To describe the outbreak of severe acute respiratory syndrome in Hong Kong.
Descriptive case series.
Hong Kong, Special Administrative Region, China
The outbreak started with a visitor from southern China on 21 February. At the hospitals where the first cases were treated the disease spread quickly among healthcare workers, and then out into the community as family members became infected. By 1 April, 685 cases had been reported with 16 deaths. Symptoms include high fever and one or more respiratory symptoms (including cough, shortness of breath, and difficulty breathing). Changes in lung tissue suggest that part of the lung damage is due to cytokines induced by the microbial agent, which has led to empirical treatment with corticosteroids, broad spectrum antiviral agent, and antibacterial cover. There is strong evidence that a novel coronavirus is the pathogen. Precautions for droplet infection should be instituted, including the wearing of masks and rigorous disinfection and hygiene procedures. On 27 March the Department of Health announced drastic measures, including vigorous contact tracing and examination, quarantine of contacts in their homes, and closure of all schools and universities.
The rapidity of the spread of the disease and the morbidity indicate that the agent responsible is highly infectious and virulent. Strict infection control measures for droplet and contact transmission by healthcare workers, a vigilant healthcare profession, and public education are essential for disease prevention.
What is already known on this topicSevere acute respiratory syndrome is a form of atypical pneumonia that originated in southern China and spread globally in a few weeksThe clinical picture, empirical treatment, and the possible mode of disease transmission have been described. The agent responsible is probably a novel coronavirusWhat this study addsThis report gives an account of the daily reported number of cases in Hong Kong, showing how the disease has spread rapidly from healthcare workers to the community, and of the drastic measures the government has finally introduced to attempt to control the diseaseA vigilant healthcare profession, strict infection control measures, and public education are essential to prevent disease disseminationEarly introduction of quarantine procedures for this disease by health authorities should be considered.