PDF SARS: A Case Study in Emerging Infections

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For instance, in response to the Ebola virus outbreak in West Africa in —, the CHP provided advice for the local hotel industry on receiving guests with a travel history or residence in an Ebola virus disease affected area. The guideline stressed the importance of enquiring about the travel history of guests and outlined procedures on handling these guests who may feel unwell. The guideline reiterated the need to keep a record of staff and residents who had stayed in the hotel, with their personal and contact details, for possible future public health actions and contact tracing [ 26 ].

Ideally, hotels should be setting their own standards of hygiene measures and providing training to staff before an outbreak occurs. Further roles and responsibilities included contingency arrangement, plan of acquisition of protective equipment, disease reporting and surveillance mechanism during outbreak period [ 27 ]. From our online and database internet search, however, there is little mention of collaboration between the government and the hotel industry. No documentation was found on setting up of task forces or committees, or of invitation to hotel representatives to the working group advising on infection control guidelines in Hong Kong.

SARS served as the classic example of how tourism and international travel can present challenges to the global health system. The spread of the illness within a single hotel and the subsequent international air travel of the victims contributed to and accelerated the speed of the spread of SARS across the globe. The experience from SARS in Hong Kong had a profound impact on the public health reform especially on the infectious disease surveillance and epidemic response [ 16 ].

These included strengthening the surveillance and the isolation and treatment of individuals with the disease according to case definitions, the establishment of communication channels between hotel and the government system, and the development of guidelines and response plans that allows the implementation of stringent infection control measures when necessary.

However, collaboration with the private sector and the hotel industry were found to be limited and focused around infection control measures. According to subsequently published literature, application of appropriate measures had likely reduced the number of people who were infected, requiring medical care and died during the influenza pandemic [ 29 ]. It has been shown that case isolation or household quarantine could have a significant impact at reducing attack rates in the community, and chemoprophylaxis can greatly reduce disease transmission during the pandemic [ 30 , 31 ].

However, the quarantine of guests at the Metropark Hotel in inevitably stirs up much discussion and controversy among the media and the public health community on the balance between the need to protect the public health and the need to safeguard civil liberties. The decision of quarantine created enormous tension between the government, guests and the hotel management. The decision of the need for quarantine and the scale of the quarantine needs to be scientifically justified. The negative effects overall of such a policy on the tourism attractiveness of a destination cannot be neglected.

The quarantine at the Metropark Hotel during swine flu also highlighted the extensive assistance needed for the quarantined persons, and the cooperation necessary in the possible future need for a hotel quarantine. Pre-established partnerships and coordination between the government and the hotel industry is key in epidemic preparedness and response. Studies have shown that the psychological impacts of SARS and the government restrictions on travel, had a great impact on the travel industry far beyond the region of SARS hit areas [ 32 ].

For the hotel industry in Hong Kong, the number of hotel guests dropped dramatically to a level that was never experienced before [ 33 ]. In order for hotels to sustain their business, the Hong Kong hotel industry adopted an industry-wide recovery effort and empathized on mutual support [ 26 ]. Previous papers called for a better preparedness of the hotel industry for future crises and epidemics [ 32 , 33 ]. Hotels are often the first point of contact for tourists arriving at a host country.

SARS Outbreak Study 1: Print Module

Hotels could provide an additional line of defence beyond entry border screening, and they could offer another layer of protection against illnesses that border screening processes may have missed, for example in the situation where travel occurs during the incubation period of an infectious disease. In view of this, the capacity of hotels in the detection of potential illness and the launching of an initial response should be fully recognised and utilised. The WHO pandemic influenza risk management recommended involving civil society and the private business sector in pandemic preparedness planning and national committees [ 34 ].

The case of hotel industry collaboration with the health sector in Hong Kong has the potential to provide a positive example of effective disaster risk reduction coordination.

Factors in the Emergence or Re-emergence of Infectious Diseases

The epidemic preparedness and infection control measures mounted against SARS and H1N1 swine flu demonstrated a role that needed to be filled by the hotel industry. During SARS, late recognition of the environmental contamination of hotel facilities and the failure of timely intervention on the hotel guests with close contact contributed to the spread of the disease internationally. While the appropriateness and best method of quarantine in future pandemic influenza warrants further research, the swine flu hotel quarantine exposed gaps in the partnership with hotel industry.

