Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003
Identifieur interne : 001618 ( Ncbi/Merge ); précédent : 001617; suivant : 001619Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003
Auteurs : Mary G. Reynolds [États-Unis] ; Bach Huy Anh [Viêt Nam] ; Vu Hoang Thu [Viêt Nam] ; Joel M. Montgomery [États-Unis] ; Daniel G. Bausch [États-Unis] ; J Jina Shah [États-Unis] ; Susan Maloney [États-Unis] ; Katrin C. Leitmeyer [Allemagne] ; Vu Quang Huy [Viêt Nam] ; Peter Horby [Viêt Nam] ; Aileen J. Plant ; Timothy M. Uyeki [États-Unis]Source :
- BMC Public Health [ 1471-2458 ] ; 2006.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Anticorps antiviraux (sang), Exposition professionnelle (), Exposition professionnelle (analyse), Facteurs de risque, Flambées de maladies, Hong Kong (ethnologie), Humains, Personnel hospitalier, Personnel infirmier hospitalier, Syndrome respiratoire aigu sévère (transmission), Syndrome respiratoire aigu sévère (épidémiologie), Transmission de maladie infectieuse du patient au professionnel de santé (analyse), Unités hospitalières, Vietnam (épidémiologie), Virus du SRAS (immunologie), Voyage, Études cas-témoins, Études de cohortes, Études séroépidémiologiques, Évaluation des risques.
- MESH :
- analyse : Exposition professionnelle, Transmission de maladie infectieuse du patient au professionnel de santé.
- ethnologie : Hong Kong.
- immunologie : Virus du SRAS.
- sang : Anticorps antiviraux.
- épidémiologie : Syndrome respiratoire aigu sévère, Vietnam.
- Adulte, Adulte d'âge moyen, Exposition professionnelle, Facteurs de risque, Flambées de maladies, Humains, Personnel hospitalier, Personnel infirmier hospitalier, Unités hospitalières, Voyage, Études cas-témoins, Études de cohortes, Études séroépidémiologiques, Évaluation des risques.
English descriptors
- KwdEn :
- Adult, Antibodies, Viral (blood), Case-Control Studies, Cohort Studies, Disease Outbreaks, Hong Kong (ethnology), Hospital Units, Humans, Infectious Disease Transmission, Patient-to-Professional (analysis), Middle Aged, Nursing Staff, Hospital, Occupational Exposure (analysis), Occupational Exposure (statistics & numerical data), Personnel, Hospital, Risk Assessment, Risk Factors, SARS Virus (immunology), Seroepidemiologic Studies, Severe Acute Respiratory Syndrome (epidemiology), Severe Acute Respiratory Syndrome (transmission), Travel, Vietnam (epidemiology).
- MESH :
- chemical , blood : Antibodies, Viral.
- geographic , epidemiology : Vietnam.
- geographic , ethnology : Hong Kong.
- analysis : Infectious Disease Transmission, Patient-to-Professional, Occupational Exposure.
- epidemiology : Severe Acute Respiratory Syndrome.
- immunology : SARS Virus.
- statistics & numerical data : Occupational Exposure.
- transmission : Severe Acute Respiratory Syndrome.
- Adult, Case-Control Studies, Cohort Studies, Disease Outbreaks, Hospital Units, Humans, Middle Aged, Nursing Staff, Hospital, Personnel, Hospital, Risk Assessment, Risk Factors, Seroepidemiologic Studies, Travel.
Abstract
In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community.
We surveyed Hospital A personnel for exposure to the index patient and for symptoms of disease during the outbreak. Additionally, serum specimens were collected and assayed for antibody to SARS-associated coronavirus (SARS-CoV) antibody and job-specific attack rates were calculated. A nested case-control analysis was performed to assess risk factors for acquiring SARS-CoV infection.
