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CORD-19:f820e5c342b0e3ce1af0905b69ebea927865a809 JSONTXT 23 Projects

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Id Subject Object Predicate Lexical cue
T1 0-54 Sentence denotes Post-SARS infection control in the hospital and clinic
T2 56-64 Sentence denotes Abstract
T3 67-250 Sentence denotes SARS is a new devastating disease, the understanding of which is still evolving and includes its clinical syndromes, infectivity and transmissibility, optimal treatment and prognosis.
T4 251-394 Sentence denotes Children are less commonly infected than adults, they have milder disease, are less infectious and present with non-specific clinical features.
T5 395-464 Sentence denotes However, severe illness can develop in adolescents and young infants.
T6 465-717 Sentence denotes 1,2 Detailed infection control guidances on SARS have been prepared by WHO, US Center for Disease Control, Health Canada, Health Protection Agency of UK, Ministry of Health Singapore, CDC of China, CDC of Taiwan and the Hospital Authority of Hong Kong.
T7 718-805 Sentence denotes A comprehensive review and account of infection control measures will not be attempted.
T8 806-932 Sentence denotes This article makes special reference to children, is based on personal experience and on local systems developed in Hong Kong.
T9 933-1032 Sentence denotes It may need modifying to suit local situations and will need to be updated as new knowledge arises.
T10 1033-1126 Sentence denotes The incubation as reported by most countries is said to be 4-6 days, with a mean of 4.6 days.
T11 1127-1240 Sentence denotes 3 Analysis of cases in Hong Kong revealed that the incubation period lies from 4-10 days with a mean of 6.4 days.
T12 1241-1305 Sentence denotes 4 The main mode of transmission differed in different countries.
T13 1306-1476 Sentence denotes Using mathematical and statistical models it was estimated that 71.1% and 74.8% of SARS infections in Hong Kong and Singapore were attributable to super-spreading events.
T14 1477-1559 Sentence denotes 5 It is not known whether the route of transmission affects the incubation period.
T15 1560-1821 Sentence denotes PAEDIATRIC Summary The recent severe acute respiratory syndrome (SARS) outbreak has almost mandated a re-evaluation of infection control practices in hospitals, clinics, schools and domestic environments, especially for patients with respiratory tract symptoms.
T16 1822-1925 Sentence denotes Triage, early case detection followed by prompt isolation and quarantine are major preventive measures.
T17 1926-2092 Sentence denotes Respiratory tract infections are the most common childhood illnesses and paediatric SARS poses special problems in diagnosis because of its non-specific presentation.
T18 2093-2451 Sentence denotes The main lessons learnt from the outbreak were: (1) despite well established guidelines on infection control precautions, poor understanding of underlying principles and deficiencies in compliance are common among healthcare professionals, especially during emergencies; (2) even a slight lapse can be fatal; and (3) over-protection can be counterproductive.
T19 2452-2849 Sentence denotes Hence it is important to: (1) be protected to protect others; (2) be vigilant and prepared for emerging infections; (3) be proficient and scrupulous in infection control measures; (4) be apposite and practical on personal protective equipments to ensure sustainability; and (5) be dutiful and prompt in informing of potential threats and work closely with others. ß 2004 Published by Elsevier Ltd.
T20 2850-2969 Sentence denotes SARS-coronavirus (CoV) can be found in respiratory secretions, saliva, tears, blood, urine and faeces of SARS patients.
T21 2970-3079 Sentence denotes SARS-CoV is stable in the environment for up to 2 days at room temperature and longer at a lower temperature.
T22 3080-3306 Sentence denotes Survival in a variety of stool suspensions varies depending on the pH, consistency of the stool and possibly other factors (up to 4 days in alkaline, diarrhoeal stool, 6 h in normal stool and 3 h in normal, acidic baby stool).
T23 3307-3461 Sentence denotes The virus loses infectivity after exposure to different commonly used disinfectants (including alcohol and hypochlorite), and heating at 56 8C for 15 min.
T24 3462-3669 Sentence denotes Based on RT-PCR data, 36% of nasopharyngeal aspirate (NPA)/nasal throat swabs tested positive for virus on days 0-2, peaking at 61% positive on days 9-11, declining to 35% on days 15-17 and are 0% by day 23.
T25 3670-3801 Sentence denotes However, 0-22% of stools tested positive for the virus on days 0-2, peaking at 100% on days 12-14 and falling to 50% by days 21-23.
