SARS Exposure and Emergency Department Workers
Of 193 emergency department workers exposed to severe acute respiratory syndrome (SARS), 9 (4.7%) were infected. Pneumonia developed in six workers, and assays showed anti-SARS immunoglobulin (Ig) M and IgG. The other three workers were IgM-positive and had lower IgG titers; in two, mild illness developed, and one remained asymptomatic.

The first case of severe acute respiratory syndrome (SARS) in Taiwan was reported from the National Taiwan University Hospital (NTUH) in mid-March 2003. An infected businessman returning from mainland China was the source of a cluster of infections involving his family and a physician. Thereafter, a number of sporadic cases or small outbreaks emerged in the following month, mostly imported from abroad.

A tertiary university medical center in metropolitan Taipei, NTUH was responsible for most SARS screening during this time. Many patients with symptoms or signs of SARS were transferred to the emergency department of NTUH for evaluation and management. After April 20, 2003, the number of SARS patients increased markedly because of outbreaks in two hospitals in Taipei. During the epidemic in Taiwan, >2,000 febrile patients visited the emergency department of NTUH, and laboratory-confirmed SARS was diagnosed in 79 of them. All 79 patients tested positive for anti-SARS immunoglobulin (Ig) G by using a commercial immunofluorescent assay (IFA) (EUROIMMUN Anti-SARS-CoV-IIFT, Lübeck, Germany), and 25 of them also had positive results of reverse transcriptase–polymerase chain reaction on two separate respiratory samples (sputum or throat swabs) or one respiratory sample and one nonrespiratory (urine or stool) sample. After exposure to SARS, fever or diarrhea occurred in many emergency department workers, and 13 of them were admitted to the hospital. On May 12, the emergency department of NTUH was closed; it was reopened on May 26, when all personnel had no indications of disease after >10 days of isolation.