Transmission of SARS-CoV appears to occur predominantly through close
interactions with infected persons. Infectious respiratory secretions
are the most likely source of infection, although fecal/oral transmission
may have occurred in some settings. Contact with contaminated body substances,
either directly (e.g., shaking hands) or indirectly (e.g., touching objects
contaminated with respiratory secretions or stool), can lead to exposure.
SARS-CoV may also be transmitted through close contact with respiratory
droplets expelled when a patient coughs or sneezes. In some instances,
however, true airborne transmission (i.e., via droplet nuclei) cannot
be excluded as a possible mode of SARS-CoV transmission. SARS-CoV has been transmitted in healthcare settings (e.g., inpatient
settings, emergency departments, nursing homes) to and from patients,
healthcare workers, and visitors. Transmission to healthcare workers
has occurred primarily after close contact with symptomatic persons before
implementation of infection control precautions. During the 2003 outbreaks,
multiple hospitals reported cases of SARS-CoV disease among healthcare
workers who were present during aerosol-generating procedures performed
on patients with SARS-CoV disease, suggesting that aerosol-generating
procedures may pose an increased risk of SARS-CoV transmission. Special
precautions during these procedures are recommended.
Infection control guidance to prevent SARS-CoV transmission is necessary
to help ensure the protection of healthcare workers and healthcare facilities.
In addition, as hospitalization of patients with SARS-CoV disease is
recommended only if medically indicated, patients with less severe disease
will likely be isolated in personal residences and designated community
facilities. Therefore, appropriate infection control measures will be
required to prevent transmission of SARS-CoV in these facilities. The
goals for all settings are to:
- Ensure
early recognition of patients at risk for SARS-CoV disease.
- Prevent
transmission of SARS-CoV by implementing appropriate infection control
precautions.
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