One hundred and fifty-three of 193 (79.3%) clinical and non-clinical staff consented to participate. Excluding job categories with <3 workers, the highest SARS attack rates occurred among nurses who worked in the outpatient and inpatient general wards (57.1, 47.4%, respectively). Nurses assigned to the operating room/intensive care unit, experienced the lowest attack rates (7.1%) among all clinical staff. Serologic evidence of SARS-CoV infection was detected in 4 individuals, including 2 non-clinical workers, who had not previously been identified as SARS cases; none reported having had fever or cough. Entering the index patient's room and having seen (viewed) the patient were the behaviors associated with highest risk for infection by univariate analysis (odds ratios 20.0, 14.0; 95% confidence intervals 4.1–97.1, 3.6–55.3, respectively).
This study highlights job categories and activities associated with increased risk for SARS-CoV infection and demonstrates that a broad diversity of hospital workers may be vulnerable during an outbreak. These findings may help guide recommendations for the protection of vulnerable occupational groups and may have implications for other respiratory infections such as influenza.
The online version of this article (doi:10.1186/1471-2458-6-207) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1471-2458-6-207
PubMed: 16907978
PubMed Central: 1562405
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PMC:1562405Le document en format XML
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<author><name sortKey="Shah, J Jina" sort="Shah, J Jina" uniqKey="Shah J" first="J Jina" last="Shah">J Jina Shah</name>
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<author><name sortKey="Maloney, Susan" sort="Maloney, Susan" uniqKey="Maloney S" first="Susan" last="Maloney">Susan Maloney</name>
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<author><name sortKey="Leitmeyer, Katrin C" sort="Leitmeyer, Katrin C" uniqKey="Leitmeyer K" first="Katrin C" last="Leitmeyer">Katrin C. Leitmeyer</name>
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<author><name sortKey="Huy, Vu Quang" sort="Huy, Vu Quang" uniqKey="Huy V" first="Vu Quang" last="Huy">Vu Quang Huy</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Antibodies, Viral (blood)</term>
<term>Case-Control Studies</term>
<term>Cohort Studies</term>
<term>Disease Outbreaks</term>
<term>Hong Kong (ethnology)</term>
<term>Hospital Units</term>
<term>Humans</term>
<term>Infectious Disease Transmission, Patient-to-Professional (analysis)</term>
<term>Middle Aged</term>
<term>Nursing Staff, Hospital</term>
<term>Occupational Exposure (analysis)</term>
<term>Occupational Exposure (statistics & numerical data)</term>
<term>Personnel, Hospital</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>SARS Virus (immunology)</term>
<term>Seroepidemiologic Studies</term>
<term>Severe Acute Respiratory Syndrome (epidemiology)</term>
<term>Severe Acute Respiratory Syndrome (transmission)</term>
<term>Travel</term>
<term>Vietnam (epidemiology)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Anticorps antiviraux (sang)</term>
<term>Exposition professionnelle ()</term>
<term>Exposition professionnelle (analyse)</term>
<term>Facteurs de risque</term>
<term>Flambées de maladies</term>
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<term>Humains</term>
<term>Personnel hospitalier</term>
<term>Personnel infirmier hospitalier</term>
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<term>Syndrome respiratoire aigu sévère (épidémiologie)</term>
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<term>Vietnam (épidémiologie)</term>
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<term>Études de cohortes</term>
<term>Études séroépidémiologiques</term>
<term>Évaluation des risques</term>
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<term>Transmission de maladie infectieuse du patient au professionnel de santé</term>
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<term>Occupational Exposure</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term>
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<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term>
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<term>Vietnam</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Case-Control Studies</term>
<term>Cohort Studies</term>
<term>Disease Outbreaks</term>
<term>Hospital Units</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Nursing Staff, Hospital</term>
<term>Personnel, Hospital</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>Seroepidemiologic Studies</term>
<term>Travel</term>
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<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Exposition professionnelle</term>
<term>Facteurs de risque</term>
<term>Flambées de maladies</term>
