2 hospitals taking steps against SARS outbreak

Coughers to be required to wear surgical masks

October 17, 2003|By Jonathan Bor and Dennis O'Brien | Jonathan Bor and Dennis O'Brien,SUN STAFF

As federal officials weigh options to stem the spread of SARS within hospitals, two local medical centers will soon require that patients and visitors with coughs wear surgical masks.

Officials at St. Joseph Medical Center in Towson and St. Agnes HealthCare in Baltimore say they see masks as a way to protect health care workers and patients not only from severe acute respiratory syndrome, but also from flu and other airborne infections.

"We plan this to be for now and forever more," said Dr. Eric Toner, medical director of disaster preparedness at St. Joseph, which plans to start the policy Oct. 29. There, masks will be required of anyone -- whether patient, doctor, paramedic or visitor -- entering the emergency room with a cough.

Starting Nov. 1, St. Agnes plans to have signs at all entrances asking anyone with a cough to wear a surgical mask, which will be available in bins throughout the hospital. The hospital will also ask those with upper-respiratory symptoms to refrain from visiting patients in their rooms.

"Our thinking is the same thing -- it's the spread of infectious, contagious upper-respiratory infections and the very real possibility of a SARS outbreak," said Dr. Kevin Scruggs, the hospital's director of emergency medicine.

In outbreaks that began in February, 8,422 people contracted the mysterious respiratory disease -- mostly in Asia and Canada. Of those, 916 died. About a fifth of the total cases were health care workers who contracted the virus while tending to the sick.

There have been 192 cases in the United States and no fatalities, but doctors and health officials are bracing for the possibility that the disease could appear this winter. Among the concerns is the possible spread in hospitals.

Franklin Square Hospital Center in eastern Baltimore County has posted signs at the emergency room entrance since February suggesting that anyone with a cough or respiratory ailment wear a mask, said spokeswoman Trina Adams.

At St. Joseph, Toner said he starting thinking about requiring masks in the emergency room last year, but a recent advisory from the U.S. Centers for Disease Control and Prevention convinced him.

The recommendations include asking people with respiratory symptoms to cover their nose and mouth with tissues, making hand-washing products available in waiting areas, and offering masks to coughers.

The CDC will soon post a similar draft recommendation on its Web site and ask doctors and public health officials for input before issuing a final policy, said spokesman Elwin Grant.

Though hospitals have always been breeding grounds for infection, the appearances of AIDS and more recently the SARS epidemic have raised consciousness about the need to take simple precautions.

Whether SARS arrives in the area, Toner said the St. Joseph emergency room will likely be filled with mask-wearing patients with influenza or other viruses.

Johns Hopkins Hospital has begun posting signs asking people with respiratory symptoms to use tissue paper, wash their hands and ask for a mask if they have a fever. Dr. Trish Perl, director of infection control at the hospital, said Hopkins will begin to offer masks aggressively if a SARS outbreak occurs.

"We won't offer masks until we know there are SARS cases anywhere in the world," said Perl. Then, she said, masks will become an important weapon against SARS at Hopkins, which draws patients from all over the globe.

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