T26 3802-3975 Sentence denotes Detection of viral RNA has a much lower yield from serum, with only 19% testing positive on days 0-2, peaking at 39% on days 6-8 of illness and being undetectable by day 12.
T27 3976-4129 Sentence denotes Viral excretion in NPA and stool peaked on days 12-14 but viral load in NPA specimen was at two orders of magnitude lower than viral excretion in stools.
T28 4130-4341 Sentence denotes Hence, respiratory specimens including nasopharyngeal aspirates, throat swabs or sputum samples were the most useful clinical specimens in the first 5 days of illness, after this stools would be the best choice.
T29 4342-4498 Sentence denotes 6 Infectivity is greatest in the second week of the illness, including those with severe illnesses, but patients can be infective within the first 1-2 days.
T30 4499-4647 Sentence denotes There is no reported instance of transmission before the onset of symptoms of the disease and transmission after the second week of illness is rare.
T31 4648-4688 Sentence denotes The size of coronavirus is about 0.1 mm.
T32 4689-4785 Sentence denotes Sneezing could have an ejection velocity of up to 30 metres per sec and cough 35 metres per sec.
T33 4786-4890 Sentence denotes The number of droplets produced from coughing is about 40 000, talking produces 10 000 and singing 1000.
T34 4891-4930 Sentence denotes Droplet size varies from 50 mm to 3 mm.
T35 4931-5048 Sentence denotes Large droplets do not travel far and usually settle within 2 metres but droplets of 3 mm can stay in the air for 3 h.
T36 5049-5195 Sentence denotes With forced ejection a good portion of these droplets can be evaporated rapidly, especially under low humidity and they may suspend in air longer.
T37 5196-5390 Sentence denotes Using fluorescentstained water, it was demonstrated that toilet seats had significant contamination by droplets after flushing and the aerosol effect can be up to the standing height of a child.
T38 5391-5696 Sentence denotes 7 Huge amounts of submicron (0.3-0.5 mm) aerosols can be generated from drainage flow, in the order of 60 000 per litre of air in the domestic sewage drainage system of high rises, suggesting that airborne transmission is possible from the empty U-traps and pipes leaking and containing infectious agents.
T39 5697-5698 Sentence denotes 8
T40 5700-5816 Sentence denotes The primary mode of transmission is by direct mucous membrane (eyes, nose and mouth) contact with infectious agents.
T41 5817-5928 Sentence denotes The main routes are through contaminated hands or direct exposure to respiratory droplets -contact and droplet.
T42 5929-6028 Sentence denotes The basic reproduction ratio of three is consistent with the main mode of transmission by droplets.
T43 6029-6132 Sentence denotes However, airborne transmission of SARS can indeed occur in hospital and in community housing complexes.
T44 6133-6257 Sentence denotes 9 Infected cases occurred primarily in persons in close contact with ill SARS patients in healthcare and household settings.
T45 6258-6444 Sentence denotes Transmission to casual and social contacts has occasionally occurred, especially as a result of intense exposure to SARS patients eg. in lifts, in the workplace, on airlines or in taxis.
T46 6445-6494 Sentence denotes Transmission from children to adults is uncommon.
T47 6495-6857 Sentence denotes 3,10 The attack rate for children was found to be lower than adults among quarantined close contacts in Beijing (5% in children <10 years of age, 11.4% in those between 30 and 39 years of age and 27.6% in those aged between 60 and 69 years) 11 There was no report of SARS transmission in schools both in Hong Kong and China where the outbreak was most extensive.
T48 6858-6965 Sentence denotes A cluster of nine mild paediatric patients had been reported in a private boarding school for 820 students.
T49 6966-7048 Sentence denotes All lived in the same building and ate daily meals together in the school canteen.
T50 7049-7196 Sentence denotes 12 Congenital and perinatal infection have not been documented in the 12 pregnancies reported in Hong Kong, 13 nine in China 14 and one in the USA.
T51 7197-7350 Sentence denotes 15 In hospital settings, aerosolised respiratory secretions and direct contact with patients' secretion, excreta and fomites are other amplifying events.
T52 7351-7520 Sentence denotes The role of faecal-oral transmission is unknown but is probably of some significance as profuse watery diarrhoea is common and large amounts of virus are found in stool.
T53 7521-7583 Sentence denotes There have been no reports of food or waterborne transmission.
