Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

I. Rationale and Goals

Supplement C: Preparedness and Response In Healthcare Facilities

Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS) Version 2/3


Since 2004, there have not been any known cases of SARS reported anywhere in the world. The content in this Web site was developed for the 2003 SARS epidemic. But, some guidelines are still being used. Any new SARS updates will be posted on this Web site.

Transmission of SARS-CoV in healthcare facilities was a major factor in the spread of SARS during the 2003 global epidemic. In areas with extensive outbreaks, the virus spread most readily among hospital workers caring for SARS patients, other patients, and visitors. In Toronto, 77% of the patients in the first phase of the outbreak were infected in the hospital setting, and half of all SARS cases in Toronto were in healthcare workers (Booth 2003). Even in Hong Kong, where there was significant community transmission, 21% of all SARS cases occurred in healthcare workers (Ho 2003). Factors that likely contribute to the disproportionate rate of transmission in healthcare settings include: 1) a higher virus titer in respiratory secretions during the second week of illness when patients are likely to be hospitalized (Peiris 2003), 2) use of ventilators, nebulizers, endotracheal intubation, and other droplet- and aerosol-generating devices and procedures, and 3) frequent exposures of workers to patients, their secretions, and potentially contaminated environments (Varia 2003).

The large number of hospital personnel who contracted SARS-CoV disease demonstrates the importance of early detection, infection control, and contact tracing in limiting the spread of disease. In every region in which major outbreaks were reported, a substantial proportion of cases resulted from delays in clinical recognition and isolation of patients. SARS-CoV was also transmitted by infected visitors and by hospitalized patients with other medical conditions that masked the symptoms of SARS (Varia 2003). Case recognition and implementation of appropriate precautions greatly reduced the risks of SARS-CoV transmission. However, even with appropriate precautions, there were isolated reports of transmission to healthcare workers in the settings of aerosol-producing procedures and lapses in infection control technique (CDC 2003).

SARS-CoV transmission in a healthcare facility presents occupational and psychological challenges that, in the 2003 outbreaks, required heroic efforts to overcome. Experience also indicates, however, that early detection and isolation of cases, strict adherence to infection control precautions, and aggressive contact tracing and monitoring can minimize the impact of a SARS outbreak (Seto 2003). The success of these measures depends on exhaustive planning, clear communication, collaboration among disciplines, authoritative leadership, and provision of relevant support.

This Supplement provides recommendations for how to prepare for and respond to an introduction of SARS-CoV in a healthcare facility. It outlines basic response measures as well as the enhanced activities that may be needed to address larger outbreaks. As preparedness and response activities for SARS are in many ways analogous to those required for other types of emergency and mass-casualty events, planning for SARS may only require integration of SARS-specific activities into existing preparedness plans and protocols.

The goals of a preparedness and response plan in a healthcare facility are:

  • Rapidly identify and isolate all potential SARS patients.
  • Implement infection control practices and contract tracing to interrupt SARS-CoV transmission.
  • Ensure rapid communication within healthcare facilities and between healthcare facilities and health departments.


Top of Page


Images and logos on this website which are trademarked/copyrighted or used with permission of the trademark/copyright or logo holder are not in the public domain. These images and logos have been licensed for or used with permission in the materials provided on this website. The materials in the form presented on this website may be used without seeking further permission. Any other use of trademarked/copyrighted images or logos requires permission from the trademark/copyright holder...more

External Web Site Policy This graphic notice means that you are leaving an HHS Web site. For more information, please see the Exit Notification and Disclaimer policy.

Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
    Contact CDC-INFO The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #