Transcript Outbreak of Severe Acute Respiratory Syndrome (SARS) in

Outbreak of Severe Acute
Respiratory Syndrome (SARS)
in Hong Kong
The Hong Kong
Medical Association
Types of Pneumonia

Bacterial Pneumonia

Atypical Pneumonia - Mycoplasma
Viral
Chemical
Severe Acute
Respiratory Syndrome (SARS)

First recognised in Feb 2003 (case in Hanoi)

A form of Atypical Pneumonia

characteristics - high fever (>38°C or 100.4° F)
- dry cough
- breathing difficulties
- rapid deterioration
No. of case of SARS worldwide
From: 1 Nov 2002 To: 11 Apr 2003, 18:00 GMT+2
Country
Brazil
Canada
China
China, Hong Kong Special Administrative Region
China, Taiwan
France
Germany
Italy
Japan
Kuwait
Malaysia
Republic of Ireland
Romania
Singapore
South Africa
Spain
Switzerland
Thailand
United Kingdom
United States
Viet Nam
Cumulative no. of
case(s)
No. of deaths
Local transmission
2
98
1,309
1,059
21
5
6
3
0
10
58
32
0
0
0
0
None
Yes
Yes
Yes
Yes
None
None
None
4
0
None
1
4
1
1
133
1
1
1
7
5
166
62
0
1
0
0
9
0
0
0
2
0
0
4
None
None
None
None
Yes
Yes
None
None
None
None
None
Yes
Figures on Atypical Pneumonia in HK
From: The Department of Health website as at 1:00 pm, 10 April 2003
Nature
Total Admission
(The numbers in bracket are those
with pneumonia symptoms)
Health care workers of
Hospitals/Clinics and medical
students
253 (253)
75 of the patients were
discharged
Patients, family members &
visitors
745 (745)
79 of the patients were
discharged
Total admission
998 (998)
154 were discharged
Epidemiological linkage
PWH index patient
1 Mainland visitor
Onset: 21 Feb 03
Succumbed at KWH
Metropole
Hotel
1 American Chinese
3 Singapore visitors
Outbreak in Singapore
Onset: 21 Feb 03
2 Canadian visitors
Hanoi outbreak index case
A private hospital outbreak on Hong Kong Island
Outbreak in Toronto, Canada
Symptoms of
Respiratory Illness
Symptoms
Frequency
Fever
Chills
Malaise
Headache
Myalgia
Cough
Dizziness
100%
92%
90%
84%
67%
50%
49%
Rigors
44%
Sore throat
Runny nose
Productive cough
43%
39%
36%
Known Facts about SARS

Less infectious than influenza

Incubation 2 to 7 days

Infective period?

A new virus?

Any treatment?

Mortality?
How does SARS spread?

NOT airborne

Droplets
- via close contact with an infected person

Contaminated working surfaces
(e.g. formites, stainless steel)
~ survival up to 6 hours
The wearing of face masks

Healthcare workers looking after
suspected/confirmed cases of SARS

Family members of suspected/
confirmed case

Wearing in public area?

N95? Surgical mask?
Guideline for wearing facemask
posted on the Department of Health website on 28/03/2003
1.
Wash hands before wearing a facemask.
2.
Follow the instructions on the packet carefully, if available.
3.
In general, when wearing a surgical facemask, the following
should be noted:
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the facemask should fit snugly over the face;
the coloured side of the facemask should face outside;
tie all the strings that keep the facemask in place or fix the
rubber bands of the facemask round the ears properly;
the facemask should fully cover the nose, mouth as well as
the chin;
the metallic wire part of the facemask should be fixed
securely over the bridge of the nose to prevent leakage;
under general circumstances, the surgical mask should be
changed daily.
Guideline for wearing facemask
posted on the Department of Health website on 28/03/2003
4.
Put the facemask into a plastic bag and tie it
properly before putting it into a rubbish bin. You
may dispose a used facemask concealed in a
separate bag with the rest of your domestic
wastes.
5.
Replace the facemask immediately if it is damaged
or soiled.
Wearing a facemask is just one of the ways to prevent
respiratory tract infections. The most important thing
a person should do is to observe good personal
hygiene. For example, wash hands frequently with
liquid soap, especially after sneezing, coughing or
cleaning the nose.
Prevention of
Respiratory Tract Infection (1)

Building good body immunity by having a
proper diet, regular exercise and adequate
rest, reducing stress and avoiding smoking;

Maintain good personal hygiene, and wash
hands after sneezing, coughing or cleaning
the nose;

Maintain good ventilation;
Prevention of
Respiratory Tract Infection (2)

Avoid visiting crowded places with poor
ventilation;

Put on a mask if taking care of a patient
with respiratory symptoms and wash hands
thoroughly afterwards;

Put on a mask if suffering from respiratory
tract infection to reduce the chance of
spreading the infection to people around
them.
Statistics on communityacquired pneumonia (CAP)
Disease
2001
2002
2003
(till 15/3/2003)
Pneumonia
24,400
18,000
3,646

There is no unusual rise in the number of CAP

The causes of CAP are similar to previous years
(50% each of known causes and unknown causes)
~ The End ~
The Hong Kong
Medical Association