<term>Humains</term>
<term>Personnel hospitalier</term>
<term>Personnel infirmier hospitalier</term>
<term>Unités hospitalières</term>
<term>Voyage</term>
<term>Études cas-témoins</term>
<term>Études de cohortes</term>
<term>Études séroépidémiologiques</term>
<term>Évaluation des risques</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community.</p>
</sec>
<sec><title>Methods</title>
<p>We surveyed Hospital A personnel for exposure to the index patient and for symptoms of disease during the outbreak. Additionally, serum specimens were collected and assayed for antibody to SARS-associated coronavirus (SARS-CoV) antibody and job-specific attack rates were calculated. A nested case-control analysis was performed to assess risk factors for acquiring SARS-CoV infection.</p>
</sec>
<sec><title>Results</title>
<p>One hundred and fifty-three of 193 (79.3%) clinical and non-clinical staff consented to participate. Excluding job categories with <3 workers, the highest SARS attack rates occurred among nurses who worked in the outpatient and inpatient general wards (57.1, 47.4%, respectively). Nurses assigned to the operating room/intensive care unit, experienced the lowest attack rates (7.1%) among all clinical staff. Serologic evidence of SARS-CoV infection was detected in 4 individuals, including 2 non-clinical workers, who had not previously been identified as SARS cases; none reported having had fever or cough. Entering the index patient's room and having seen (viewed) the patient were the behaviors associated with highest risk for infection by univariate analysis (odds ratios 20.0, 14.0; 95% confidence intervals 4.1–97.1, 3.6–55.3, respectively).</p>
</sec>
<sec><title>Conclusion</title>
<p>This study highlights job categories and activities associated with increased risk for SARS-CoV infection and demonstrates that a broad diversity of hospital workers may be vulnerable during an outbreak. These findings may help guide recommendations for the protection of vulnerable occupational groups and may have implications for other respiratory infections such as influenza.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/1471-2458-6-207) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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<double pmid="16907978"><pmc><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003</title>
<author><name sortKey="Reynolds, Mary G" sort="Reynolds, Mary G" uniqKey="Reynolds M" first="Mary G" last="Reynolds">Mary G. Reynolds</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Anh, Bach Huy" sort="Anh, Bach Huy" uniqKey="Anh B" first="Bach Huy" last="Anh">Bach Huy Anh</name>
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<institution-id institution-id-type="ISNI">0000 0004 0642 8489</institution-id>
<institution>Department of Medicine,</institution>
<institution>Hanoi Medical University,</institution>
</institution-wrap>
Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Hanoi</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thu, Vu Hoang" sort="Thu, Vu Hoang" uniqKey="Thu V" first="Vu Hoang" last="Thu">Vu Hoang Thu</name>
<affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medicine, French Hospital, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Department of Medicine, French Hospital, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Montgomery, Joel M" sort="Montgomery, Joel M" uniqKey="Montgomery J" first="Joel M" last="Montgomery">Joel M. Montgomery</name>
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</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Bausch, Daniel G" sort="Bausch, Daniel G" uniqKey="Bausch D" first="Daniel G" last="Bausch">Daniel G. Bausch</name>
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<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
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<institution-id institution-id-type="ISNI">0000000122178588</institution-id>
<institution>Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine,</institution>
</institution-wrap>
New Orleans, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New Orleans</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Shah, J Jina" sort="Shah, J Jina" uniqKey="Shah J" first="J Jina" last="Shah">J Jina Shah</name>
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<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Maloney, Susan" sort="Maloney, Susan" uniqKey="Maloney S" first="Susan" last="Maloney">Susan Maloney</name>
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<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Leitmeyer, Katrin C" sort="Leitmeyer, Katrin C" uniqKey="Leitmeyer K" first="Katrin C" last="Leitmeyer">Katrin C. Leitmeyer</name>
<affiliation wicri:level="1"><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="GRID">grid.13652.33</institution-id>
<institution-id institution-id-type="ISNI">0000000109403744</institution-id>
