SARS and Health Care Work: What have we learnt?

The severe acute respiratory syndrome (SARS) was first reported in Singapore in March 2003. The first few cases were reported among three persons who had travelled to Hong Kong during late February and were admitted during a 5-day period to local hospitals in Singapore for pneumonia. Subsequently, two healthcare workers (HCWs) who had close contact with cases were diagnosed with SARS. At the start of the outbreak, most of the cases were through nosocomial transmission caused by persons who were not immediately recognised as having SARS.

The efficient transmission in healthcare facilities has highlighted the vulnerability of our modern healthcare system to nosocomial infection. Frequent unprotected or inadequately protected patient-to-healthcare worker interactions and grouping large numbers of ill persons can greatly amplify intrahospital transmission.

As of 31 May 2003 when Singapore had no more local SARS transmission there were a total of 206 probable SARS cases had been diagnosed, of which 40.8% were in healthcare workers; 39.8% were in family, friends, or visitors to hospitals; and 12.2% were in inpatients. The outbreak in Tan Tock Seng Hospital spread to Singapore General Hospital and National University Hospital.

Professor Dr David Koh the Professor and Head of Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore shared his experience on the management and containment of the SARS outbreak among healthcare workers in Singapore and the findings of his study looking at the work and non-work related problems among health care workers in Singapore with the staff of the Faculty of Medicine and other occupational health practitioners in Malaysia. Prof Dr Koh was in the Faculty of Medicine, the University of Malaya as the External Examiner for the Master of Public Health (Occupational Health) final examination.

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