Biomedical Engineering Reference
In-Depth Information
23 Response to SARS as a prototype
for bioterrorism: Lessons in a Regional
Hospital in Hong Kong
ARTHUR CHUN-WING LAU, IDA KAM-SIU YIP, MAN-CHING LI, MARY WAN,
ALFRED WING-HANG SIT, RODNEY ALLAN LEE, RAYMOND WAI-HUNG YUNG,
AND LORETTA YIN-CHUN YAM
23.1 Introduction
Following the boom of the post-war years in
the latter half of the twentieth century, the only
large-scale infectious disease outbreaks were the
influenza pandemics of 1957 and 1968 [1]. Apart
from the aged and those with co-morbidities, in
whom high morbidity and mortality was recorded,
most patients had mild manifestations. With the
advent of potent antimicrobial agents, the possible
threat of widespread and lethal infections was
generally considered minimal, and the world
was ill-prepared for the severe acute respira-
tory syndrome (SARS) outbreak caused by the
novel SARS-associated coronavirus (SARS-CoV)
in early 2003. SARS wreaked havoc in 29 coun-
tries and infected 8422 patients within a short span
of a few months [2]. By virtue of its novelty, infec-
tious potential, associated mortality and in partic-
ular the lack of proven therapy, SARS-CoV has all
the characteristics of a biological agent of choice
in bioterrorism. Response to the SARS outbreak
can thus serve as a prototype for combating against
acts of bioterrorism. We describe our response to
this SARS outbreak in the setting of a Hong Kong
acute care hospital.
23.2 Recognition of an Impending
Outbreak in Hong Kong
On February 11, 2003, the Chinese Ministry of
Health reported to the World Health Organization
(WHO) 305 cases of an acute respiratory syndrome
of unknown etiology, occurring in Southern China
between November 16, 2002 and February 9, 2003
[3]. On the same day, the Hong Kong Hospital
Authority Head Office (HAHO), which operates
40 public hospitals and delivers over 92% of in-
patient services in the territory, convened an Expert
Panel on Severe Community-acquired Pneumonia
(SCAP) in response to rumors about this infec-
tious condition adjacent to the territory. It aimed to
investigate the possibility of a similar situation in
Hong Kong, to formulate guidelines for the preven-
tion of its spread, and to require the reporting
of all patients presenting with features of SCAP.
The Chief of Service (COS) of the Department of
Medicine of our institution, Pamela Youde Nether-
sole Eastern Hospital (PYNEH), which employs
over 3500 staff to operate 1829 beds (1219 general
beds and 610 psychiatric beds) to serve a popu-
lation of 750,000 on Hong Kong Island, was
appointed to the Panel.
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