<institution>Centre for Biological Safety, Robert Koch Institut,</institution>
</institution-wrap>
Berlin, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Berlin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Huy, Vu Quang" sort="Huy, Vu Quang" uniqKey="Huy V" first="Vu Quang" last="Huy">Vu Quang Huy</name>
<affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medicine, French Hospital, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Department of Medicine, French Hospital, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Horby, Peter" sort="Horby, Peter" uniqKey="Horby P" first="Peter" last="Horby">Peter Horby</name>
<affiliation wicri:level="1"><nlm:aff id="Aff6">Southeast Asia Regional Office, World Health Organization, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Southeast Asia Regional Office, World Health Organization, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Plant, Aileen J" sort="Plant, Aileen J" uniqKey="Plant A" first="Aileen J" last="Plant">Aileen J. Plant</name>
<affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="GRID">grid.1032.0</institution-id>
<institution-id institution-id-type="ISNI">0000000403754078</institution-id>
<institution>Division of Health Sciences,</institution>
<institution>Curtin University of Technology,</institution>
</institution-wrap>
Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M" last="Uyeki">Timothy M. Uyeki</name>
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<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003</title>
<author><name sortKey="Reynolds, Mary G" sort="Reynolds, Mary G" uniqKey="Reynolds M" first="Mary G" last="Reynolds">Mary G. Reynolds</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Anh, Bach Huy" sort="Anh, Bach Huy" uniqKey="Anh B" first="Bach Huy" last="Anh">Bach Huy Anh</name>
<affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.56046.31</institution-id>
<institution-id institution-id-type="ISNI">0000 0004 0642 8489</institution-id>
<institution>Department of Medicine,</institution>
<institution>Hanoi Medical University,</institution>
</institution-wrap>
Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Hanoi</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Thu, Vu Hoang" sort="Thu, Vu Hoang" uniqKey="Thu V" first="Vu Hoang" last="Thu">Vu Hoang Thu</name>
<affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medicine, French Hospital, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Department of Medicine, French Hospital, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Montgomery, Joel M" sort="Montgomery, Joel M" uniqKey="Montgomery J" first="Joel M" last="Montgomery">Joel M. Montgomery</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Bausch, Daniel G" sort="Bausch, Daniel G" uniqKey="Bausch D" first="Daniel G" last="Bausch">Daniel G. Bausch</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff4"><institution-wrap><institution-id institution-id-type="GRID">grid.265219.b</institution-id>
<institution-id institution-id-type="ISNI">0000000122178588</institution-id>
<institution>Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine,</institution>
</institution-wrap>
New Orleans, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New Orleans</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Shah, J Jina" sort="Shah, J Jina" uniqKey="Shah J" first="J Jina" last="Shah">J Jina Shah</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Maloney, Susan" sort="Maloney, Susan" uniqKey="Maloney S" first="Susan" last="Maloney">Susan Maloney</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Leitmeyer, Katrin C" sort="Leitmeyer, Katrin C" uniqKey="Leitmeyer K" first="Katrin C" last="Leitmeyer">Katrin C. Leitmeyer</name>
<affiliation wicri:level="1"><nlm:aff id="Aff5"><institution-wrap><institution-id institution-id-type="GRID">grid.13652.33</institution-id>
<institution-id institution-id-type="ISNI">0000000109403744</institution-id>
<institution>Centre for Biological Safety, Robert Koch Institut,</institution>
</institution-wrap>
Berlin, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Berlin</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Huy, Vu Quang" sort="Huy, Vu Quang" uniqKey="Huy V" first="Vu Quang" last="Huy">Vu Quang Huy</name>
<affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Medicine, French Hospital, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Department of Medicine, French Hospital, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Horby, Peter" sort="Horby, Peter" uniqKey="Horby P" first="Peter" last="Horby">Peter Horby</name>
<affiliation wicri:level="1"><nlm:aff id="Aff6">Southeast Asia Regional Office, World Health Organization, Hanoi, Vietnam</nlm:aff>
<country xml:lang="fr">Viêt Nam</country>
<wicri:regionArea>Southeast Asia Regional Office, World Health Organization, Hanoi</wicri:regionArea>
