Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003
Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003
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DOI：
10.1001/jama.290.24.3215
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发表时间：
2003-12-24
影响因子：
120.7
通讯作者：
Feikin, DR
中科院分区：
文献类型：
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作者：
Pang, XH;Zhu, ZH;Feikin, DR
2003年3月，中国北京爆发了世界上最大规模的严重急性呼吸系统综合征（SARS）疫情，疫情在4月下旬达到高峰后的6周内迅速消退。鲜为人知的是，在这次爆发期间实施的控制措施。目的描述和评估所采取的措施，以控制SARS爆发，设计，设置和参与者的数据进行了审查，从SARS病例（2521可能的情况下）和他们的密切接触者观察在北京3月5日，2003年5月29日之间的标准化监测表。通过审查官方文件和与公共卫生官员讨论，对卫生当局实施的程序进行了调查。“主要指标主要控制措施的时间轴;病例数和隔离密切接触者和发病率，以及感染控制措施、管理和疑似病例分诊的变化;结果对医务人员进行个人防护用品使用、SARS病人管理培训，建立发热门诊和SARS定点病房在病例最急剧下降之前，疫情期间，有30178人被隔离。在5个地区的2195名隔离密切接触者中，发病率为6.3%（95%置信区间[CI]，5.3%-7.3%），范围为配偶15.4%（95% CI，11.5%-19.2%）至工作和学校接触者0.36%（95% CI，0%-0.77%）。被隔离家庭成员的发病率随着年龄的增长而增加，从10岁以下儿童的5.0%（95%CI，0%-10.5%）增加到60至69岁成人的27.6%（95%CI，18.2%-37.0%）。在机场、火车站和路边检查站接受发烧筛查的近1400万人中，只有12人被发现可能患有SARS。国家和市政府召开了13次关于SARS的新闻发布会。发病至入院的时间，由2003年4月20日（公布爆发当日）或之前的5至6天，缩短至4月20日之后的2天（P
Context Beijing, China, experienced the world's largest outbreak of severe acute respiratory syndrome (SARS) beginning in March 2003, with the outbreak resolving rapidly, within 6 weeks of its peak in late April. Little is known about the control measures implemented during this outbreak.Objective To describe and evaluate the measures undertaken to control the SARS outbreak.Design, Setting, and Participants Data were reviewed from standardized surveillance forms from SARS cases (2521 probable cases) and their close contacts observed in Beijing between March 5, 2003, and May 29, 2003. Procedures implemented by health authorities were investigated through review of official documents and discussions with public health officials.'Main Outcome Measures Timeline of major control measures; number of cases and quarantined close contacts and attack rates, with changes in infection control measures, management, and triage of suspected cases; and time lag between illness onset and hospitalization with information dissemination.Results Healthcare worker training in use of personal protective equipment and management of patients with SARS and establishing fever clinics and designated SARS wards in hospitals predated the steepest decline in cases. During the outbreak, 30178 persons were quarantined. Among 2195 quarantined close contacts in 5 districts, the attack rate was 6.3 % (95% confidence interval [CI], 5.3 % -7.3 %), with a range of 15.4% (95% Cl, 11.5%-19.2%) among spouses to 0.36% (95% CI, 0%-0.77%) among work and school contacts. The attack rate among quarantined household members increased with age from 5.0% (95 % Cl, 0% -10.5%) in children younger than 10 years to 27.6% (95% Cl, 18.2%-37.0%) in adults aged 60 to 69 years. Among almost 14 million people screened for fever at the airport, train stations, and roadside checkpoints, only 12 were found to have probable SARS. The national and municipal governments held 13 press conferences about SARS. The time lag between illness onset and hospitalization decreased from a median of 5 to 6 days on or before April 20, 2003, the day the outbreak was announced to the public, to 2 days after April 20 (P