Public health implications of using various case definitions in The Netherlands during the worldwide SARS outbreak
Public health implications of using various case definitions in The Netherlands during the worldwide SARS outbreak
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DOI：
10.1111/j.1469-0691.2006.01552.x
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发表时间：
2006-12-01
影响因子：
14.2
通讯作者：
van Steenbergen, J. E.
中科院分区：
文献类型：
--
作者：
Timen, A.;van Doornum, G. J. J.;van Steenbergen, J. E.
这项研究分析了偏离WHO病例定义的后果，以评估2003年荷兰可疑严重急性呼吸综合征（SARS）的患者。由于平衡敏感性和特异性的困境，2003年3月17日至7月7日之间。 ，使用了五个不同的案例定义。从公共卫生的角度分析了转介SARS评估的患者。基于血清学和病毒学标准的患者中，没有一个患者均具有SARS。然而，所有72名患者均需要进行彻底的评估，并取决于评估结果，适当的预防和控制措施。改变案例定义在分类案例中引起混乱。具有临床和公共卫生专业知识（流行病学和地理风险评估）团队对报告案件的集中评估是解决应用案例定义方面差异的实用解决方案。在分配公共卫生资源时，管理非案例的负担是一个重要的问题，应在准备阶段而不是在爆发期间考虑到。这不仅适用于SARS，还适用于其他公共卫生威胁，例如大流行性流感或生物恐怖主义事件。
This study analysed the consequences of deviation from the WHO case definition for the assessment of patients with suspected severe acute respiratory syndrome (SARS) in The Netherlands during 2003. Between 17 March and 7 July 2003, as a result of dilemmas in balancing sensitivity and specificity, five different case definitions were used. The patients referred for SARS assessment were analysed from a public health perspective. None of the patients referred had SARS, based on serological and virological criteria. Nevertheless, all 72 patients required thorough assessment and, depending on the results of the assessment, institution of appropriate prevention and control measures. Changing case definitions caused confusion in classifying cases. A centralised assessment of the reported cases by a team with clinical and public health expertise (epidemiological and geographical risk assessment) is a practical solution for addressing differences in applying case definitions. The burden of managing non-cases is an important issue when allocating public health resources, and should be taken into account during the preparation phase, rather than during an outbreak. This applies not only to SARS, but also to other public health threats, such as pandemic influenza or a bioterrorist episode.