<wicri:noRegion>Hanoi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Plant, Aileen J" sort="Plant, Aileen J" uniqKey="Plant A" first="Aileen J" last="Plant">Aileen J. Plant</name>
<affiliation><nlm:aff id="Aff7"><institution-wrap><institution-id institution-id-type="GRID">grid.1032.0</institution-id>
<institution-id institution-id-type="ISNI">0000000403754078</institution-id>
<institution>Division of Health Sciences,</institution>
<institution>Curtin University of Technology,</institution>
</institution-wrap>
Australia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M" last="Uyeki">Timothy M. Uyeki</name>
<affiliation wicri:level="2"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.419261.9</institution-id>
<institution-id institution-id-type="ISNI">0000000121674520</institution-id>
<institution>National Centers for Infectious Diseases, Centers for Disease Control and Prevention,</institution>
</institution-wrap>
Atlanta, GA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Atlanta</wicri:cityArea>
</affiliation>
</author>
</analytic>
<series><title level="j">BMC Public Health</title>
<idno type="eISSN">1471-2458</idno>
<imprint><date when="2006">2006</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community.</p>
</sec>
<sec><title>Methods</title>
<p>We surveyed Hospital A personnel for exposure to the index patient and for symptoms of disease during the outbreak. Additionally, serum specimens were collected and assayed for antibody to SARS-associated coronavirus (SARS-CoV) antibody and job-specific attack rates were calculated. A nested case-control analysis was performed to assess risk factors for acquiring SARS-CoV infection.</p>
</sec>
<sec><title>Results</title>
<p>One hundred and fifty-three of 193 (79.3%) clinical and non-clinical staff consented to participate. Excluding job categories with <3 workers, the highest SARS attack rates occurred among nurses who worked in the outpatient and inpatient general wards (57.1, 47.4%, respectively). Nurses assigned to the operating room/intensive care unit, experienced the lowest attack rates (7.1%) among all clinical staff. Serologic evidence of SARS-CoV infection was detected in 4 individuals, including 2 non-clinical workers, who had not previously been identified as SARS cases; none reported having had fever or cough. Entering the index patient's room and having seen (viewed) the patient were the behaviors associated with highest risk for infection by univariate analysis (odds ratios 20.0, 14.0; 95% confidence intervals 4.1–97.1, 3.6–55.3, respectively).</p>
</sec>
<sec><title>Conclusion</title>
<p>This study highlights job categories and activities associated with increased risk for SARS-CoV infection and demonstrates that a broad diversity of hospital workers may be vulnerable during an outbreak. These findings may help guide recommendations for the protection of vulnerable occupational groups and may have implications for other respiratory infections such as influenza.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/1471-2458-6-207) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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</pmc>
<pubmed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003.</title>
<author><name sortKey="Reynolds, Mary G" sort="Reynolds, Mary G" uniqKey="Reynolds M" first="Mary G" last="Reynolds">Mary G. Reynolds</name>
<affiliation wicri:level="2"><nlm:affiliation>National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. nzr6@cdc.gov</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName><region type="state">Géorgie (États-Unis)</region>
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</affiliation>
</author>
<author><name sortKey="Anh, Bach Huy" sort="Anh, Bach Huy" uniqKey="Anh B" first="Bach Huy" last="Anh">Bach Huy Anh</name>
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<author><name sortKey="Thu, Vu Hoang" sort="Thu, Vu Hoang" uniqKey="Thu V" first="Vu Hoang" last="Thu">Vu Hoang Thu</name>
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<author><name sortKey="Montgomery, Joel M" sort="Montgomery, Joel M" uniqKey="Montgomery J" first="Joel M" last="Montgomery">Joel M. Montgomery</name>
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<author><name sortKey="Bausch, Daniel G" sort="Bausch, Daniel G" uniqKey="Bausch D" first="Daniel G" last="Bausch">Daniel G. Bausch</name>
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<author><name sortKey="Huy, Vu Quang" sort="Huy, Vu Quang" uniqKey="Huy V" first="Vu Quang" last="Huy">Vu Quang Huy</name>
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<author><name sortKey="Horby, Peter" sort="Horby, Peter" uniqKey="Horby P" first="Peter" last="Horby">Peter Horby</name>
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<author><name sortKey="Plant, Aileen Y" sort="Plant, Aileen Y" uniqKey="Plant A" first="Aileen Y" last="Plant">Aileen Y. Plant</name>
