Preventing Severe Acute Respiratory Syndrome (SARS)
Guidelines for Hotels
On 23 June 2003, the World Health Organisation removed Hong Kong from its list of areas with recent local transmission of Severe Acute Respiratory Syndrome (SARS). While the Tourism Sector is preparing a number of promotional activities and offers to welcome visitors back, we must continue to be vigilant and take appropriate precautionary measures to safeguard our health as well as that of our visitors.
The Department of Health has formulated the following health guidelines for hotel operators. We need your participation to keep Hong Kong a clean and healthy place for its local residents as well as visitors from the mainland and abroad.
During Non-SARS period
1. Environmental hygiene
Floors and floor coverings
- Rooms should be maintained at a reasonable standard of cleanliness. Furniture items should be kept at a practical minimum.
- All surfaces should be cleaned at least daily using a 1:99 diluted
household bleach solution (1 part of bleach mixed with 99 parts
of water), rinsed, and dried. If surfaces are dirtied with vomit
or other body fluids, a 1:49 diluted household bleach solution
(1 part of bleach mixed with 49 parts of water) should be used
- It is best to dry all surfaces after cleaning as moisture attracts contaminants.
- Rubber gloves should be worn when cleaning involves the use of detergents or when cleaning surfaces which are very dirty e.g. contaminated by bodily secretions. After cleaning a guest room, the gloves should be washed thoroughly with soap and water as if they were your hands before proceeding to the next guest room. If the cleaning involves contact with body fluids, such as respiratory secretions, urine, faeces etc., the gloves should be washed with soap and water to remove any contaminants, and then soaked in a 1:49 diluted household bleach for at least 30 minutes before next use.
- Hands should be washed after undertaking cleaning activities.
- Public washrooms and food consumption/service areas should be
cleaned regularly, as determined by custom traffic and their use.
- Every washroom should be equipped with liquid soap, paper towels or hand dryers.
- Supervisors should undertake regular monitoring to ensure that existing hygiene standards are strictly enforced.
- Clean toilets of the guest rooms at least once a day with a 1:99 diluted household bleach solution.
- Wipe the rim, seat and lid of the toilet bowl with a 1:99 diluted household bleach solution, rinse with water and then wipe dry. Pour a teaspoon of the diluted household bleach solution into the toilet bowl after each wash or put a chlorine tablet into the toilet cistern for a longer disinfection effect as per the manufacturer's instructions.
- Clean floor drain outlets at least once a week to prevent putrid air and insects in the soil pipes from entering the premises. Pour about half a litre of water into the drain outlet followed by a teaspoon of a 1:99 diluted household bleach solution. After cleansing, spray insecticide into the floor drain outlets.
- Carpets or rugs/mats may be vacuumed using a cleaner that does
not throw dust into the air or steam cleaned if soiled with body
- Do not hang up and swat carpets or rugs/mats as this will create aerosols.
- Hard floor surfaces should be cleaned with wet vacuum systems. They leave the surface almost dry, reducing the risk of occupational health and safety hazard from wet floors.
- If wet vacuum systems are not available, hard floor surfaces should be damp mopped using a 1:99 diluted household bleach solution, rinsed and dried. A bucket with an attached wringer is preferred. Wringing by hand exposes staff to the risk of aerosols.
- These include items such as curtains, drapes, screens, lampshades and furniture items.
- They should be washed/wiped with a 1:99 diluted household bleach solution or steam cleaned regularly.
- If contaminated with body fluids, they should be washed/wiped with a 1:49 diluted household bleach solution immediately.
- Laundries should be washed at least daily. This process should involve cleaning all surfaces and all laundry machinery including washers, dryers and ironing presses, with detergent and warm water.
- Linen (sheets, pillowcases, cotton blankets) should be washed
in hot water (70 to 80oC) and detergent, rinsed
and dried preferably in a dryer or in the sun.
- Linen should be ironed at high temperatures (60oC).
- Linen should be changed at least twice a week and whenever a guest has checked out.
- Woollen blankets should be washed in warm water and dried in the sun, in dryers on cool temperatures or dry-cleaned.
- Quilts can be dry-cleaned. Where appropriate, quilts may be washed in hot water (70oC) and detergent, rinsed and dried preferably in a dryer or in the sun.
