1. Outbreak of Severe Acute Respiratory Syndrome (SARS) in Hong Kong
The Hong Kong Medical Association

2. Types of Pneumonia Bacterial Pneumonia Atypical Pneumonia - Mycoplasma
Viral
Chemical

3. Severe Acute Respiratory Syndrome (SARS)
First recognised in Feb 2003 (case in Hanoi)
A form of Atypical Pneumonia
characteristics - high fever (>38°C or 100.4° F)
- dry cough
- breathing difficulties
- rapid deterioration

4. No. of case of SARS worldwide (1)
From: 1 Nov 2002 To: 20 May 2003, 16:00 GMT+2
Country
Cumulative no. of case(s)
No. of deaths
No. recovered
Local transmission
Australia 6
None
Brazil 2
Canada
140 23
106
China
5,248
294
2,254
Yes
China, Hong Kong Special Administrative Region
1,718
253
1,229
China, Macao Special Administrative Region 1
China, Taiwan
383 52 63
Colombia
Finland
France 7
Germany 9
India 3
Indonesia
Italy
Kuwait
Malaysia 5

5. No. of case of SARS worldwide (2)
From: 1 Nov 2002 To: 20 May 2003, 16:00 GMT+2
Country
Cumulative no. of case(s)
No. of deaths
No. recovered
Local transmission
Mongolia 9 8
Yes
New Zealand 1
None
Philippines 12 2
Republic of Ireland
Republic of Korea 3
Romania
Singapore
206 28
161
South Africa
Spain
Sweden
Switzerland
Thailand 5
United Kingdom 4
United States 67 34
Viet Nam 63 58
Total
7,919
662
3,984

6. Figures on Atypical Pneumonia in HK
From: The Department of Health website as at 20 May 2003
Nature
Cumulative Number
Total No. of Discharged Patients
Total No. of Deaths
No. of Patients in Hospital
Health care workers of Hospitals/Clinics and medical students
379
330 (+ 6)
253 (+ 2)
236 (- 14)
Recovering patients in convalescene: 58
Active cases: 178 (- 9)
Patients, family members & visitors
1,339 (+ 4)
889 (+ 10)
Total
1,718 (+ 4)
1,229 (+ 16)
Suspected cases 16

7. Epidemiological linkage
1 Mainland visitor
Onset: 21 Feb 03
Metropole
Hotel
PWH index patient
Onset: 21 Feb 03
Succumbed at KWH
1 American Chinese
3 Singapore visitors
2 Canadian visitors
Outbreak in Singapore
Hanoi outbreak index case
A private hospital outbreak on Hong Kong Island
Outbreak in Toronto, Canada

8. Symptoms of Respiratory Illness
Frequency
Fever
94%
Chills
65%
Malaise
64%
Headache
50%
Myalgia
Cough
Rigors
43%
Dizziness
30%
Diarrhoea
27%
Runny nose
24%
Sore throat
23%

9. Known Facts about SARS Less infectious than influenza
Incubation 2 to 7 days
Infective period?
A new virus?
Any treatment?
Mortality?

10. How does SARS spread? NOT airborne Droplets
- via close contact with an infected person
Contaminated working surfaces
(e.g. formites, stainless steel)
~ survival up to 6 hours

11. The wearing of face masks
Healthcare workers looking after suspected/confirmed cases of SARS
Family members of suspected/ confirmed case
Wearing in public area?
N95? Surgical mask?

12. Guideline for wearing facemask
posted on the Department of Health website on 28/03/2003
Wash hands before wearing a facemask.
Follow the instructions on the packet carefully, if available.
In general, when wearing a surgical facemask, the following should be noted:
the facemask should fit snugly over the face;
the coloured side of the facemask should face outside;
tie all the strings that keep the facemask in place or fix the rubber bands of the facemask round the ears properly;
the facemask should fully cover the nose, mouth as well as the chin;
the metallic wire part of the facemask should be fixed securely over the bridge of the nose to prevent leakage;
under general circumstances, the surgical mask should be changed daily.

13. Guideline for wearing facemask
posted on the Department of Health website on 28/03/2003
Put the facemask into a plastic bag and tie it properly before putting it into a rubbish bin. You may dispose a used facemask concealed in a separate bag with the rest of your domestic wastes.
Replace the facemask immediately if it is damaged or soiled.
Wearing a facemask is just one of the ways to prevent respiratory tract infections. The most important thing a person should do is to observe good personal hygiene. For example, wash hands frequently with liquid soap, especially after sneezing, coughing or cleaning the nose.

14. Prevention of Respiratory Tract Infection (1)
Building good body immunity by having a proper diet, regular exercise and adequate rest, reducing stress and avoiding smoking;
Maintain good personal hygiene, and wash hands after sneezing, coughing or cleaning the nose;
Maintain good ventilation;

15. Prevention of Respiratory Tract Infection (2)
Avoid visiting crowded places with poor ventilation;
Put on a mask if taking care of a patient with respiratory symptoms and wash hands thoroughly afterwards;
Put on a mask if suffering from respiratory tract infection to reduce the chance of spreading the infection to people around them.

16. Statistics on community-acquired pneumonia (CAP)
Disease
2001
2002
2003
(till 15/3/2003)
Pneumonia
24,400
18,000
3,646
There is no unusual rise in the number of CAP
The causes of CAP are similar to previous years
(50% each of known causes and unknown causes)

17. The Hong Kong Medical Association
~ The End ~
The Hong Kong Medical Association