T54 7584-7749 Sentence denotes The role of contaminated fomites in transmission is uncertain but must not be under estimated as the virus can survive for days at room temperature on most surfaces.
T55 7750-7843 Sentence denotes In one report of 193 emergency department workers exposed to SARS, nine (4.7%) were infected.
T56 7844-7923 Sentence denotes Pneumonia developed in six, two had mild illness and one remained asymptomatic.
T57 7924-8074 Sentence denotes 16 The emergency department is a high-risk area because of its nature of trauma, heavy workload, crowded environment and lack of isolation facilities.
T58 8075-8151 Sentence denotes There were at least two outbreaks in community clinic settings in Hong Kong.
T59 8152-8294 Sentence denotes In one, a nurse was first infected by a SARS patient attending the clinic and subsequently infected two other nurses, the doctor and his wife.
T60 8295-8405 Sentence denotes In the second, a doctor was found to be infected on contact tracing of a household cluster of four SARS cases.
T61 8406-8490 Sentence denotes On further case tracing two more of the doctor's patients were found to be infected.
T62 8491-8786 Sentence denotes 17 Despite great concerns, compliance to infection control precautions by community general practitioners in Hong Kong lagged behind their hospital counterparts -97.7% had not worn masks at all times, a third did not wash their hands after seeing/examining a patient and half did not wear gowns.
T63 8787-9024 Sentence denotes Three-quarters did not wear goggles during patient encounters, just over half insisted patients wore masks during their consultation and over 10 doctors (12.4%) who were diagnosed with suspected or probable SARS had closed their clinics.
T64 9025-9126 Sentence denotes 18 However, the sample size is small and may not be representative of community doctors in Hong Kong.
T65 9127-9310 Sentence denotes Healthcare workers (HCWs) working in small clinics are of particular concern because of their small size and lack of adequate decontamination facilities and a good ventilation system.
T66 9311-9374 Sentence denotes Ingenious designs have been developed by some to overcome this.
T67 9375-9795 Sentence denotes The rate of transmition of the disease to their household contacts were 26.1%, 9.8% and 0% in non-healthcare workers, healthcare workers infected before the use of protective equipments and healthcare workers infected after the use of protective equipments respectively, indicating that use of protective equipments, adhering to infection control precautions and early quarantine were effective in stopping transmission.
T68 9796-9963 Sentence denotes 19 A similar study in Singapore also found that HCWs had a lower rate of household transmission but that their secondary household transmission rate was higher (6.2%).
T69 9964-10072 Sentence denotes 20 Phasing of illnesses is probably the reason for a much higher transmission rate in healthcare facilities.
T70 10073-10355 Sentence denotes In a study of 1192 patients with probable SARS reported in Hong Kong, 26.6% were hospital workers, 16.1% were members of the same household as SARS patients, 14.3% were Amoy garden residents, 4.9% were in-patients and 9.9% were contacts of SARS patients who were not family members.
T71 10356-10389 Sentence denotes Using multivariate analysis of 1:
T72 10390-10580 Sentence denotes 2 matched casecontrols of the remaining cases of undefined sources of infection, it was found that having visited mainland China, hospitals or the Amoy Gardens were significant risk factors.
T73 10581-10724 Sentence denotes In addition, frequent mask use in public venues, frequent hand washing and disinfection of living quarters were significant protective factors.
T74 10725-10875 Sentence denotes 21 A similar study conducted in Beijing on 94 unlinked probable SARS cases also showed that clinical SARS was associated with visits to fever clinics.
T75 10876-10984 Sentence denotes 22 These indicate that household transmission is much less common and should allay public anxiety and panic.
T76 10985-11057 Sentence denotes The main infection control measures are droplet and contact precautions.
T77 11058-11173 Sentence denotes Practices in paediatric and neonatal wards in Hong Kong that were utilised during the outbreak were well described.
T78 11174-11408 Sentence denotes 23, 24 It is important that strict hand hygiene and adequate decontamination be performed after each direct or potential exposure to patients and at any time that body parts are perceived to be contaminated by patients' bodily fluids.
T79 11409-11500 Sentence denotes A shower after high-risk procedures and before leaving duty would have been most desirable.
T80 11501-11670 Sentence denotes The employment of a 'policing nurse' had been found to be very effective in ensuring compliance to infection control precautions and procedures during the SARS epidemic.
