Transmission dynamics of the etiological agent of SARS in Hong Kong: Impact of public health interventions
Transmission dynamics of the etiological agent of SARS in Hong Kong: Impact of public health interventions
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DOI：
10.1126/science.1086478
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发表时间：
2003-06-20
期刊：
影响因子：
56.9
通讯作者：
Anderson, RM
中科院分区：
文献类型：
--
作者：
Riley, S;Fraser, C;Anderson, RM
我们对香港严重急性呼吸系统综合症(SARS)疫情的头10周进行了分析。到目前为止，疫情的特点是由两个独立的“超级传播”事件(SSE)发起的两个大型聚集性疾病和持续的社区传播。通过对包括这些聚集性在内的1512例病例的数据进行随机模型拟合，我们表明SARS的病原体是适度可传播的。不包括SSE，我们估计，在疫情开始时，每个病例平均产生2.7例继发感染，其中很大一部分是由医院传播造成的。在疫情期间传播率下降，主要是由于人口接触率下降和医院感染控制得到改善，但也是因为有症状的个人就诊速度更快。因此，疫情现在正在下降，尽管保持警惕是必要的。在某些情况下，对较长范围的人口流动的限制被证明是一项潜在的有用的额外控制措施。我们估计，目前大多数感染者现在都在住院，这突出了控制医院传播的重要性。
We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong. The epidemic to date has been characterized by two large clusters - initiated by two separate "super-spread" events (SSEs) - and by ongoing community transmission. By fitting a stochastic model to data on 1512 cases, including these clusters, we show that the etiological agent of SARS is moderately transmissible. Excluding SSEs, we estimate that 2.7 secondary infections were generated per case on average at the start of the epidemic, with a substantial contribution from hospital transmission. Transmission rates fell during the epidemic, primarily as a result of reductions in population contact rates and improved hospital infection control, but also because of more rapid hospital attendance by symptomatic individuals. As a result, the epidemic is now in decline, although continued vigilance is necessary for this to be maintained. Restrictions on longer range population movement are shown to be a potentially useful additional control measure in some contexts. We estimate that most currently infected persons are now hospitalized, which highlights the importance of control of nosocomial transmission.