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Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series.
Infect Control Hosp Epidemiol. 2006 May; 27(5):473-8.IC

Abstract

OBJECTIVE

To review the severe acute respiratory syndrome (SARS) infection control practices, the types of exposure to patients with SARS, and the activities associated with treatment of such patients among healthcare workers (HCWs) who developed SARS in Toronto, Canada, after SARS-specific infection control precautions had been implemented.

METHODS

A retrospective review of work logs and patient assignments, detailed review of medical records of patients with SARS, and comprehensive telephone-based interviews of HCWs who met the case definition for SARS after implementation of infection control precautions.

RESULTS

Seventeen HCWs from 6 hospitals developed disease that met the case definition for SARS after implementation of infection control precautions. These HCWs had a mean age (+/-SD) of 39+/-2.3 years. Two HCWs were not interviewed because of illness. Of the remaining 15, only 9 (60%) reported that they had received formal infection control training. Thirteen HCWs (87%) were unsure of proper order in which personal protective equipment should be donned and doffed. Six HCWs (40%) reused items (eg, stethoscopes, goggles, and cleaning equipment) elsewhere on the ward after initial use in a room in which a patient with SARS was staying. Use of masks, gowns, gloves, and eyewear was inconsistent among HCWs. Eight (54%) reported that they were aware of a breach in infection control precautions. HCWs reported fatigue due to an increased number and length of shifts; participants worked a median of 10 shifts during the 10 days before onset of symptoms. Seven HCWs were involved in the intubation of a patient with SARS. One HCW died, and the remaining 16 recovered.

CONCLUSION

Multiple factors were likely responsible for SARS in these HCWs, including the performance of high-risk patient care procedures, inconsistent use of personal protective equipment, fatigue, and lack of adequate infection control training.

Authors+Show Affiliations

Nosocomial and Occupational Infections Section, Blood Safety and Surveillance, Health-Care Acquired Infections Division, Public Health Agency of Canada, Tunney's Pasture, PL 0601E2, Ottawa, Canada K1A 0L2. m.ofner@utoronto.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16671028

Citation

Ofner-Agostini, Marianna, et al. "Cluster of Cases of Severe Acute Respiratory Syndrome Among Toronto Healthcare Workers After Implementation of Infection Control Precautions: a Case Series." Infection Control and Hospital Epidemiology, vol. 27, no. 5, 2006, pp. 473-8.
Ofner-Agostini M, Gravel D, McDonald LC, et al. Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series. Infect Control Hosp Epidemiol. 2006;27(5):473-8.
Ofner-Agostini, M., Gravel, D., McDonald, L. C., Lem, M., Sarwal, S., McGeer, A., Green, K., Vearncombe, M., Roth, V., Paton, S., Loeb, M., & Simor, A. (2006). Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series. Infection Control and Hospital Epidemiology, 27(5), 473-8.
Ofner-Agostini M, et al. Cluster of Cases of Severe Acute Respiratory Syndrome Among Toronto Healthcare Workers After Implementation of Infection Control Precautions: a Case Series. Infect Control Hosp Epidemiol. 2006;27(5):473-8. PubMed PMID: 16671028.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cluster of cases of severe acute respiratory syndrome among Toronto healthcare workers after implementation of infection control precautions: a case series. AU - Ofner-Agostini,Marianna, AU - Gravel,Denise, AU - McDonald,L Clifford, AU - Lem,Marcus, AU - Sarwal,Shelley, AU - McGeer,Allison, AU - Green,Karen, AU - Vearncombe,Mary, AU - Roth,Virginia, AU - Paton,Shirley, AU - Loeb,Mark, AU - Simor,Andrew, Y1 - 2006/04/26/ PY - 2005/04/08/received PY - 2005/06/27/accepted PY - 2006/5/4/pubmed PY - 2006/11/2/medline PY - 2006/5/4/entrez SP - 473 EP - 8 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol VL - 27 IS - 5 N2 - OBJECTIVE: To review the severe acute respiratory syndrome (SARS) infection control practices, the types of exposure to patients with SARS, and the activities associated with treatment of such patients among healthcare workers (HCWs) who developed SARS in Toronto, Canada, after SARS-specific infection control precautions had been implemented. METHODS: A retrospective review of work logs and patient assignments, detailed review of medical records of patients with SARS, and comprehensive telephone-based interviews of HCWs who met the case definition for SARS after implementation of infection control precautions. RESULTS: Seventeen HCWs from 6 hospitals developed disease that met the case definition for SARS after implementation of infection control precautions. These HCWs had a mean age (+/-SD) of 39+/-2.3 years. Two HCWs were not interviewed because of illness. Of the remaining 15, only 9 (60%) reported that they had received formal infection control training. Thirteen HCWs (87%) were unsure of proper order in which personal protective equipment should be donned and doffed. Six HCWs (40%) reused items (eg, stethoscopes, goggles, and cleaning equipment) elsewhere on the ward after initial use in a room in which a patient with SARS was staying. Use of masks, gowns, gloves, and eyewear was inconsistent among HCWs. Eight (54%) reported that they were aware of a breach in infection control precautions. HCWs reported fatigue due to an increased number and length of shifts; participants worked a median of 10 shifts during the 10 days before onset of symptoms. Seven HCWs were involved in the intubation of a patient with SARS. One HCW died, and the remaining 16 recovered. CONCLUSION: Multiple factors were likely responsible for SARS in these HCWs, including the performance of high-risk patient care procedures, inconsistent use of personal protective equipment, fatigue, and lack of adequate infection control training. SN - 0899-823X UR - https://www.unboundmedicine.com/medline/citation/16671028/Cluster_of_cases_of_severe_acute_respiratory_syndrome_among_Toronto_healthcare_workers_after_implementation_of_infection_control_precautions:_a_case_series_ L2 - https://www.cambridge.org/core/product/identifier/ICHE2005115/type/journal_article DB - PRIME DP - Unbound Medicine ER -