ORIGINAL ARTICLE

Impact of an outbreak of severe acute respiratory syndrome on a hospital in Taiwan, ROC

M C Tsai¹, J L Arnold², C C Chuang¹, C H Chi¹, C C Liu¹, Y J Yang¹

¹ National Cheng Kung University Hospital, Tainan, Taiwan, ROC
² Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA

Correspondence to:
Correspondence to:
Dr J Arnold
Yale-New Haven Center for Emergency and Terrorism Preparedness, I Church Street, 5th Floor, New Haven, CT 06510, USA; jeffrey.arnold{at}ynhh.org

Study objective: To estimate the impact of the severe acute respiratory syndrome (SARS) outbreak in early 2003 on a tertiary care hospital in Taiwan, ROC.

Methods: The study estimated the utilisation of resources related to infection control, SARS related medical services, and routine medical services, and SARS related medical outcomes at National Cheng Kung University Hospital (NCKUH) from 25 March to 16 June 2003 through a cross sectional survey of hospital records.

Results: A mean of 5100 persons per day (95%CI 4580 to 5610) underwent fever screening at the outpatient and emergency department (ED) entrances to the hospital, of which 35 per day (95% CI 30 to 40) were referred for further evaluation for suspected or probable SARS. ED isolation surge capacity was created via 12 new beds outside the ED: eight for SARS assessment, three for patients awaiting inhospital bed assignment, and one for resuscitation. A total of 382 patients were fully evaluated for suspected or probable SARS outside the ED, of which 27 were admitted. The mean numbers of outpatient clinic patient visits, ED visits, ED trauma patient visits, ED admissions, hospital admissions, and operative procedures decreased during the outbreak. Thirty eight patients were hospitalised with suspected SARS, of which three received the final diagnosis of probable SARS. Two patients with probable SARS died. No cases of nosocomial SARS transmission occurred.

Conclusions: This SARS outbreak was associated with substantial use of hospital and ED resources aimed at infection control, comparatively less use of resources related to the medical care of patients with suspected or probable SARS, and decreased use of routine medical services.

Keywords: infection control; severe acute respiratory syndrome

Abbreviations: SARS, severe acute respiratory syndrome; ED, emergency department

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