Overview: Toronto SARS Outbreak

Publication: Medical Laboratory Observer
Publication Date: 01-FEB-07
Delivery: Immediate Online Access
Author: Poutanen, Susan M.

Article Excerpt
Whether it be a lab accident, release of a biologic weapon into the community, the next flu pandemic, or the next SARS (severe acute respiratory syndrome) outbreak, clinical laboratories must be prepared for possible biohazard and bioterror emergencies.

Clinical laboratories in Toronto faced such an emergency during the 2002-2003 SARS outbreak that affected 26 countries and was associated with 8,096 cases and 774 deaths worldwide. In Canada, 251 cases and 43 deaths were reported--the majority of which were hospital-acquired in various Toronto hospitals. Hospital-based labs were mostly affected; and while some had emergency plans, many only had drafts or no plans. All were faced with real-time decision making, adapting daily to the outbreak as it unfolded throughout the city. In the end, the outbreak was controlled and the majority of clinical laboratories have since reviewed their practices and implemented changes based on the many lessons learned from this experience. The impact that the SARS outbreak had on our laboratory and how we responded are presented here with a summary of what we did well and what we could have done better, and recommendations for laboratory biohazard or bioterror emergency planning and preparedness.

Overview: Toronto SARS Outbreak

In Canada, all hospitals and hospital-affiliated laboratories are government-funded. Our laboratory is an academic containment level-2 microbiology service shared between two large academic hospitals. At the time of the SARS outbreak, we had two sites--one housed within an academic hospital and one in an offsite building. We serve a total of nine Ontario hospitals with approximately 5,000 beds and five non-hospital clients. Approximately 40,000 specimens are processed per month.

On March 13, 2003, the World Health Organization (WHO) released an e-mail alert regarding a severe respiratory syndrome in Hong Kong and Vietnam. The following day, we became aware of patients with possible SARS in two of our client hospitals including the base hospital in which one of our sites was located. A local press release...

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