T81 11671-11844 Sentence denotes While N95 masks have higher filtration efficiency compared with surgical masks, they have lower breathability, higher thermal stress, more discomfort and cause more fatigue.
T82 11845-12239 Sentence denotes 25 CDC recommended the use of N95 (95% filtration of 0.1 mm sodium chloride particles at a flow rate of 85 l/min), 26 the EU recommended the use of FFP2 or FFP3 masks (which had a filtering efficiency of 92% and 98% respectively, tested at 95 l/min with 0.1 mm sodium chloride particles) and Canada N100 respirators (filtering efficiency of 99.97% for mono-dispersed particles of size 0.12 mm).
T83 12240-12477 Sentence denotes 27 A full face respirator with an ultra-low penetrating air filter has also been recommended for its higher efficiency, good fit and protection of the mucous membranes but the disadvantage is cost, cleaning, disinfection and maintenance.
T84 12478-12555 Sentence denotes 28 N95 masks should be test-fitted and the same model used whenever possible.
T85 12556-12664 Sentence denotes A check fit should be performed each time one puts on the respirator and before entering the patient's room.
T86 12665-13040 Sentence denotes In a study looking into factors affecting nosocomial infection in Hong Kong, it was found that all HCWs consistently used N95s or surgical masks and perceived that the inadequacy of personal protective equipment (PPE) supply, infection control training <2 h and inconsistent use of goggles, gowns, gloves and caps were significant independent risk factors for SARS infection.
T87 13041-13134 Sentence denotes 29 The wearing of masks, gowns and goggles does pose considerable stress and fatigue to HCWs.
T88 13135-13201 Sentence denotes Comfort and usability are other important issues to be considered.
T89 13202-13255 Sentence denotes Masks can also affect visibility and patient rapport.
T90 13256-13325 Sentence denotes The psychological impact of masking on children has not been studied.
T91 13326-13399 Sentence denotes In low-risk times and areas, surgical masks would probably be sufficient.
T92 13400-13590 Sentence denotes It would be useful to have children wearing a surgical mask of appropriate size when they have respiratory symptoms, though the risk of transmission is considered to be lower than in adults.
T93 13591-13695 Sentence denotes The associated discomfort may make it difficult to continue wearing the masks for a long period of time.
T94 13696-13823 Sentence denotes With education, most children can be taught to put on a mask, at least when being examined or nursed and when outside the room.
T95 13824-13891 Sentence denotes Prescribed eye glass is not sufficient to protect against splashes.
T96 13892-14040 Sentence denotes Face shields should be sufficient for most pro-cedures unless excess splashes or direct coughing is expected, in these cases goggles should be worn.
T97 14041-14100 Sentence denotes Full face masks and hoods are more cumbersome alternatives.
T98 14101-14355 Sentence denotes PPC are essential elements of infection control precautions, but which type of the available PPC provide better protection in terms of water repellency, water resistance, risk of environmental contamination, usability and comfort has not been determined.
T99 14356-14491 Sentence denotes It is important to identify risk factors for non-compliance and design interventions and routines that are sustainable and practicable.
T100 14492-14631 Sentence denotes In a study comparing different types of PPC available in Hong Kong, the use of a surgical gown in ordinary work procedures was recommended.
T101 14632-14742 Sentence denotes When heavy splashes or droplets are expected, an additional plastic apron should be worn to protect the trunk.
T102 14743-14801 Sentence denotes 30 It is important that PPC should be removed when soiled.
T103 14802-14960 Sentence denotes Due care should be taken to avoid contamination of the environment and PPC should only be worn when needed and removed immediately on leaving isolation rooms.
T104 14961-15006 Sentence denotes Great care should be taken when removing PPC.
T105 15007-15099 Sentence denotes Lack of appropriate PPC removal procedures can lead to lapses in infection control measures.
T106 15100-15239 Sentence denotes This should be done outside the patient's area and with adequate spacing to avoid cross contamination and contamination of the environment.
T107 15240-15309 Sentence denotes Mirrors would be helpful so that one can observe the whole procedure.
T108 15310-15429 Sentence denotes One must avoid contamination of the nose, mouth and eyes while removing the cap, gown, gloves, mask and eye protectors.
T109 15430-15504 Sentence denotes There are several sets of recommendations on the sequence of removing PPC.
T110 15505-15607 Sentence denotes The one recommended by the National Institute for Infectious Diseases in Italy is probably the safest.
