The predicted bio-aerosol concentration distribution in the ward seemed to agree fairly well with the spatial infection pattern of SARS cases (Li et al., 2005b). Even though the patient cubicles were in positive pressure with respect to the corridor, the virus-containing

bio-aerosols generated from the index patient’s cubicle were still transmitted to the other cubicles. Using a computational fluid dynamic simulation test in a retrospective analysis, it was found that the air exchange related to the small temperature differences between cubicles might have contributed to SARS transmission (Chen et al., 2011). In view of the Selleck RO4929097 lack of effective antiviral therapy and vaccines, infection control measures remain the most important modality to prevent human-to-human transmission of SARS. Early isolation of suspected patients is important to prevent nosocomial transmission (Chowell et al., 2003). In Hong Kong, patients triaged at the emergency department and transferred from other hospitals were evaluated using a set of clinical and BMS 754807 epidemiological criteria, such as fever over 38 °C, cough, or shortness of breath, and with history of close contact to SARS case. Patients fulfilling those criteria were admitted to designated wards, where the number of

beds in each cubicle was reduced to allow a bed-to-bed distance of at least 2 meters, so as to minimize the risk of transmission (Ho et al., 2003c). A dedicated team of physicians and nurses, led by experienced respiratory and infectious disease experts, was established to provide special care to all patients admitted to the designated wards. Active surveillance of patients with community or nosocomial acquired pneumonia was also conducted in general wards to identify and isolate any unrecognized cases. Standard, contact, and droplet precautions were enforced in all clinical areas in the hospital. Risk-stratified infection control measures were proposed in acute pediatric wards in Hong Kong. By stratifying the clinical areas into

ultrahigh-, high- and moderate-risk areas, according Astemizole to different risk levels of nosocomial SARS transmission and the implementation of different levels of infection control precautions, there was no nosocomial transmission of SARS in the pediatric service (Leung et al., 2004). In Taiwan, an integrated infection control approach was implemented at a SARS designated hospital where airborne infection isolation rooms were not available. Fever screening stations, triage of fever patients, separating SARS patients from other patients, separation of entrances and passageways between patients and healthcare workers, and increase of hand-washing facilities all demonstrated a protective effect for healthcare workers (Yen et al., 2011 and Yen et al., 2006). Besides the infection control preparedness in the emergency department, triage areas, general wards, and designated SARS wards, special arrangements were also made for operating rooms.