Outbreak of Severe Acute Respiratory Syndrome (SARS)

in Hong Kong

The Hong Kong The Hong Kong Medical AssociationMedical 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 worldwideFrom: 1 Nov 2002 To: 9 Apr 2003, 15:00 GMT+2

Country Cumulative no. of case(s) No. of deaths Local transmission

Brazil 2 0 None

Canada 97 10 Yes

China 1,290 55 Yes

China, Hong Kong Special Administrative Region 998 30 Yes

China, Taiwan 19 0 Yes

France 4 0 None

Germany 6 0 None

Italy 3 0 None

Kuwait 1 0 None

Malaysia 3 1 None

Republic of Ireland 1 0 None

Romania 1 0 None

Singapore 126 9 Yes

Spain 1 0 None

Switzerland 1 0 None

Thailand 7 2 None

United Kingdom 5 0 None

United States 154 0 None

Viet Nam 62 4 YesTotal 2,781 111

Figures on Atypical Pneumonia in HKFrom: The Department of Health website as at 3:00 pm, 7 April 2003

Nature Total Admission (The numbers in bracket are those with pneumonia symptoms)

Health care workers of Hospitals/Clinics and medical students

208 (208)

69 of the patients were discharged

Patients, family members & visitors

675 (675)

58 of the patients were discharged

Total admission 883 (883)

127 were discharged

Epidemiological linkage

MetropoleHotel

3 Singapore visitors

Outbreak in Singapore 2 Canadian visitors

A private hospital outbreak on Hong Kong Island

Outbreak in Toronto, Canada

1 American Chinese

Hanoi outbreak index case

PWH index patientOnset: 21 Feb 03

1 Mainland visitorOnset: 21 Feb 03

Succumbed at KWH

Symptoms of Respiratory Illness

Symptoms FrequencyFever 100%

Chills 92%

Malaise 90%

Headache 84%

Myalgia 67%

Cough 50%

Dizziness 49%

Rigors 44%

Sore throat 43%

Runny nose 39%

Productive cough 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

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:

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 r

ubber 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 secur

ely over the bridge of the nose to prevent leakage; under general circumstances, the surgical mask should be

changed daily.

posted on the Department of Health website on 28/03/2003

Guideline for wearing facemask

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.

posted on the Department of Health website on 28/03/2003

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 community-acquired pneumonia (CAP)

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)

Disease 2001 20022003

(till 15/3/2003)

Pneumonia 24,400 18,000 3,646

~ The End ~

The Hong Kong The Hong Kong Medical AssociationMedical Association