• Moira Chan-Yeung and W C Yu.
• Division of Respiratory and Critical Care Medicine, 4/F, Professorial Block, Queen Mary Hospital, University of Hong Kong, Hong Kong, SAR, China. mmwchan@hkucc.hku.hk
• BMJ. 2003 Apr 19; 326 (7394): 850-2.

ObjectiveTo describe the outbreak of severe acute respiratory syndrome in Hong Kong.DesignDescriptive case series.SettingHong Kong, Special Administrative Region, ChinaResultsThe outbreak started with a visitor from southern China on 21 February. At the hospitals where the first cases were treated the disease spread quickly among healthcare workers, and then out into the community as family members became infected. By 1 April, 685 cases had been reported with 16 deaths. Symptoms include high fever and one or more respiratory symptoms (including cough, shortness of breath, and difficulty breathing). Changes in lung tissue suggest that part of the lung damage is due to cytokines induced by the microbial agent, which has led to empirical treatment with corticosteroids, broad spectrum antiviral agent, and antibacterial cover. There is strong evidence that a novel coronavirus is the pathogen. Precautions for droplet infection should be instituted, including the wearing of masks and rigorous disinfection and hygiene procedures. On 27 March the Department of Health announced drastic measures, including vigorous contact tracing and examination, quarantine of contacts in their homes, and closure of all schools and universities.ConclusionThe rapidity of the spread of the disease and the morbidity indicate that the agent responsible is highly infectious and virulent. Strict infection control measures for droplet and contact transmission by healthcare workers, a vigilant healthcare profession, and public education are essential for disease prevention.

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