T111 15608-15693 Sentence denotes 31 The essentials are that the procedures are clear, consistent and simple to follow.
T112 15694-15806 Sentence denotes The use of shoe covers is controversial and was not used in several hospitals in Hong Kong during the epidemics.
T113 15807-16040 Sentence denotes Stringent infection precautions, especially for high-risk procedures, appropriate triage and prompt isolation of potential SARS patients will contribute to the control of nosocomial spread and acquisition of HCW in hospital settings.
T114 16041-16291 Sentence denotes 23, 24, 32 In a retrospective case control study of 91 intubations, risk factors for infection included difficult intubation (OR 8.8), extensive bagging (OR 25.9), intubation in a general ward environment (OR 8.2) and extensive droplet contamination.
T115 16292-16460 Sentence denotes 33 Before performing high-risk pro-cedures including CPR, intubation etc, one must ensure adequate protection in appropriate and properly equipped isolation facilities.
T116 16461-16549 Sentence denotes Call for help if alone and choose the right technique before embarking on the procedure.
T117 16550-16680 Sentence denotes 34 The analogy of putting on your own oxygen mask before attending to others while in air flight emergencies should be remembered.
T118 16681-16797 Sentence denotes Neubulisation, bronchoscopy induced sputum collection and face mask ventilation should be avoided as far a possible.
T119 16798-16911 Sentence denotes If medically indicated, they should be undertaken in a negative pressure room with minimal but adequate staffing.
T120 16912-17006 Sentence denotes All staff should be in PPC covering the torso, arms and hands as well as eyes, nose and mouth.
T121 17007-17076 Sentence denotes N95s, N-99s or N-100s are adequate but full face masks are desirable.
T122 17077-17206 Sentence denotes However, the use of powered air purifying respirators is not recommended because of risk to self and environmental contamination.
T123 17207-17311 Sentence denotes The use of a face mask with a good fit and attached valved manifold may reduce the risk of transmission.
T124 17312-17421 Sentence denotes 35 No infection has been attributed to the taking of nasopharyngeal aspirate from SARS patients in Hong Kong.
T125 17422-17496 Sentence denotes When performed it should be taken in a single room while wearing full PPC.
T126 17497-17628 Sentence denotes A new upper respiratory tract irrigation method has been devised to replace nasopharyngeal aspirate testing, which should be safer.
T127 17629-17708 Sentence denotes 36 The disadvantage of this method is that it cannot be used in young children.
T128 17709-17898 Sentence denotes Early recognition followed by prompt initiation of isolation and infection control precautions are the most important strategies for controlling SARS and other emerging infectious diseases.
T129 17899-17989 Sentence denotes Clinical features alone cannot reliably distinguish SARS from other respiratory illnesses.
T130 17990-18108 Sentence denotes Having an epidemiological linkage was the most consistent finding (95.5%) in children infected with SARS in Hong Kong.
T131 18109-18327 Sentence denotes 37 Combining clinical findings and epidemiological linkage or clustering of cases and interpreting clinical findings with key epidemiological risk factors serves as a good framework for triage, especially for children.
T132 18328-18502 Sentence denotes Precise and timely information about these epidemiological risks should be provided, coupled with proper training of frontline healthcare professionals on its interpretation.
T133 18503-18733 Sentence denotes A predictive model basing on a four-item clinical score of cough before or concomitant with fever, myalgia, diarrhoea and rhinorrhoea or sore throat had a 100% sensitivity and 75.9% specificity of early detection of probable SARS.
T134 18734-18820 Sentence denotes The addition of lymphopaenia and thrombocytopaenia increased the specificity to 86.2%.
T135 18821-19202 Sentence denotes 38 In another model, a scoring system of attributing 11, 10, 3, 3 and 3 points to the presence of independent risk factors of epidemiological link, radiographic deterioration, myalgia, lymphopaenia and elevated ALT respectively, generated high- (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) and low-(0-10) risk scores for SARS.
T136 19203-19334 Sentence denotes The sensitivity and specificity of this prediction rule in positively identifying a SARS patient were 97.7% and 81.3% respectively.
T137 19335-19389 Sentence denotes 39 The prediction rule could be useful at the bedside.
T138 19390-19500 Sentence denotes However, these studies were conducted in adult patients and would need to be validated in paediatric patients.
T139 19501-19611 Sentence denotes Other clinical guidance has also been developed but again is probably only applicable to the adult population.
