Rapid awareness and transmission of severe acute respiratory syndrome in Hanoi French Hospital, Vietnam

Rapid awareness and transmission of severe acute respiratory syndrome in Hanoi French Hospital, Vietnam
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DOI:
10.4269/ajtmh.2005.73.17
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发表时间:
2005-07-01
影响因子:
3.3
通讯作者:
Anderson, RM
Anderson, RM
中科院分区:
医学4区
文献类型:
--
作者:
Nishiura, H;Kuratsuji, T;Anderson, RM

文献摘要

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为探讨严重急性呼吸综合征(SARS)与越南河内法国医院(HFH)暴发期间采取的时间相关预防行为之间的关系,进行了一项病例对照研究。口罩(优势比[OR]=0.3;95%可信区间[CI]:0.1、0.7)和长袍(OR=0.2;95%可信区间:0.0、0.8)似乎可以预防SARS的传播。继发病例发生后,采取各项措施的医护人员比例明显提高(x~(2)=9.8551,P=0.043)。通过数学方法研究了个体行为对疫情的影响。通知后,繁殖量从4.1只下降到0.7只。对基本繁殖数量进行了估计,显示仅使用口罩不足以遏制疫情。通过随机个体模拟获得的直观结果表明,行为和隔离的快速改善将增加灭绝的可能性。
A case-control study was conducted to examine the relationship between severe acute respiratory syndrome (SARS) and the time-dependent precautionary behaviors taken during an outbreak of SARS in Hanoi French Hospital (HFH), Vietnam. Masks (odds ratio [OR] = 0.3; 95% confidence interval [Cl]: 0.1, 0.7) and gowns (OR = 0.2; 95% CI: 0.0, 0.8) appeared to prevent SARS transmission. The proportion of doctors and nurses who undertook each measure significantly improved (chi(2) = 9.8551, P = 0.043) after the onset of secondary cases. The impact of individual behaviors on an outbreak was investigated through mathematical approaches. The reproduction number decreased from 4.1 to 0.7 after notification. The basic reproduction number was estimated, and the use of masks alone was shown to be insufficient in containing an epidemic. Intuitive results obtained by means of stochastic individual-based simulations showed that rapid improvements in behavior and isolation would increase the probability of extinction.