The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients
The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients
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DOI：
10.7326/0003-4819-141-9-200411020-00006
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发表时间：
2004-11-02
影响因子：
39.2
通讯作者：
Lam, TH
中科院分区：
文献类型：
--
作者：
Leung, GM;Hedley, AJ;Lam, TH
背景资料：目的：对香港2003年SARS疫情进行流行病学分析，研究对象：1755例SARS病例和302例死亡病例，研究方法：社会人口学特征，研究对象：2003年香港SARS疫情。感染集群的时间，职业，设置和工作场所;和地理空间关系确定。在一小组已知暴露的患者中估计从感染到发作的时间（潜伏期）的平均值和方差。计算从发病到入院、从入院到出院或从入院到死亡的时间的平均值和方差。结果：49.3%的病人是在诊所、医院、老人院或疗养院感染的，其中淘大花园聚集区占18.8%。感染者中的男女比例为5：4。医护人员占所有报告病例的23.1%。估计的平均潜伏期为4.6天（95% CI，3.8 - 5.8天）。从出现症状到住院治疗的平均时间为2至8天不等，随着流行病的发展而减少。从发病至死亡的平均时间为23.7天（CI，22.0至25.3天），从发病至出院的平均时间为26.5天（CI，25.8至27.2天）。年龄增加，男性，不典型的表现症状，存在的共病条件下，和高乳酸脱氢酶水平入院与死亡的风险更大。局限性：估计的潜伏期依赖于统计假设，因为很少有患者有已知的暴露时间。随着疫情的发展，不可用的治疗信息，以及几个潜在的重要因素，不能彻底分析，因为有限的样本量复杂的解释相关的因素，病例fatality.Conclusions：2003年SARS疫情在香港的完整数据的分析揭示了关键的流行病学特征的流行病，因为它的演变。
Background: As yet, no one has written a comprehensive epidemiologic account of a severe acute respiratory syndrome (SARS) outbreak from an affected country.Objective: To provide a comprehensive epidemiologic account of a SARS outbreak from an affected territory.Design: Epidemiologic analysis.Setting: The 2003 Hong Kong SARS outbreak.Participants: All 1755 cases and 302 deaths.Measurements: Sociodemographic characteristics; infection clusters by time, occupation, setting, and workplace; and geospatial relationships were determined. The mean and variance in the time from infection to onset (incubation period) were estimated in a small group of patients with known exposure. The mean and variance in time from onset to admission, from admission to discharge, or from admission to death were calculated. Logistic regression was used to identify important predictors of case fatality.Results: 49.3% of patients were infected in clinics, hospitals, or elderly or nursing homes, and the Amoy Gardens cluster accounted for 18.8% of cases. The ratio of women to men among infected individuals was 5:4. Health care workers accounted for 23.1% of all reported cases. The estimated mean incubation period was 4.6 days (95% CI, 3.8 to 5.8 days). Mean time from symptom onset to hospitalization varied between 2 and 8 days, decreasing over the course of the epidemic. Mean time from onset to death was 23.7 days (CI, 22.0 to 25.3 days), and mean time from onset to discharge was 26.5 days (CI, 25.8 to 27.2 days). Increasing age, male sex, atypical presenting symptoms, presence of comorbid conditions, and high lactate dehydrogenase level on admission were associated with a greater risk for death.Limitations: Estimates of the incubation period relied on statistical assumptions because few patients had known exposure times. Temporal changes in case management as the epidemic progressed, unavailable treatment information, and several potentially important factors that could not be thoroughly analyzed because of the limited sample size complicate interpretation of factors related to case fatality.Conclusions: This analysis of the complete data on the 2003 SARS epidemic in Hong Kong has revealed key epidemiologic features of the epidemic as it evolved.