T140 19612-20460 Sentence denotes 40 The case definition for clinical SARS used by Leung et al. in Hong Kong was: fever (rectal temperature of 38.58C or oral temperature of 388C); chest radiograph (CXR) findings of pulmonary infiltrates or acute respiratory distress syndrome; and suspected or probable contact with a person under investigation for SARS or exposure to a locality with suspected or documented community transmission of SARS through either travel or residence within 10 days of the onset of symptoms, as well as 1 of the following: chills, malaise, myalgia, muscle fatigue, cough, dyspnoea, tachypnoea, hypoxia, lymphopenia, decreasing lymphocyte count, or failure to respond, in terms of fever and general well-being, to antibiotics covering the usual pathogens of community-acquired pneumonia (e.g. a broad-spectrum lactam plus a macrolide) after 2 days of therapy.
T141 20461-20604 Sentence denotes This case definition had a sensitivity and specificity of 97.8% and 92.7% respectively in identifying paediatric SARS during the SARS outbreak.
T142 20605-20862 Sentence denotes 36 While almost all reported patients with laboratory evidence of SARS have radiographic evidence of pneumonia at some point during their illness, paediatric SARS have non-specific radiographic features, making it difficult for radiological differentiation.
T143 20863-21177 Sentence denotes 41 A private general clinic participating in the SARS-screening programme in Hong Kong during the SARS epidemic -by using telephone triage followed by chest radiograph of cases with 'flu-like' illness, the author successfully and safely screened 1161 attendees, X-rayed 151 patients and diagnosed one case of SARS.
T144 21178-21259 Sentence denotes Therefore, a chest X-ray (CXR) would be a useful screening tool during outbreaks.
T145 21260-21459 Sentence denotes 42 A SARS and avian influenza algorithm for early recognition and investigation of potential paediatric cases, modified from the UK Health Protection Agency's algorithm, is suggested in the Appendix.
T146 21460-21462 Sentence denotes 40
T147 21464-21544 Sentence denotes Negative pressure rooms are recommended for the isolation of patients with SARS.
T148 21545-21735 Sentence denotes However, it should be noted that negative pressure rooms only prevent the virus from travelling outside the room and may not reduce viral load or environmental contamination inside the room.
T149 21736-21881 Sentence denotes Several designs such as low level suction and laminar flow have tried to reduce the viral load inside the room but the effectiveness is unproven.
T150 21882-22117 Sentence denotes 43 Various devices such as portable/mobile local exhaust ventilation devices, tents and personal isolation systems have been designed and tested but the usability, risk of contamination of staff and effectiveness are still under study.
T151 22118-22270 Sentence denotes 44, 45 A rethink on the best design for effective infection control which also improves clinical and psychological care of patients is very much needed.
T152 22271-22395 Sentence denotes No matter how good the design this cannot replace preparedness, a good clinical routine and appropriate personal protection.
T153 22396-22501 Sentence denotes Elaborate ventilation designs and negative pressure systems would be difficult in most clinical settings.
T154 22502-22631 Sentence denotes Exhaust fans and mobile local exhaust ventilation devices with HEPA filters have been used in hospitals and clinics in Hong Kong.
T155 22632-22667 Sentence denotes Their efficacy has not been tested.
T156 22668-22980 Sentence denotes Several ingenious barrier precaution designs have been made by local medical practitioners: a torch mounted to a face shield for throat examination; cling film wrapping of telephones, keyboards and medical instrument to facilitate cleaning; and home-made air powered helmet hoods or tents for high-risk patients.
T157 22981-23085 Sentence denotes These have not been tested and cannot replace hand hygiene, appropriate PPC and regular decontamination.
T158 23086-23311 Sentence denotes While having adequate infection control equipment and facilities are important, overcrowding or inadequate bed/ clinic spacing or triage rooms and insufficient manpower are two major risk factors for hospital cross infection.
T159 23312-23577 Sentence denotes Having clear clinical guidelines and timely information are essential but it is it even more important that everyone has adequate information and proper training, practice and enforcement on infections and infection control starting in schools and in the community.
T160 23578-23637 Sentence denotes Panic and fear can be more harmful than the disease itself.
T161 23638-23815 Sentence denotes SARS and avian flu have taught us that infections are not just a problem for healthcare professionals, they involve everyone of all ages within communities throughout the world.