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Article: Evidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virus

TitleEvidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virus
Authors
Issue Date2004
PublisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/
Citation
New England Journal Of Medicine, 2004, v. 350 n. 17, p. 1731-1739 How to Cite?
AbstractBACKGROUND: There is uncertainty about the mode of transmission of the severe acute respiratory syndrome (SARS) virus. We analyzed the temporal and spatial distributions of cases in a large community outbreak of SARS in Hong Kong and examined the correlation of these data with the three-dimensional spread of a virus-laden aerosol plume that was modeled using studies of airflow dynamics. METHODS: We determined the distribution of the initial 187 cases of SARS in the Amoy Gardens housing complex in 2003 according to the date of onset and location of residence. We then studied the association between the location (building, floor, and direction the apartment unit faced) and the probability of infection using logistic regression. The spread of the airborne, virus-laden aerosols generated by the index patient was modeled with the use of airflow-dynamics studies, including studies performed with the use of computational fluid-dynamics and multizone modeling. RESULTS: The curves of the epidemic suggested a common source of the outbreak. All but 5 patients lived in seven buildings (A to G), and the index patient and more than half the other patients with SARS (99 patients) lived in building E. Residents of the floors at the middle and upper levels in building E were at a significantly higher risk than residents on lower floors; this finding is consistent with a rising plume of contaminated warm air in the air shaft generated from a middle-level apartment unit. The risks for the different units matched the virus concentrations predicted with the use of multizone modeling. The distribution of risk in buildings B, C, and D corresponded well with the three-dimensional spread of virus-laden aerosols predicted with the use of computational fluid-dynamics modeling. CONCLUSIONS: Airborne spread of the virus appears to explain this large community outbreak of SARS, and future efforts at prevention and control must take into consideration the potential for airborne spread of this virus. Copyright © 2004 Massachusetts Medical Society.
Persistent Identifierhttp://hdl.handle.net/10722/42649
ISSN
2015 Impact Factor: 59.558
2015 SCImago Journal Rankings: 14.619
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYu, ITSen_HK
dc.contributor.authorLi, Yen_HK
dc.contributor.authorWong, TWen_HK
dc.contributor.authorTam, Wen_HK
dc.contributor.authorChan, ATen_HK
dc.contributor.authorLee, JHWen_HK
dc.contributor.authorLeung, DYCen_HK
dc.contributor.authorHo, Ten_HK
dc.date.accessioned2007-03-23T04:28:50Z-
dc.date.available2007-03-23T04:28:50Z-
dc.date.issued2004en_HK
dc.identifier.citationNew England Journal Of Medicine, 2004, v. 350 n. 17, p. 1731-1739en_HK
dc.identifier.issn0028-4793en_HK
dc.identifier.urihttp://hdl.handle.net/10722/42649-
dc.description.abstractBACKGROUND: There is uncertainty about the mode of transmission of the severe acute respiratory syndrome (SARS) virus. We analyzed the temporal and spatial distributions of cases in a large community outbreak of SARS in Hong Kong and examined the correlation of these data with the three-dimensional spread of a virus-laden aerosol plume that was modeled using studies of airflow dynamics. METHODS: We determined the distribution of the initial 187 cases of SARS in the Amoy Gardens housing complex in 2003 according to the date of onset and location of residence. We then studied the association between the location (building, floor, and direction the apartment unit faced) and the probability of infection using logistic regression. The spread of the airborne, virus-laden aerosols generated by the index patient was modeled with the use of airflow-dynamics studies, including studies performed with the use of computational fluid-dynamics and multizone modeling. RESULTS: The curves of the epidemic suggested a common source of the outbreak. All but 5 patients lived in seven buildings (A to G), and the index patient and more than half the other patients with SARS (99 patients) lived in building E. Residents of the floors at the middle and upper levels in building E were at a significantly higher risk than residents on lower floors; this finding is consistent with a rising plume of contaminated warm air in the air shaft generated from a middle-level apartment unit. The risks for the different units matched the virus concentrations predicted with the use of multizone modeling. The distribution of risk in buildings B, C, and D corresponded well with the three-dimensional spread of virus-laden aerosols predicted with the use of computational fluid-dynamics modeling. CONCLUSIONS: Airborne spread of the virus appears to explain this large community outbreak of SARS, and future efforts at prevention and control must take into consideration the potential for airborne spread of this virus. Copyright © 2004 Massachusetts Medical Society.en_HK
dc.format.extent129872 bytes-
dc.format.extent25088 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.languageengen_HK
dc.publisherMassachusetts Medical Society. The Journal's web site is located at http://content.nejm.org/en_HK
dc.relation.ispartofNew England Journal of Medicineen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsNew England Journal of Medicine. Copyright © Massachusetts Medical Society.en_HK
dc.subject.meshAir microbiologyen_HK
dc.subject.meshDisease outbreaksen_HK
dc.subject.meshHousingen_HK
dc.subject.meshModels, theoreticalen_HK
dc.subject.meshSevere acute respiratory syndrome - epidemiology - transmissionen_HK
dc.titleEvidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virusen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0028-4793&volume=350&issue=17&spage=1731&epage=1739&date=2004&atitle=Evidence+of+airborne+transmission+of+the+severe+acute+respiratory+syndrome+virusen_HK
dc.identifier.emailLi, Y: liyg@hkucc.hku.hken_HK
dc.identifier.emailTam, W: wwstam@hkucc.hku.hken_HK
dc.identifier.emailLee, JHW: hreclhw@hku.hken_HK
dc.identifier.emailLeung, DYC: ycleung@hku.hken_HK
dc.identifier.authorityLi, Y=rp00151en_HK
dc.identifier.authorityTam, W=rp01378en_HK
dc.identifier.authorityLee, JHW=rp00061en_HK
dc.identifier.authorityLeung, DYC=rp00149en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1056/NEJMoa032867en_HK
dc.identifier.pmid15102999-
dc.identifier.scopuseid_2-s2.0-1942467995en_HK
dc.identifier.hkuros89086-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1942467995&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume350en_HK
dc.identifier.issue17en_HK
dc.identifier.spage1731en_HK
dc.identifier.epage1739en_HK
dc.identifier.isiWOS:000220947300007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYu, ITS=7102120508en_HK
dc.identifier.scopusauthoridLi, Y=7502094052en_HK
dc.identifier.scopusauthoridWong, TW=7403531744en_HK
dc.identifier.scopusauthoridTam, W=9740867000en_HK
dc.identifier.scopusauthoridChan, AT=55465240100en_HK
dc.identifier.scopusauthoridLee, JHW=36078318900en_HK
dc.identifier.scopusauthoridLeung, DYC=7203002484en_HK
dc.identifier.scopusauthoridHo, T=8239583900en_HK

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