Lift cars and escalators
- Mattresses and pillows with plastic covers can be wiped with a 1:99 diluted household bleach solution.
- Mattresses without plastic covers may be steam cleaned if contaminated with body fluids.
- Pillows can be either washed using the standard laundering procedure described above, or dry cleaned if contaminated with body fluids.
- Wipe lift cars and escalators, particularly the call buttons and handrails with a 1:99 diluted household bleach solution at least four times a day.
- Clean lift ventilation vans regularly.
Common facilities and public toilets
- Wash and wipe building entrances, door knobs/handles with a 1:99 diluted household bleach solution at least four times a day.
- Wash and wipe chairs, resting areas and other facilities used by the public in the hotel and public toilets with a 1:99 diluted household bleach solution at least four times a day.
- Operators of restaurants should follow the guidelines and instructions on food safety and food premises hygiene issued by the Food and Environmental Hygiene Department (FEHD) so as to safeguard the health of the clients and to ensure that satisfactory standards are reached.
- The most updated guidelines and information are posted on the FEHD's website:
- Enquiries can be addressed by telephone at 2868-0000.
- Ventilation system should function properly and be regularly maintained.
- Air-conditioning systems should be cleaned according to the manufacturer's instructions.
- Filters should be changed or cleaned according to the manufacturer's instructions. If they are changed after a possible case of SARS, then the staff changing the filter must wear a full set of PPE .
- Hotel guests who have a fever, cough, respiratory symptoms or signs of infection should NOT use common showers, saunas, jacuzzis or spas (such as those provided in hotel health clubs or gyms) as a moist atmosphere will aggravate the spread of respiratory viruses.
- Strengthen the surveillance of the water quality and the disinfection system of the swimming pool. For swimming pools using ozone for disinfection, ensure that the water should contain not less than 0.5 parts per million (ppm) of chlorine. For swimming pools using chlorine for disinfection, ensure that the water should contain not less than 1.0 ppm of chlorine.
- The pH of the water of the swimming pool should maintain at a level between 7.2 and 7.8.
- A water sample of the swimming pool should be taken at least once a month for testing during opening hours to ensure that the chlorine level and the pH of the water met the above standard.
- Any persons with respiratory symptoms should be prohibited from swimming in the pool. Signs can be displayed in the swimming pool area to alert hotel guests of this restriction and to advise users not to spit or urinate in the pool.
- Should a staff member see any persons with respiratory symptoms in the swimming pool area, the staff should advise that person to leave the pool and to see a doctor as soon as possible.
- Wash and wipe general facilities of the gymnasium with a 1:99 diluted household bleach solution at least once daily. The frequency of cleaning should be stepped up if the facilities become dirty.
2. Personal hygiene of staff
- Smoking decreases the general resistance of the body and is harmful to health. To safeguard the health of guests and staff members, the hotel should be smoke-free or provide adequate smoke-free areas/rooms at no additional cost to the guest.
3. Guests coming from areas with local transmission of SARS
- All staff should observe strict personal hygiene.
- Wash hands frequently.
- Cover nose and mouth with tissue paper when sneezing or coughing.
- Change and wash uniform at least daily.
- If the staff feels unwell, he or she should see a doctor immediately and stay away from work as advised by the doctor.
Report any guest/staff member suspected to be infected with SARS to the Department of Health as soon as possible by telephone 187 2222.
During SARS period
- Guests should be advised to measure their own body temperature. Thermometers and assistance in temperature checking should be provided by the hotel if requested by guests. (see appendix 2)
- Should a guest develop fever, that is persistently having a body temperature at or above 37.5oC, the guest should inform the hotel staff, who should assist the guest to seek medical consultation immediately.
The cleaning procedures described above also apply. The supervisors
of the hotel should monitor closely the hygiene standard and step
up the standard as necessary. Below are some additional points to
observe during a SARS infected period:
- When laundering linen collected from a room where the guest is suspected to have SARS, the staff member should wear a full set of Personal Protective Equipment (PPE) (see appendix 1).
- In this circumstance, linen should not be sorted, shaken, or excessively handled to avoid the generation of contaminated aerosols. Linen should be placed gently into coded laundry bags and washing machines.
- Step up the frequency of taking water sample from the swimming pool from at least twice a day to every hour and consider closing the swimming pool temporarily when community infection rate is high.
