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Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong
BACKGROUND: Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong. METHODS: We included 1425 cases reported up to...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2003
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112380/ https://www.ncbi.nlm.nih.gov/pubmed/12781533 http://dx.doi.org/10.1016/S0140-6736(03)13410-1 |
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author | Donnelly, Christl A Ghani, Azra C Leung, Gabriel M Hedley, Anthony J Fraser, Christophe Riley, Steven Abu-Raddad, Laith J Ho, Lai-Ming Thach, Thuan-Quoc Chau, Patsy Chan, King-Pan Lam, Tai-Hing Tse, Lai-Yin Tsang, Thomas Liu, Shao-Haei Kong, James HB Lau, Edith MC Ferguson, Neil M Anderson, Roy M |
author_facet | Donnelly, Christl A Ghani, Azra C Leung, Gabriel M Hedley, Anthony J Fraser, Christophe Riley, Steven Abu-Raddad, Laith J Ho, Lai-Ming Thach, Thuan-Quoc Chau, Patsy Chan, King-Pan Lam, Tai-Hing Tse, Lai-Yin Tsang, Thomas Liu, Shao-Haei Kong, James HB Lau, Edith MC Ferguson, Neil M Anderson, Roy M |
author_sort | Donnelly, Christl A |
collection | PubMed |
description | BACKGROUND: Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong. METHODS: We included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients’age and the time from onset to admission. FINDINGS: After the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6.4 days (95% Cl 5.2–7.7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13.2% (9.8–16.8) for patients younger than 60 years and 43.3% (35.2–52.4) for patients aged 60 years or older assuming a parametric γ distribution. A non-parametric method yielded estimates of 6.8% (4.0–9.6) and 55.0% (45.3–64.7), respectively. Case clusters have played an important part in the course of the epidemic. INTERPRETATION: Patients’age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quarantine. Published online May 7, 2003 http://image.thelancet.com/extras/03art4453web.pdf |
format | Online Article Text |
id | pubmed-7112380 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2003 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71123802020-04-02 Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong Donnelly, Christl A Ghani, Azra C Leung, Gabriel M Hedley, Anthony J Fraser, Christophe Riley, Steven Abu-Raddad, Laith J Ho, Lai-Ming Thach, Thuan-Quoc Chau, Patsy Chan, King-Pan Lam, Tai-Hing Tse, Lai-Yin Tsang, Thomas Liu, Shao-Haei Kong, James HB Lau, Edith MC Ferguson, Neil M Anderson, Roy M Lancet Article BACKGROUND: Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong. METHODS: We included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients’age and the time from onset to admission. FINDINGS: After the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6.4 days (95% Cl 5.2–7.7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13.2% (9.8–16.8) for patients younger than 60 years and 43.3% (35.2–52.4) for patients aged 60 years or older assuming a parametric γ distribution. A non-parametric method yielded estimates of 6.8% (4.0–9.6) and 55.0% (45.3–64.7), respectively. Case clusters have played an important part in the course of the epidemic. INTERPRETATION: Patients’age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quarantine. Published online May 7, 2003 http://image.thelancet.com/extras/03art4453web.pdf Elsevier Ltd. 2003-05-24 2003-05-22 /pmc/articles/PMC7112380/ /pubmed/12781533 http://dx.doi.org/10.1016/S0140-6736(03)13410-1 Text en Copyright © 2003 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Donnelly, Christl A Ghani, Azra C Leung, Gabriel M Hedley, Anthony J Fraser, Christophe Riley, Steven Abu-Raddad, Laith J Ho, Lai-Ming Thach, Thuan-Quoc Chau, Patsy Chan, King-Pan Lam, Tai-Hing Tse, Lai-Yin Tsang, Thomas Liu, Shao-Haei Kong, James HB Lau, Edith MC Ferguson, Neil M Anderson, Roy M Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title | Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title_full | Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title_fullStr | Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title_full_unstemmed | Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title_short | Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong |
title_sort | epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in hong kong |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7112380/ https://www.ncbi.nlm.nih.gov/pubmed/12781533 http://dx.doi.org/10.1016/S0140-6736(03)13410-1 |
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