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Volume 12, Number 1—January 2006

Dispatch

Coordinated Response to SARS, Vancouver, Canada

Danuta M. Skowronski*Comments to Author , Martin Petric*, Patricia Daly†, Robert A. Parker‡, Elizabeth Bryce†, Patrick W. Doyle†, Michael A. Noble†, Diane L. Roscoe†, Joan Tomblin§, Tung C. Yang¶, Mel Krajden*, David M. Patrick*, Babak Pourbohloul*, Swee Han Goh*, William R. Bowie#, Tim F. Booth**, S. Aleina Tweed*, Thomas L. Perry†, Allison McGeer††, and Robert C. Brunham*
Author affiliations: *British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; †Vancouver Coastal Health, Vancouver, British Columbia, Canada; ‡Fraser Health, New Westminster, British Columbia, Canada; §Royal Columbian Hospital, New Westminster, British Columbia, Canada; ¶St. Paul's Hospital, Vancouver, British Columbia, Canada; #University of British Columbia, Vancouver, British Columbia, Canada; **National Microbiology Laboratory, Winnipeg, Manitoba, Canada; ††Mount Sinai Hospital, Toronto, Ontario, Canada

Main Article

Table 2

Epidemiologic and clinical profile of patients with confirmed SARS, Vancouver*

Patient characteristics Patient 0 Patient 1 Patient 2 Patient 3 Patient 4
Baseline characteristics
    Sex Male Female Female Male Female
Age (y) 55 54 64 49 44
Medical condition No Diabetes Hypertension No No
Epidemiologic characteristics
    Travel related Yes Yes Yes Yes No
City of likely source of SARS Hong Kong Hong Kong Hong Kong Hong Kong VCMA
Known contact with SARS No No Yes No Yes
Likely date(s) of exposure, 2003 Feb 21 Feb 21 Mar 19 Mar 28–30 Mar 29 or Mar 30
Likely setting of exposure Hotel M Hotel M Dinner party Amoy Gardens Hospital B
Date of return to Canada, 2003 Mar 6 Mar 6 Mar 20 Mar 30 NA
Clinical profile
Symptoms and onset, 2003
    Malaise Feb 26 Feb 26 Mar 24 No Apr 4
Myalgia No Feb 28 Mar 24 Apr 1 Apr 10
Headache Feb 28 Feb 28 Mar 27 Apr 1 Apr 4
Fever Feb 28 Feb. 28 Mar 29 Apr 1 Apr 15
Chills Feb 28 Feb 28 Mar 29 No No
Chest discomfort No No Mar 24 No No
Cough Mar 1 No Mar 29 No Apr 11
Shortness of breath Mar 1 No Mar 29 Apr 3 Apr 11
Nausea No No Mar 27 No No
Vomiting No No No No No
Diarrhea Mar 7 No Mar 28 Apr 6 Apr 11
Hospitalized Yes No Yes Yes Yes
Oxygen saturation (%) on room air at admission 45 NA 80 97; fell to 62 within 3 h 86
Aerosolized medication or nebulizer before isolation No No No No No
Date of hospital admission Mar 7 NA Mar 28 Apr 3 Apr 15
No. days after symptom onset that patient was hospitalized 10 4 2 11
Date of final hospital discharge Jun 12 NA Apr 21 Apr 21 May 24
ICU Yes No Yes No Yes
Date of ICU admission Mar 8 NA Apr 1 NA Apr 15
Date of ICU discharge May 13 NA Apr 18 NA Apr 24
Mechanical ventilation Yes No Yes No No
Delay to implementation at hospital of:
Respiratory precautions† 15 min‡ NA Immediate§ Immediate§ 7 min¶
Negative-pressure isolation 165 min‡ NA Immediate§ Immediate§ 11 min¶

*SARS, severe acute respiratory syndrome; VCMA, Vancouver census metropolitan area; NA, not applicable; ICU, intensive care unit; ER, emergency room; NPIR, negative-pressure isolation room.
†Defined as standard precautions (gloves, gown, eyewear) plus N95 mask and mask on patient when transported. Full respiratory precautions also include NPIR.
‡Arrived in triage March 7, 2003 1:55 p.m. By 2:10 p.m., admission sheet advises "full respiratory precautions" be taken. By 2:20 p.m. in single room in ER. Transferred to NPIR in ER at 4:40 p.m.
§Arrived at hospital masked and admitted directly into NPIR.
¶Arrived in ER on April 14, 2003, at 9:49 p.m. Identified as suspected SARS patient at 9:56 p.m. Masked and transferred to NPIR in ER at 10 p.m. Admitted to ICU NPIR on April 15.

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