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Article: Temporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients

TitleTemporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients
Authors
Issue Date2005
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2005, v. 40 n. 9, p. 1237-1243 How to Cite?
AbstractBackground. We report the temporal-spatial spread of severe acute respiratory syndrome (SARS) among inpatients in a hospital ward during a major nosocomial outbreak and discuss possible mechanisms for the outbreak. Methods. All inpatients who had stayed in the same ward as the initial index case patient for any duration before isolation were recruited into a cohort and followed up to document the occurrence of SARS. The normalized concentration of virus-laden aerosols at different locations of the ward was estimated by use of computational fluid dynamics modeling. The attack rates in the various subgroups stratified by bed location were calculated. Multivariate Cox proportional hazards regression was used to document important risk factors. Results. The overall attack rate of SARS was 41% (30 of 74 subjects). It was 65%, 52%, and 18% in the same bay, adjacent bay, and distant bays, respectively (P = .001). Computation fluid dynamics modeling indicated that the normalized concentration of virus-laden aerosols was highest in the same bay and lowest in the distant bays. Cox regression indicated that staying in the ward on 6 or 10 March entailed higher risk, as well as staying in the same or adjacent bays. The epidemic curve showed 2 peaks, and stratified analyses by bed location suggested >1 generation of spread. Conclusions. The temporal-spatial spread of SARS in the ward was consistent with airborne transmission, as modeled by use of computational fluid dynamics. Infected health care workers likely acted as secondary sources in the latter phase of the outbreak. © 2005 by the Infectious Diseases Society of America. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/43007
ISSN
2015 Impact Factor: 8.736
2015 SCImago Journal Rankings: 4.742
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYu, ITSen_HK
dc.contributor.authorTze, WWen_HK
dc.contributor.authorYuk, LCen_HK
dc.contributor.authorLee, Nen_HK
dc.contributor.authorLi, Yen_HK
dc.date.accessioned2007-03-23T04:36:46Z-
dc.date.available2007-03-23T04:36:46Z-
dc.date.issued2005en_HK
dc.identifier.citationClinical Infectious Diseases, 2005, v. 40 n. 9, p. 1237-1243en_HK
dc.identifier.issn1058-4838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43007-
dc.description.abstractBackground. We report the temporal-spatial spread of severe acute respiratory syndrome (SARS) among inpatients in a hospital ward during a major nosocomial outbreak and discuss possible mechanisms for the outbreak. Methods. All inpatients who had stayed in the same ward as the initial index case patient for any duration before isolation were recruited into a cohort and followed up to document the occurrence of SARS. The normalized concentration of virus-laden aerosols at different locations of the ward was estimated by use of computational fluid dynamics modeling. The attack rates in the various subgroups stratified by bed location were calculated. Multivariate Cox proportional hazards regression was used to document important risk factors. Results. The overall attack rate of SARS was 41% (30 of 74 subjects). It was 65%, 52%, and 18% in the same bay, adjacent bay, and distant bays, respectively (P = .001). Computation fluid dynamics modeling indicated that the normalized concentration of virus-laden aerosols was highest in the same bay and lowest in the distant bays. Cox regression indicated that staying in the ward on 6 or 10 March entailed higher risk, as well as staying in the same or adjacent bays. The epidemic curve showed 2 peaks, and stratified analyses by bed location suggested >1 generation of spread. Conclusions. The temporal-spatial spread of SARS in the ward was consistent with airborne transmission, as modeled by use of computational fluid dynamics. Infected health care workers likely acted as secondary sources in the latter phase of the outbreak. © 2005 by the Infectious Diseases Society of America. All rights reserved.en_HK
dc.format.extent401370 bytes-
dc.format.extent15017 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/pdf-
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_HK
dc.relation.ispartofClinical Infectious Diseasesen_HK
dc.rightsClinical Infectious Diseases. Copyright © University of Chicago Press.en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCohort studiesen_HK
dc.subject.meshHospital design and constructionen_HK
dc.subject.meshProportional hazards modelsen_HK
dc.subject.meshRetrospective studiesen_HK
dc.subject.meshSevere acute respiratory syndromeen_HK
dc.titleTemporal-spatial analysis of severe acute respiratory syndrome among hospital inpatientsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1058-4838&volume=40&issue=9&spage=1237&epage=1243&date=2005&atitle=Temporal-spatial+analysis+of+severe+acute+respiratory+syndrome+among+hospital+inpatientsen_HK
dc.identifier.emailLi, Y:liyg@hkucc.hku.hken_HK
dc.identifier.authorityLi, Y=rp00151en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1086/428735en_HK
dc.identifier.pmid15825024-
dc.identifier.scopuseid_2-s2.0-17644397589en_HK
dc.identifier.hkuros101409-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-17644397589&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume40en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1237en_HK
dc.identifier.epage1243en_HK
dc.identifier.isiWOS:000228145600005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.f10001025280-
dc.identifier.scopusauthoridYu, ITS=7102120508en_HK
dc.identifier.scopusauthoridTze, WW=8333472800en_HK
dc.identifier.scopusauthoridYuk, LC=8333472900en_HK
dc.identifier.scopusauthoridLee, N=7402722286en_HK
dc.identifier.scopusauthoridLi, Y=7502094052en_HK

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