Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

Autor:	Tai Hing Lam, Lai-Yin Tse, Azra C. Ghani, King Pan Chan, Anthony J. Hedley, Thomas Tsang, Lai-Ming Ho, Christl A. Donnelly, J. Kong, Steven Riley, Neil M. Ferguson, Patsy Chau, Edith M. C. Lau, Thuan-Quoc Thach, Laith J. Abu-Raddad, Christophe Fraser, Roy M. Anderson, Gabriel M. Leung, SH Liu
Rok vydání:	2003
Předmět:	Adult Male medicine.medical_specialty Pediatrics Adolescent Disease Severe Acute Respiratory Syndrome Article Disease Outbreaks Incubation period 03 medical and health sciences Age Distribution 0302 clinical medicine Epidemiology Case fatality rate medicine Humans 030212 general & internal medicine Child Survival rate Aged 030304 developmental biology Likelihood Functions 0303 health sciences business.industry Incidence Incidence (epidemiology) Infant General Medicine Middle Aged medicine.disease 3. Good health Survival Rate Child Preschool Quarantine Disease Progression Hong Kong Female Severe acute respiratory syndrome business Contact tracing
Zdroj:	Lancet (London, England)
ISSN:	0140-6736
DOI:	10.1016/s0140-6736(03)13410-1
Popis:	Summary Background Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong. Methods We included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients’age and the time from onset to admission. Findings After the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6.4 days (95% Cl 5.2–7.7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13.2% (9.8–16.8) for patients younger than 60 years and 43.3% (35.2–52.4) for patients aged 60 years or older assuming a parametric γ distribution. A non-parametric method yielded estimates of 6.8% (4.0–9.6) and 55.0% (45.3–64.7), respectively. Case clusters have played an important part in the course of the epidemic. Interpretation Patients’age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quarantine. Published online May 7, 2003 http://image.thelancet.com/extras/03art4453web.pdf
Databáze:	OpenAIRE
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