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Infection control and anesthesia: lessons learned from the Toronto SARS outbreak

[La lutte anti-infectieuse et l’anesthésie : les leçons de l’éclosion du SRAS à Toronto]

Philip W.H. Peng, MBBS FRCPC^*, David T. Wong, MD^*, David Bevan, MB MRCP FRCA FRCPC^* and Michael Gardam, MD CM MSC FRCPC^,

^* From the Departments of Anesthesia,
and Medicine, University Health Network, University of Toronto;
and the Infection Control and Prevention Unit, University Health Network, Toronto, Ontario, Canada.

Address correspondence to: Dr. Philip Peng, Department of Anesthesia, Toronto Western Hospital, EC 2-046, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Phone: 416-603-5118; Fax: 416-603-6494; E-mail: philip.peng{at}uhn.on.ca

Purpose: To describe the outbreak of severe acute respiratory syndrome (SARS) in Toronto, its impact on anesthesia practice and the infection control guidelines adopted to manage patients in the operating room (OR) and to provide emergency intubation outside the OR.

Clinical features: The SARS outbreak in Toronto was the result of a single index patient. The causative virus, SARS-CoV, is moderately contagious, and is spread by droplets and contact. The virus gains access to host through the mucosa of the respiratory tract and the eyes. It can affect both healthy and compromised patients. The use of several precautionary measures such as goggles, gloves, gowns and facemasks and the application of various infection control strategies designed to minimize the spread of the virus are discussed.

Conclusion: In containing the spread of SARS, vigilance and strict infection control are important. This results in the rediscovery of standards of infection control measures in daily anesthesia practice.

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