Abstract
Severe Acute Respiratory Syndrome (SARS) is a newly described infectious disease caused by a coronavirus. Two outbreaks occurred in Toronto in the spring of 2003, resulting in the closure of 3 hospitals, including 2 obstetrical units.
Strategies, devised using information about the coronavirus available at the time as well as epidemiologic and infectious disease containment measures were initiated to protect obstetrical patients and staff. In the first outbreak, the obstetrical unit of an affected Toronto hospital was kept open while other clinical services were closed. In the second outbreak, the obstetrical unit was closed along with all other clinical activities. This report details the stepwise processes used to make decisions during the SARS outbreaks and the implementation of the decisions made. It is recommended that these or similar protocols be used when an obstetrical unit is confronted with a large-scale nosocomial infectious outbreak that has a mechanism of transmission similar to that of SARS.
Key Words: Obstetrics, SARS, infectious outbreaks, nosocomial infections, contagious diseases
Résumé
Le syndrome respiratoire aigu sévère (SRAS) est une nouvelle maladie infectieuse causée par un coronavirus. Deux flambées épidémiques se sont produites à Toronto, au printemps de 2003, et ont forcé la fermeture de 3 hôpitaux, y compris 2 unités d’obstétrique.
À partir de l’information disponible à l’époque sur le coronavirus on a mis en place des straté,gies et des mesures de confinement des épidémies et des maladies infectieuses, dans le but de protéger les patientes et le personnel des services d’obstétrique. Lors de la première flambée, l’unité d’obstétrique d’un hôpital de Toronto affecté est demeurée ouverte, alors que les autres services cliniques étaient fermés. Au cours de la seconde flambée l’unité d’obstétrique en question a été fermee tout comme tous les autres services cliniques. Le présent rapport présente les étapes du processus mis en place pour la prise de décision pendant les flambées épidémiques du SRAS et pour l’application des décisions prises. Nous recommandons l’utilisation de ce protocole ou d’un protocole semblable lorsqu’une unité d’obstétrique fait face à une flambée infectieuse nosocomiale de grande envergure dont le mode de transmission est comparable à celui du SRAS.
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