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<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2006">2006</date>
<idno type="RBID">pubmed:16907978</idno>
<idno type="pmid">16907978</idno>
<idno type="doi">10.1186/1471-2458-6-207</idno>
<idno type="wicri:Area/PubMed/Corpus">002128</idno>
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<idno type="wicri:Area/PubMed/Curation">002128</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002128</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003.</title>
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<affiliation wicri:level="2"><nlm:affiliation>National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. nzr6@cdc.gov</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>National Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA</wicri:regionArea>
<placeName><region type="state">Géorgie (États-Unis)</region>
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</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Antibodies, Viral (blood)</term>
<term>Case-Control Studies</term>
<term>Cohort Studies</term>
<term>Disease Outbreaks</term>
<term>Hong Kong (ethnology)</term>
<term>Hospital Units</term>
<term>Humans</term>
<term>Infectious Disease Transmission, Patient-to-Professional (analysis)</term>
<term>Middle Aged</term>
<term>Nursing Staff, Hospital</term>
<term>Occupational Exposure (analysis)</term>
<term>Occupational Exposure (statistics & numerical data)</term>
<term>Personnel, Hospital</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>SARS Virus (immunology)</term>
<term>Seroepidemiologic Studies</term>
<term>Severe Acute Respiratory Syndrome (epidemiology)</term>
<term>Severe Acute Respiratory Syndrome (transmission)</term>
<term>Travel</term>
<term>Vietnam (epidemiology)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Anticorps antiviraux (sang)</term>
<term>Exposition professionnelle ()</term>
<term>Exposition professionnelle (analyse)</term>
<term>Facteurs de risque</term>
<term>Flambées de maladies</term>
<term>Hong Kong (ethnologie)</term>
<term>Humains</term>
<term>Personnel hospitalier</term>
<term>Personnel infirmier hospitalier</term>
<term>Syndrome respiratoire aigu sévère (transmission)</term>
<term>Syndrome respiratoire aigu sévère (épidémiologie)</term>
<term>Transmission de maladie infectieuse du patient au professionnel de santé (analyse)</term>
<term>Unités hospitalières</term>
<term>Vietnam (épidémiologie)</term>
<term>Virus du SRAS (immunologie)</term>
<term>Voyage</term>
<term>Études cas-témoins</term>
<term>Études de cohortes</term>
<term>Études séroépidémiologiques</term>
<term>Évaluation des risques</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Viral</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Vietnam</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="ethnology" xml:lang="en"><term>Hong Kong</term>
</keywords>
<keywords scheme="MESH" qualifier="analyse" xml:lang="fr"><term>Exposition professionnelle</term>
<term>Transmission de maladie infectieuse du patient au professionnel de santé</term>
</keywords>
<keywords scheme="MESH" qualifier="analysis" xml:lang="en"><term>Infectious Disease Transmission, Patient-to-Professional</term>
<term>Occupational Exposure</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="ethnologie" xml:lang="fr"><term>Hong Kong</term>
</keywords>
<keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Virus du SRAS</term>
</keywords>
<keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>SARS Virus</term>
</keywords>
<keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticorps antiviraux</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Occupational Exposure</term>
</keywords>
<keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Syndrome respiratoire aigu sévère</term>
<term>Vietnam</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Case-Control Studies</term>
<term>Cohort Studies</term>
<term>Disease Outbreaks</term>
<term>Hospital Units</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Nursing Staff, Hospital</term>
<term>Personnel, Hospital</term>
<term>Risk Assessment</term>
<term>Risk Factors</term>
<term>Seroepidemiologic Studies</term>
<term>Travel</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Exposition professionnelle</term>
<term>Facteurs de risque</term>
<term>Flambées de maladies</term>
<term>Humains</term>
<term>Personnel hospitalier</term>
<term>Personnel infirmier hospitalier</term>
<term>Unités hospitalières</term>
<term>Voyage</term>
<term>Études cas-témoins</term>
<term>Études de cohortes</term>
<term>Études séroépidémiologiques</term>
<term>Évaluation des risques</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community.</div>
</front>
</TEI>
</pubmed>
</double>
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