- Measure the body temperature before work each day. If the body temperature is persistently at or above 37.5oC, the staff member should consult a doctor and refrain from work until recovery.
- Cleaning staff should wear masks, gloves and protective clothing.
- Staff members should wear masks and disposable gloves when handling food.
Thank you for your cooperation in providing a healthy and comfortable environment for tourists visiting Hong Kong.
Full Personal Protective Equipment (PPE) consists of:
- Face mask
- Plastic apron
- Coverall or gown
- Boots (may be required)
PPE should always be considered potentially contaminated following cleaning, and should be removed and disposed of in a proper manner.
Guidelines on Measuring Body Temperature
1. Ear thermometer
Tympanic (or eardrum) temperature accurately reflects core body temperature, since the eardrum shares the blood supply with the temperature control centre in the brain. It is also a faster method to measure core body temperature than taking oral temperature.
After each and every use, the used plastic ear-probe jacket should be discarded and a new one primed for the next measurement. The probe tip is the most delicate part of the thermometer and has to be clean and intact to ensure accurate readings.
If the ear thermometer reading is more than 37.5o
C, the person is likely to have a fever and should seek medical attention.
The following may affect the accuracy of the temperature measurement:
1.2 Trouble shooting
- Change of ambient temperature
- Wearing hearing aid
- After exercise
- Pressing the ear for a long time
- Presence of ear wax / obstruction in ear canal
Read and follow the instructions provided by the manufacturer of the
thermometer you purchased. Allow the thermometer to remain in the
room for 30 minutes where the temperature is between 10-40o
use. In general, ensure that a new ear-probe jacket is in use when
taking a temperature from a different person. If the guest is wearing
a hearing aid, advise him to take out his hearing aid and wait for
5 minutes before taking his measurement. A guest who has recently
exercised should wait for 5-10 minutes to cool down before taking
his measurement. If the guest is unwilling to be touched or take off
his/her veil, consider using the oral thermometer to check his/her
Use a soft, dry cloth to clean the thermometer display and exterior. Do not use abrasive cleaners. Probe head should only be cleaned with alcohol. Store the thermometer and ear-probe jackets in a dry location free from dust and contamination and away from direct sunlight.
2. Handheld Infrared thermometer
Read and follow the instructions provided by the manufacturer of the thermometer you purchased. Always make sure that the battery is inserted properly in the "handle" of the handheld infrared thermometer. Point the scan at the forehead of the guest from the right distance (2.5cm). Press the "trigger" for a few seconds to take the temperature reading. No reset is necessary when taking the next measurement.
If the scan reading is 36o
C or above, ear thermometer and/or oral thermometer
should be used to ascertain the guest's body temperature. If the reading
is too low ( under 32o
C), you may have pointed at the wrong position.
Repeat the measurement and try to aim at the guest's forehead. If
the guest's forehead is covered by a hat/cap/hair, ask the guest to
take off the hat/cap or pull the hair back. If the guest is unwilling
to do so, consider using the ear or oral thermometer to check his/her
3. Mercury Oral Thermometer
Read and follow the instructions provided by the manufacturer of the
thermometer you purchased. Shake the thermometer so that the mercury
line is below 35C before and after every use. Use a new sterile sleeve
for each guest. Remove the sleeve from the thermometer when taking
the reading. Wipe and sterilize the thermometer after every use.
4. Forehead Thermometer
Read and follow the instructions provided by the manufacturer of the thermometer you purchased.
5. Instructions to operators
- The thermometer should be used indoor at room temperature.
- For accurate measurement, do not take temperature if the guest has been eating, drinking or exercising within the previous 30 minutes.
- After use, clean the thermometer with alcohol wipe, and store it in its protective case and keep out of sunlight.
The operator should wear a mask and gloves at all times for self protection. Masks and gloves should be replaced immediately if soiled. Sterile non-contact technique should be observed as far as possible.
The operator should observe good personal hygiene by washing hands frequently with soap and water or using 70% alcohol handwipes or spray. The operator should communicate clear instructions to the guests on his/her intended procedures. He/she should remain courteous and professional at all times.
Practice makes perfect. Try to practise on each other when you are first learning to use the equipment, especially the ear thermometer. The operator should seek the advice of the supervisor if in doubt.
9 September 2003