Health authorities in Hong Kong had since provided guidelines mostly in the area of disinfection and hygiene, and focused on educating hotel workers on basic hygiene to prevent the spread of infectious diseases. The potential to establish traveller screening, timely reporting and isolation for the infected guests during epidemics could be explored. The capacity of the hotel industry in controlling infections should be recognised not only in Hong Kong but also in other parts of the world.

All authors read and approved the final manuscript. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Kevin K.

Examples of How Diseases Emerge

Hung, Email: kh. Carman K. Mark, Email: moc. May P. Yeung, Email: kh. Emily Y. Chan, Email: kh. Colin A. National Center for Biotechnology Information , U. Journal List Global Health v. Global Health. Published online Nov Hung , 1, 2 Carman K. Mark , 2 May P. Yeung , 2 Emily Y. Chan , 1, 2 and Colin A. Graham 1, 2.

Emerging Infectious Diseases | Baylor College of Medicine | Houston, Texas

Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Jul 9; Accepted Nov Abstract Background The global travel and tourism industry has been rapidly expanding in the past decades. Methods This case study focuses on the epidemic outbreaks of SARS in and H1N1 swine flu in in Hong Kong, and the subsequent guidelines published by the health authority in relation to the hotel industry in Hong Kong which provide the backbone for discussion. Results The Metropole Hotel hastened the international spread of the SARS outbreak by the index case infecting visitors from Singapore, Vietnam, Canada as well as local people via close contact with the index case and the environmental contamination.

Conclusion Positive collaborations may bring about effective preparedness across the health and the tourism sectors for future epidemics. Keywords: Epidemics, Hotel industry, Infection control, International travel, Private sector engagement, Quarantine, Tourism, Health-related emergency disaster risk management. Background The global travel and tourism industry has expanded rapidly in recent years.

Results The search identified 34 records from MEDLINE of which five were relevant references [ 6 , 12 — 15 ] , and an additional 13 records were identified through other sources and the grey literature. DH ensured hotel management conducted proper cleansing and disinfection. Open in a separate window. All guests and staff were quarantined. Discussion SARS served as the classic example of how tourism and international travel can present challenges to the global health system.

Effects of epidemics on the hotel industry Studies have shown that the psychological impacts of SARS and the government restrictions on travel, had a great impact on the travel industry far beyond the region of SARS hit areas [ 32 ]. Collaborations with the hotel industry to mitigate the impact of epidemics Hotels are often the first point of contact for tourists arriving at a host country. Conclusions The epidemic preparedness and infection control measures mounted against SARS and H1N1 swine flu demonstrated a role that needed to be filled by the hotel industry.

Acknowledgements Not applicable. Funding No funding available for this study. Availability of data and materials Not applicable. Notes Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Contributor Information Kevin K. References 1. The World Bank. International tourism, number of arrivals. Accessed 29 May World Health Organization.

International Health Regulations. International travel and health.


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Infectious Disease Case Study

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Rapid response research to emerging infectious diseases: lessons from SARS

Severe acute respiratory syndrome: developing a research response. Stadler, K. SARS — beginning to understand a new virus. Nature Review Microbiology. Download references. We would like to thank all SAVI members for their dedication and commitment towards this rapid response initiative. We would also like to thank T. Conley and K. Roberts for graphic layout and design. Correspondence to B.


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  • Brett Finlay. To obtain permission to re-use content from this article visit RightsLink. Public Health Critical Reviews in Microbiology The American Journal of Bioethics Emerging Infectious Diseases Journal of General Virology Article metrics. Advanced search. Skip to main content. You are viewing this page in draft mode. Abstract New and emerging infectious diseases continue to plague the world, and there is significant concern that recombinant infectious agents can be used as bioterrorism threats.

    Rent or Buy article Get time limited or full article access on ReadCube. References 1. PubMed Article Google Scholar 3. Google Scholar 4. PubMed Article Google Scholar 5. PubMed Article Google Scholar Google Scholar Acknowledgements We would like to thank all SAVI members for their dedication and commitment towards this rapid response initiative. Author information Affiliations B. Brett Finlay Raymond H.