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Multiple cases of suspected Severe Acute Respiratory Syndrome (SARS) have occurred in healthcare personnel who had cared for other patients with SARS. During the course of the investigation, CDC has received anecdotal reports that aerosol-generating procedures may have facilitated transmission of the etiologic agent of SARS in some cases. Procedures that induce coughing can increase the likelihood of droplet nuclei being expelled into the air. These potentially aerosol-generating procedures include aerosolized medication treatments (e.g., albuterol), diagnostic sputum induction, bronchoscopy, airway suctioning and endotracheal intubation.
For this reason, healthcare personnel should ensure that patients have been evaluated for SARS before initiation of aerosol-generating procedures. Evaluation for SARS should be based on the most recent case definition for SARS, see: http://www.cdc.gov/ncidod/sars/casedefinition.htm
Aerosol-inducing procedures should be performed on patients who may have SARS only when such procedures are deemed medically necessary. These procedures should be performed using airborne precautions as previously described for other infectious agents, such as Mycobacterium tuberculosis; "Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities" found at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00035909.htm
In summary, healthcare personnel should apply standard, (e.g., hand hygiene), airborne (e.g., respiratory protective devices with a filter efficiency of greater than or equal to 95%), and contact (e.g., gloves, gown, and eyewear) precautions when aerosol-generating procedures are being performed on patients who may have SARS.
Other information on appropriate infection control precautions for patients with suspected SARS can be found at: http://www.cdc.gov/ncidod/sars/infectioncontrol.htm