Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study
Identifieur interne : 000562 ( Ncbi/Curation ); précédent : 000561; suivant : 000563Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study
Auteurs : Khuan Yew Chow ; Chien Earn Lee ; Moi Lin Ling ; Derrick Mok Kwee Heng ; Soon Ghee YapSource :
- BMJ : British Medical Journal [ 0959-8138 ] ; 2004.
Abstract
Url:
DOI: 10.1136/bmj.37939.465729.44
PubMed: 14726369
PubMed Central: 318482
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Khuan Yew Chow<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>
<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>
<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>
<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>
<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>
Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Outbreak of severe acute respiratory syndrome in a tertiary hospital in Singapore, linked to an index patient with atypical presentation: epidemiological study</title>
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<affiliation><nlm:aff id="aff1"> Health Screening Department, Adult Health Division, Health Promotion Board, 3 Second Hospital Avenue #06-00, Singapore 168937</nlm:aff>
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<author><name sortKey="Lee, Chien Earn" sort="Lee, Chien Earn" uniqKey="Lee C" first="Chien Earn" last="Lee">Chien Earn Lee</name>
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<wicri:noCountry code="subfield">Singapore 169608</wicri:noCountry>
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<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>
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<wicri:noCountry code="subfield">Singapore 169039</wicri:noCountry>
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<author><name sortKey="Yap, Soon Ghee" sort="Yap, Soon Ghee" uniqKey="Yap S" first="Soon Ghee" last="Yap">Soon Ghee Yap</name>
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<wicri:noCountry code="subfield">Singapore General Hospital</wicri:noCountry>
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<series><title level="j">BMJ : British Medical Journal</title>
<idno type="ISSN">0959-8138</idno>
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<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>
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