Infection Special Book: Control, Prevention, BBP, SARS, FluPage 29 of 46

3. Management of SARS

[Material from this section is taken largely from CDC, 2005.]

Several healthcare workers developed SARS after caring for patients with the disease. Transmission to healthcare workers occurred after close contact with symptomatic individuals (persons with fever or respiratory symptoms) before recommended infection control precautions for SARS were implemented (for unprotected exposures). Personal protective equipment (PPE) appropriate for standard, contact, and airborne precautions (e.g., hand hygiene, gown, gloves, and N95 respirator), in addition to eye protection, were recommended for healthcare workers to prevent transmission of SARS in healthcare settings.

CDC, in collaboration with state and local health departments, developed a systematic approach for surveillance of SARS exposures and infection in healthcare workers for use by healthcare facilities (CDC, 2018).

Exposures to SARS in a Healthcare Facility

CDC guidance was to recommend exclusion from duty for a healthcare worker if fever or respiratory symptoms developed during the 10 days following an unprotected exposure to a SARS patient. Exclusion from duty continued for 10 days after the resolution of fever and respiratory symptoms. During this period, infected workers avoided contact with persons both in the facility and in the community.

Exclusion from duty was not recommended for an exposed healthcare worker if they did not have either fever or respiratory symptoms; however, the worker was required to report any unprotected exposure to SARS patients to the appropriate facility point of contact (infection control or occupational health) immediately.

Active surveillance for fever and respiratory symptoms (e.g., daily screening) was conducted on healthcare workers with unprotected exposure, and the worker was told to be vigilant for the onset of illness. Workers with unprotected exposure developing such symptoms could not report for duty, but instead were to stay home and report symptoms to the appropriate facility point of contact immediately.

Passive surveillance (review of occupational health or other sick leave records) was to be conducted among all healthcare workers in a facility with a SARS patient, and all healthcare facility workers educated concerning the symptoms of SARS.

Close contacts (e.g., family members) of SARS patients were at risk for infection. Close contacts with either fever or respiratory symptoms could not enter the healthcare facility as visitors and were educated about this policy. A system for screening for fever or respiratory symptoms was needed for close contacts who were visitors to the facility. Healthcare facilities were required to educate all visitors about use of infection control precautions when visiting SARS patients and their responsibility for adherence to them.