Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore

M. D. TELEMAN; I. C. BOUDVILLE; B. H. HENG; D. ZHU; Y. S. LEO

doi:10.1017/S0950268804002766

Abstract

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Between 1 and 22 March 2003, a nosocomial outbreak of Severe Acute Respiratory Syndrome (SARS) occurred at the Communicable Disease Centre in Tan Tock Seng Hospital, Singapore, the national treatment and isolation facility for patients with SARS. A case-control study with 36 cases and 50 controls was conducted of factors associated with the transmission of SARS within the hospital. In univariate analysis, contact with respiratory secretions elevated the odds ratio to 6·9 (95% CI 1·4–34·6, P=0·02). Protection was conferred by hand washing (OR 0·06, 95% CI 0·007–0·5, P=0·03) and wearing of N95 masks (OR 0·1, 95% CI 0·03–0·4, P=0·001). Use of gloves and gowns had no effect. Multivariate analysis confirmed the strong role of contact with respiratory secretions (adjusted OR 21·8, 95% CI 1·7–274·8, P=0·017). Both hand washing (adjusted OR 0·07, 95% CI 0·008–0·66, P=0·02) and wearing of N95 masks (adjusted OR 0·1, 95% CI 0·02–0·86, P=0·04) remained strongly protective but gowns and gloves had no effect.

Crossref Citations

This article has been cited by the following publications. This list is generated based on data provided by Crossref.

Marshall, Andrew H Rachlis, Anita and Chen, Joseph 2005. Severe acute respiratory syndrome: responses of the healthcare system to a global epidemic. Current Opinion in Otolaryngology & Head and Neck Surgery, Vol. 13, Issue. 3, p. 161.

Fung, Isaac Chun‐Hai and Cairncross, Sandy 2006. Effectiveness of handwashing in preventing SARS: a review. Tropical Medicine & International Health, Vol. 11, Issue. 11, p. 1749.

Madsen, James M. and Darling, Robert G. 2006. Disaster Medicine. p. 424.

McBryde, E. S. Gibson, G. Pettitt, A. N. Zhang, Y. Zhao, B. and McElwain, D. L. S. 2006. Bayesian modelling of an epidemic of severe acute respiratory syndrome. Bulletin of Mathematical Biology, Vol. 68, Issue. 4, p. 889.

Muller, Matthew P and McGeer, Allison 2006. Febrile respiratory illness in the intensive care unit setting: an infection control perspective. Current Opinion in Critical Care, Vol. 12, Issue. 1, p. 37.

Aquino, M. Raboud, J. M. McGeer, A. Green, K. Chow, R. Dimoulas, P. Loeb, M. and Scales, D. 2006. Accuracy of Healthcare Worker Recall and Medical Record Review for Identifying Infectious Exposures to Hospitalized Patients. Infection Control & Hospital Epidemiology, Vol. 27, Issue. 7, p. 722.

Tsai, Ying-Huang Wan, Gwo-Hwa Wu, Yao-Kuang and Tsao, Kuo-Chien 2006. Airborne Severe Acute Respiratory Syndrome Coronavirus Concentrations in a Negative-Pressure Isolation Room. Infection Control & Hospital Epidemiology, Vol. 27, Issue. 5, p. 523.

Xie, X. Li, Y. Chwang, A. T. Y. Ho, P. L. and Seto, W. H. 2007. How far droplets can move in indoor environments ? revisiting the Wells evaporation?falling curve. Indoor Air, Vol. 17, Issue. 3, p. 211.

Yu, I. T. Xie, Z. H. Tsoi, K. K. Chiu, Y. L. Lok, S. W. Tang, X. P. Hui, D. S. Lee, N. Li, Y. M. Huang, Z. T. Liu, T. Wong, T. W. Zhong, N. S. and Sung, J. J. 2007. Why Did Outbreaks of Severe Acute Respiratory Syndrome Occur in Some Hospital Wards but Not in Others?. Clinical Infectious Diseases, Vol. 44, Issue. 8, p. 1017.

Jefferson, Tom Foxlee, Ruth Del Mar, Chris Dooley, Liz Ferroni, Eliana Hewak, Bill Prabhala, Adi Nair, Sreekumaran Rivetti, Alessandro and Jefferson, Tom 2007. Cochrane Database of Systematic Reviews.

Weber, David J. Sickbert-Bennett, Emily E. Brown, Vickie M. Brooks, Rebecca H. Kittrell, Irene P. Featherstone, Brenda J. Adams, Tina L. and Rutala, William A. 2007. Compliance With Isolation Precautions at a University Hospital. Infection Control & Hospital Epidemiology, Vol. 28, Issue. 3, p. 358.

Sansom, Guy W 2007. Emergency department personal protective equipment requirements following out‐of‐hospital chemical biological or radiological events in Australasia. Emergency Medicine Australasia, Vol. 19, Issue. 2, p. 86.

Shigayeva, A. Green, K. Raboud, J. M. Henry, B. Simor, A. E. Vearncombe, M. Zoutman, D. Loeb, M. and McGeer, A. 2007. Factors Associated With Critical-Care Healthcare Workers' Adherence to Recommended Barrier Precautions During the Toronto Severe Acute Respiratory Syndrome Outbreak. Infection Control & Hospital Epidemiology, Vol. 28, Issue. 11, p. 1275.

Mathieu, E. and Sodahlon, Y. 2008. International Encyclopedia of Public Health. p. 401.

Gubbay, J. B. and Matlow, A. G. 2008. Commentary on ‘Interventions for the interruption or reduction of the spread of respiratory viruses’. Evidence-Based Child Health: A Cochrane Review Journal, Vol. 3, Issue. 4, p. 1016.

Jefferson, Tom Foxlee, Ruth Del Mar, Chris Dooley, Liz Ferroni, Eliana Hewak, Bill Prabhala, Adi Nair, Sreekumaran and Rivetti, Alessandro 2008. Cochrane Review: Interventions for the interruption or reduction of the spread of respiratory viruses. Evidence-Based Child Health: A Cochrane Review Journal, Vol. 3, Issue. 4, p. 951.

2008. Infection Prevention and Control. p. 279.

Wilder-Smith, Annelies and Goh, Kee Tai 2008. Emerging Infections in Asia. p. 97.

Rose, Gregory and Roth, Virginia R. 2009. Evidence‐Based Infectious Diseases. p. 291.

Liu, Wei Tang, Fang Fang, Li‐Qun De Vlas, Sake J. Ma, Huai‐Jian Zhou, Jie‐Ping Looman, Caspar W. N. Richardus, Jan Hendrik and Cao, Wu‐Chun 2009. Risk factors for SARS infection among hospital healthcare workers in Beijing: a case control study. Tropical Medicine & International Health, Vol. 14, Issue. s1, p. 52.

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Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore

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