Precautions in ophthalmic practice in a hospital with a major acute SARS outbreak: an experience from Hong Kong W-M Chan 1; 2 , DTL Liu 1 , PKS Chan 3 , KKL Chong 1 , KSC Yuen 1 , TYH Chiu 1 , BSM Tam 1 , JSK Ng 1; 2 and DSC Lam 1; 2 Abstract Many new infectious diseases in humans have been derived from animal sources in the past 20 years. Some are highly contagious and fatal. Vaccination may not be available and antiviral drugs are not effective enough. Infectious control is important in clinical medicine and in Ophthalmology. Severe acute respiratory syndrome (SARS), as an example, is a highly contagious respiratory disease that has recently been reported in Asia, North America, and Europe. Within a matter of weeks, the outbreak has evolved to become a global health threat and more than 30 countries have been afflicted with a novel Coronavirus strain (SARS-CoV) that is the aetiologic agent of SARS. The primary route of transmission of SARS appears involving close person-to- person contact through droplets. Ophthalmologists may be particularly susceptible to the infection as routine ophthalmic examinations like direct ophthalmoscopy and slit-lamp examination are usually performed in a setting that has close doctor–patient contact. Being the Ophthalmology Department of the only hospital in the world that has just gone through the largest outbreak of SARS, we would like to share our strategy, measures, and experiences of preventing contracting or spreading of SARS infection as an infection control model. SARS is one of the many viruses against which personnel will need protecting in an ophthalmic setting. The experiences attained and the measures established might also apply to other infectious conditions spreading by droplets such as the avian influenza with H5N1. Eye (2006) 20, 283–289. doi:10.1038/sj.eye.6701885; published online 29 April 2005 Keywords: acute SARS outbreak; avian influenza A (H5N1) outbreak; infection control measures; ophthalmic practice precautions; Hong Kong Introduction Severe acute respiratory syndrome (SARS) is the ‘modern plague’ of the new era for its infectivity, novelty, casualty, and high fatality. 1,2 Hong Kong, Guangdong Province, some other provinces of China, Singapore, Taiwan, Vietnam, Canada, and the whole world are now under unprecedented threats from this deadly infectious disease. 1–8 The culprit virulent agent is believed to be a novel Coronavirus strain (SARS-CoV) that is not closely related to any of the previously characterized coronavirus, according to the World Health Organization (WHO) and local infection control experts. 4,5 The awful impact of this disease can be reflected by the alarming health-care statistics recorded since the massive outbreak in Hong Kong on March 12, 2003. The accumulative number of SARS infection by October 15, 2003 was 1755 with a total number of deaths of 299 and among them eight of the deceased were doctors, nurses, and health-care assistants. 7 SARS has unveiled many virgin health-care issues that have not caught the attention of the general public in the past and the whole health- care system in Hong Kong has been significantly percolated and bombarded by SARS in terms of changes in daily practices and everyday routines. Ophthalmology is no Received: 24 May 2004 Accepted: 22 February 2005 Published online: 29 April 2005 Financial and proprietary interest: Nil Financial support: Nil 1 Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China 2 Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China 3 Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People’s Republic of China Correspondence: DSC Lam, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F., Hong Kong Eye Hospital, 147 K Argyle Street, Kowloon, Hong Kong, People’s Republic of China Tel: þ 852 2762 3157; Fax: þ 852 2715 9490. E-mail: dennislam@ cuhk.edu.hk Eye (2006) 20, 283–289 & 2006 Nature Publishing Group All rights reserved 0950-222X/06 $30.00 www.nature.com/eye PERSPECTIVE