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Article: Using models to identify routes of nosocomial infection: a large hospital outbreak of SARS in Hong Kong.

TitleUsing models to identify routes of nosocomial infection: a large hospital outbreak of SARS in Hong Kong.
Authors
KeywordsMathematical modelling
Nosocomial
Severe acute respiratory syndrome
Issue Date2007
PublisherThe Royal Society. The Journal's web site is located at http://www.pubs.royalsoc.ac.uk/index.cfm?page=1087
Citation
Proceedings. Biological Sciences / The Royal Society, 2007, v. 274 n. 1610, p. 611-617 How to Cite?
AbstractTwo factors dominated the epidemiology of severe acute respiratory syndrome (SARS) during the 2002-2003 global outbreak, namely super-spreading events (SSE) and hospital infections. Although both factors were important during the first and the largest hospital outbreak in Hong Kong, the relative importance of different routes of infection has not yet been quantified. We estimated the parameters of a novel mathematical model of hospital infection using SARS episode data. These estimates described levels of transmission between the index super-spreader, staff and patients, and were used to compare three plausible hypotheses. The broadest of the supported hypotheses ascribes the initial surge in cases to a single super-spreading individual and suggests that the per capita risk of infection to patients increased approximately one month after the start of the outbreak. Our estimate for the number of cases caused by the SSE is substantially lower than the previously reported values, which were mostly based on self-reported exposure information. This discrepancy suggests that the early identification of the index case as a super-spreader might have led to biased contact tracing, resulting in too few cases being attributed to staff-to-staff transmission. We propose that in future outbreaks of SARS or other directly transmissible respiratory pathogens, simple mathematical models could be used to validate preliminary conclusions concerning the relative importance of different routes of transmission with important implications for infection control.
Persistent Identifierhttp://hdl.handle.net/10722/151641
ISSN
2015 Impact Factor: 4.823
2015 SCImago Journal Rankings: 2.375
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwok, KOen_US
dc.contributor.authorLeung, GMen_US
dc.contributor.authorLam, WYen_US
dc.contributor.authorRiley, Sen_US
dc.date.accessioned2012-06-26T06:25:52Z-
dc.date.available2012-06-26T06:25:52Z-
dc.date.issued2007en_US
dc.identifier.citationProceedings. Biological Sciences / The Royal Society, 2007, v. 274 n. 1610, p. 611-617en_US
dc.identifier.issn0962-8452en_US
dc.identifier.urihttp://hdl.handle.net/10722/151641-
dc.description.abstractTwo factors dominated the epidemiology of severe acute respiratory syndrome (SARS) during the 2002-2003 global outbreak, namely super-spreading events (SSE) and hospital infections. Although both factors were important during the first and the largest hospital outbreak in Hong Kong, the relative importance of different routes of infection has not yet been quantified. We estimated the parameters of a novel mathematical model of hospital infection using SARS episode data. These estimates described levels of transmission between the index super-spreader, staff and patients, and were used to compare three plausible hypotheses. The broadest of the supported hypotheses ascribes the initial surge in cases to a single super-spreading individual and suggests that the per capita risk of infection to patients increased approximately one month after the start of the outbreak. Our estimate for the number of cases caused by the SSE is substantially lower than the previously reported values, which were mostly based on self-reported exposure information. This discrepancy suggests that the early identification of the index case as a super-spreader might have led to biased contact tracing, resulting in too few cases being attributed to staff-to-staff transmission. We propose that in future outbreaks of SARS or other directly transmissible respiratory pathogens, simple mathematical models could be used to validate preliminary conclusions concerning the relative importance of different routes of transmission with important implications for infection control.en_US
dc.languageengen_US
dc.publisherThe Royal Society. The Journal's web site is located at http://www.pubs.royalsoc.ac.uk/index.cfm?page=1087en_US
dc.relation.ispartofProceedings. Biological sciences / The Royal Societyen_US
dc.subjectMathematical modelling-
dc.subjectNosocomial-
dc.subjectSevere acute respiratory syndrome-
dc.subject.meshCross Infection - Epidemiologyen_US
dc.subject.meshDisease Outbreaksen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHospitalsen_US
dc.subject.meshHumansen_US
dc.subject.meshModels, Theoreticalen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSevere Acute Respiratory Syndrome - Epidemiology - Transmissionen_US
dc.titleUsing models to identify routes of nosocomial infection: a large hospital outbreak of SARS in Hong Kong.en_US
dc.typeArticleen_US
dc.identifier.emailLeung, GM:gmleung@hku.hken_US
dc.identifier.emailRiley, S:sriley@hkucc.hku.hk, steven.riley@hku.hken_US
dc.identifier.authorityLeung, GM=rp00460en_US
dc.identifier.authorityRiley, S=rp00511en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1098/rspb.2006.0026en_US
dc.identifier.pmid17254984-
dc.identifier.scopuseid_2-s2.0-33947532268en_US
dc.identifier.hkuros126481-
dc.identifier.volume274en_US
dc.identifier.issue1610en_US
dc.identifier.spage611en_US
dc.identifier.epage617en_US
dc.identifier.isiWOS:000243439700002-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridKwok, KO=35983448100en_US
dc.identifier.scopusauthoridLeung, GM=7007159841en_US
dc.identifier.scopusauthoridLam, WY=55127150300en_US
dc.identifier.scopusauthoridRiley, S=7102619416en_US

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