel coronavirus</term><term>Nurse onset date</term><term>Onset date</term><term>Outbreak</term><term>Outram road</term><term>Probable case</term><term>Probable sars cases</term><term>Radiographer</term><term>Radiology</term><term>Respiratory symptoms</term><term>Respiratory syndrome</term><term>Same time</term><term>Sars</term><term>Sars infection</term><term>Sars outbreak</term><term>Sars patients</term><term>Seng</term><term>Singapore</term><term>Syndrome</term><term>Tertiary hospital</term><term>Tock</term><term>Tock seng hospital</term><term>Visitor onset date</term><term>World health organization</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To describe an outbreak of severe acute respiratory syndrome (SARS) in a tertiary hospital in Singapore, linked to an index patient with atypical presentation, and the lessons learnt from it. Design Descriptive study. Setting A tertiary hospital in Singapore. Participants Patients, healthcare workers, and visitors who contracted SARS in Singapore General Hospital. Main outcome measures Probable SARS as defined by the World Health Organization. Results The index patient presented with gastrointestinal bleeding, initially without changes to his chest radiograph. Altogether 24 healthcare workers, 15 patients, and 12 family members and visitors were infected. The incubation period ranged from three to eight days. Only 13 patients were isolated on their dates of onset. Conclusions Atypical presentation of SARS infection must be taken into consideration when managing patients with a history of contact with SARS patients. The main gap in the containment strategy in this outbreak was the failure to identify the index patient as someone who had been discharged from a ward in another hospital that managed probable SARS cases. Strict infection control measures, a good surveillance system, early introduction of isolation procedures, and vigilant healthcare professionals are essential for controlling outbreaks.</div></front></TEI></ISTEX><PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study</title><author><name sortKey="Chow, Khuan Yew" sort="Chow, Khuan Yew" uniqKey="Chow K" first="Khuan Yew" last="Chow">Khuan Yew Chow</name><affiliation><nlm:aff id="aff1"> Health Screening Department, Adult Health Division, Health Promotion Board, 3 Second Hospital Avenue #06-00, Singapore 168937</nlm:aff><wicri:noCountry code="subfield">Singapore 168937</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Chien Earn" sort="Lee, Chien Earn" uniqKey="Lee C" first="Chien Earn" last="Lee">Chien Earn Lee</name><affiliation><nlm:aff id="aff2"> Casemix Project Office, Planning and Development Division, Ministry of Health Singapore, College of Medicine Building, 16 College Road, Singapore 169854</nlm:aff><wicri:noCountry code="subfield">Singapore 169854</wicri:noCountry></affiliation></author><author><name sortKey="Ling, Moi Lin" sort="Ling, Moi Lin" uniqKey="Ling M" first="Moi Lin" last="Ling">Moi Lin Ling</name><affiliation><nlm:aff id="aff3"> Quality Management, Singapore General Hospital, Outram Road, Singapore 169608</nlm:aff><wicri:noCountry code="subfield">Singapore 169608</wicri:noCountry></affiliation></author><author><name sortKey="Heng, Derrick Mok Kwee" sort="Heng, Derrick Mok Kwee" uniqKey="Heng D" first="Derrick Mok Kwee" last="Heng">Derrick Mok Kwee Heng</name><affiliation><nlm:aff id="aff5"> Clinical Trials and Epidemiology Research Unit, 226 Outram Road Blk A #03-01, Singapore 169039</nlm:aff><wicri:noCountry code="subfield">Singapore 169039</wicri:noCountry></affiliation></author><author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name><affiliation><nlm:aff id="aff4"> Ear, Nose, and Throat Department, Singapore General Hospital</nlm:aff><wicri:noCountry code="subfield">Singapore General Hospital</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">14726369</idno><idno type="pmc">318482</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC318482</idno><idno type="RBID">PMC:318482</idno><idno type="doi">10.1136/bmj.37939.465729.44</idno><date when="2004">2004</date><idno type="wicri:Area/Pmc/Corpus">000616</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000616</idno><idno type="wicri:Area/Pmc/Curation">000616</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000616</idno><idno type="wicri:Area/Pmc/Checkpoint">001577</idno><idno type="wicri:explorRef" wicri:stream="Pmc" 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first="Chien Earn" last="Lee">Chien Earn Lee</name><affiliation><nlm:aff id="aff2"> Casemix Project Office, Planning and Development Division, Ministry of Health Singapore, College of Medicine Building, 16 College Road, Singapore 169854</nlm:aff><wicri:noCountry code="subfield">Singapore 169854</wicri:noCountry></affiliation></author><author><name sortKey="Ling, Moi Lin" sort="Ling, Moi Lin" uniqKey="Ling M" first="Moi Lin" last="Ling">Moi Lin Ling</name><affiliation><nlm:aff id="aff3"> Quality Management, Singapore General Hospital, Outram Road, Singapore 169608</nlm:aff><wicri:noCountry code="subfield">Singapore 169608</wicri:noCountry></affiliation></author><author><name sortKey="Heng, Derrick Mok Kwee" sort="Heng, Derrick Mok Kwee" uniqKey="Heng D" first="Derrick Mok Kwee" last="Heng">Derrick Mok Kwee Heng</name><affiliation><nlm:aff id="aff5"> Clinical Trials and Epidemiology Research Unit, 226 Outram Road Blk A #03-01, Singapore 169039</nlm:aff><wicri:noCountry code="subfield">Singapore 169039</wicri:noCountry></affiliation></author><author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name><affiliation><nlm:aff id="aff4"> Ear, Nose, and Throat Department, Singapore General Hospital</nlm:aff><wicri:noCountry code="subfield">Singapore General Hospital</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMJ : British Medical Journal</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><date when="2004">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective</bold> To describe an outbreak of severe acute respiratory syndrome (SARS) in a tertiary hospital in Singapore, linked to an index patient with atypical presentation, and the lessons learnt from it.</p><p><bold>Design</bold> Descriptive study.</p><p><bold>Setting</bold> A tertiary hospital in Singapore.</p><p><bold>Participants</bold> Patients, healthcare workers, and visitors who contracted SARS in Singapore General Hospital.</p><p><bold>Main outcome measures</bold> Probable SARS as defined by the World Health Organization.</p><p><bold>Results</bold> The index patient presented with gastrointestinal bleeding, initially without changes to his chest radiograph. Altogether 24 healthcare workers, 15 patients, and 12 family members and visitors were infected. The incubation period ranged from three to eight days. Only 13 patients were isolated on their dates of onset.</p><p><bold>Conclusions</bold> Atypical presentation of SARS infection must be taken into consideration when managing patients with a history of contact with SARS patients. The main gap in the containment strategy in this outbreak was the failure to identify the index patient as someone who had been discharged from a ward in another hospital that managed probable SARS cases. Strict infection control measures, a good surveillance system, early introduction of isolation procedures, and vigilant healthcare professionals are essential for controlling outbreaks.</p></div></front></TEI></PMC></double></record>Pour manipuler ce document sous Unix (Dilib)
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