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Volume 15, Number 12—December 2009
Research

Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat

Yock Young Dan, Paul A. TambyahComments to Author , Joe Sim, Jeremy Lim, Li Yang Hsu, Wai Leng Chow, Dale A. Fisher, Yue Sie Wong, and Khek Yu Ho
Author affiliations: National University Health System, Singapore (Y.Y. Dan, P.A. Tambyah, J. Sim, L.Y. Hsu, D.A. Fisher, K.Y. Ho); Singapore General Hospital, Singapore (J. Lim, W.L. Chow, Y.S. Wong)

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Table 1

Characteristics of Singapore MOH influenza outbreak response system*

Singapore MOH
DORSCON alert level WHO pandemic alert level Global/local situation Hospital measures Community measures
Green 0 1 No novel influenza virus circulating Triage and isolation of febrile patients, use of PPE as appropriate Surveillance, maintenance of antiviral drug stockpile
Green 1 2–3 Novel virus but predominantly animal disease with limited transmission to humans Full PPE for suspect cases, contact tracing for confirmed cases, antiviral treatment for all confirmed cases Enhanced surveillance, communication, readiness measures
Yellow 4 Inefficient human-to-human transmission of novel virus Full PPE for HCWs in high risk contact, visitor restriction, restrict movement of patients and HCWs Enhanced surveillance, public health education, border body temperature screening, surveillance of returned travelers from affected areas
Orange 5 Global or local clusters but transmission still localized PPE stepped up to cover “medium-risk” patients, no visitors, no interhospital movement of patients or HCWs, post-exposure prophylaxis for contacts Body temperature screening at community areas, consider school closure, body temperature screening at borders, enhanced public health education
Red 6 Pandemic under way, import into Singapore is inevitable As above with establishment of 18 influenza clinics As above with possible use of masks in the community

*MOH, Ministry of Health; DORSCON, Disease Outbreak Response System; WHO, World Health Organization; PPE, personal protective equipment; HCWs, healthcare workers. Adapted from (5).

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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