Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003

Reynolds, Mary G.; Bach Huy Anh; Vu Hoang Thu; Montgomery, Joel M.; Bausch, Daniel G.; Jina Shah, J.; Maloney, Susan; Leitmeyer, Katrin C.; Vu Quang Huy; Horby, Peter; Plant, Aileen J.; Uyeki, Timothy M.
January 2006
BMC Public Health;2006, Vol. 6, p207
Academic Journal
Background: 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. Methods: 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. Results: 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). Conclusion: This study highlights job categories and activities associated with increased risk for SARSCoV 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.


Related Articles

  • SARS: 'a domino effect through entire system' Mackay, Brad // CMAJ: Canadian Medical Association Journal;5/13/2003, Vol. 168 Issue 10, p1308 

    Describes the impact of the outbreak of the severe acute respiratory syndrome (SARS) to health care staff in Toronto, Ontario in 2003. Comments from Donald Low, chief of microbiology at Mount Sinai Hospital; Isolation of workers exposed to someone who developed SARS; Impact of hospital closures.

  • A Major Outbreak of Severe Acute Respiratory Syndrome in Hong Kong. Lee, Nelson; Hui, David; Wu, Alan; Chan, Paul; Cameron, Peter; Joynt, Gavin M.; Ahuja, Anil; Yung, Man Yee; Leung, C.B.; To, K.F.; Lui, S.F.; Szeto, C.C.; Chung, Sydney; Sung, Joseph J.Y. // New England Journal of Medicine;5/15/2003, Vol. 348 Issue 20, p1986 

    Background: There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong. Methods: From March 11 to 25, 2003, all patients with suspected...

  • Severe Acute Respiratory Syndrome:Is the Worst of It Over? Howard-Ruben, Josie // ONS News;Sep2003, Vol. 18 Issue 9, p3 

    Examines the impact of the outbreak of severe acute respiratory syndrome (SARS) in several countries in 2003. Statistics representing retrospective analysis of SARS cases in Canada; Nursing procedures that place nurses at an increased risk of contracting SARS; Impact of SARS on healthcare workers.

  • SARS, pandemic flu: Fear, memory, infection control. Winslow, Dean L. // Hospital Infection Control;Mar2008, Vol. 35 Issue 3, p33 

    The article discusses a study of the response of health care workers, who had been involved in the outbreak of severe acute respiratory syndrome (SARS), to an impending influenza epidemic. The research found the association between the SARS experience and the sense of needing to remain vigilant...

  • Stress and Psychological Impact on SARS Patients During the Outbreak. Chua, Siew E.; Cheung, Vinci; McAlonan, Grainne M.; Cheung, Charlton; Wong, Josephine W. S.; Cheung, Erik P. T.; Chan, Marco T. Y.; Wong, Teresea K. W.; Choy, Khai M.; Chu, Chung M.; Lee, Peter W. H.; Tang, Kenneth W. T. // Canadian Journal of Psychiatry;Jun2004, Vol. 49 Issue 6, p385 

    To examine stress and psychological impact in severe acute respiratory syndrome (SARS) patients during the 2003 outbreak. SARS is a novel, highly infectious pneumonia, and its psychological impact is still unclear. At the peak of the outbreak, SARS patients (n = 79) and healthy control subjects...

  • Psychological Effects of the SARS Outbreak in Hong Kong on High-Risk Health Care Workers. Chua, Siew E.; Cheung, Vinci; Cheung, Charlton; McAlonan, Grainne M.; Wong, Josephine W. S.; Cheung, Erik P. T.; Chan, Marco T. Y.; Wong, Michael M. C.; Tang, Siu W.; Choy, Khai M.; Wong, Meng K.; Chu, Chung M.; Tsang, Kenneth W. T. // Canadian Journal of Psychiatry;Jun2004, Vol. 49 Issue 6, p391 

    To quantify stress and the psychological impact of severe acute respiratory syndrome (SARS) on high-risk health care workers (HCWs). We evaluated 271 HCWs from SARS units and 342 healthy control subjects, using the Perceived Stress Scale (PSS) to assess stress levels and a structured list of...

  • The new normal: a SARS diary. Greiver, Michelle // CMAJ: Canadian Medical Association Journal;12/9/2003, Vol. 169 Issue 12, p1283 

    Details the experiences of a medical personnel, who have undergone quarantine during the outbreak of severe acute respiratory syndrome. Restrictions imposed to every physicians who were assigned in North York General Hospital in Ontario in May 2003; Physical and emotional impact of undergoing...

  • War on SARS: a Singapore experience. Marcus, Ong E.H. // CJEM: Canadian Journal of Emergency Medicine;Jan2004, Vol. 6 Issue 1, p31 

    On Mar. 12, 2003, the World Health Organization issued a global alert regarding cases of a severe atypical pneumonia termed "severe acute respiratory syndrome" (or SARS). In Singapore alone, there have been 238 SARS cases and 33 deaths, including 5 health care workers. With modern global...

  • Lack of SARS Transmission among Healthcare Workers, United States. Park, Benjamin J.; Peck, Angela J.; Kuehnert, Matthew J.; Newbern, Claire; Smelser, Chad; Comer, James A.; Jernigan, Daniel; McDonald, L. Clifford // Emerging Infectious Diseases;Feb2004, Vol. 10 Issue 2, p244 

    Healthcare workers accounted for a large proportion of persons with severe acute respiratory syndrome (SARS) during the worldwide epidemic of early 2003. We conducted an investigation of healthcare workers exposed to laboratory-confirmed SARS patients in the United States to evaluate...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics