Primary prevention

Implementation and maintenance of appropriate control measures on the handling and trading of wild animals offered for human consumption in food markets is critical in the primary prevention of SARS.

Secondary prevention

As disease transmission appears to occur through close interactions with infected individuals, early recognition of new SARS cases is the cornerstone for preventing the spread of the disease.[88][89] A high level of suspicion is required in the inter-epidemic period, especially when 'unusual' cases of severe lower respiratory tract infection are identified. There are a number of strategies to reduce further transmission of the disease within both the hospital and the community setting.

  • Healthcare workers or others exposed to SARS patients should be monitored for possible development of the disease.

  • Individuals who have had unprotected contact with a confirmed or suspected case of SARS must be quarantined for 10 days after the potential exposure. No specific precautions are required for those sharing the household with a person in quarantine as long as that person remains asymptomatic.

  • Implementation of infection control precautions should be immediate, with the initiation of triage strategies that ensure early recognition of possible cases. The healthcare infrastructure has to be examined and upgraded in order to handle efficiently a possible re-emergence of SARS.[90]

  • Fever screening stations, triage of fever patients, separating SARS patients from other patients, separation of entrances and passageways between patients and healthcare workers, and increasing hand-washing facilities all demonstrated a protective effect for healthcare workers.[91]

  • Healthcare workers should be adequately trained in and diligently adhere to infection control guidelines.[92]

  • Healthcare workers must use protective masks, such as the N95,[93] or HEPA filter-containing respirators, long sleeve forms, impermeable gowns, and clean gloves.[94] If slash or spray of respiratory secretions or other body fluids is likely, protection of the eyes with goggles or a face shield is required. Good air ventilation in SARS wards may be effective in minimising or preventing SARS transmission among healthcare workers in hospitals.[95]

  • Labour and delivery of pregnant patients with suspected and probable SARS should be managed in a designated negative pressure isolation room, by personnel with specialised infection control preparation and protective gear.[96]

  • Neonates of mothers with SARS should be isolated in a designated unit until the infant has been well for 10 days, or until the mother's period of isolation is complete. The mother should not breastfeed during this period.[96]

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