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Article: Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong

TitleEpidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong
Authors
Issue Date2003
PublisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lancet
Citation
Lancet, 2003, v. 361 n. 9371, p. 1761-1766 How to Cite?
AbstractBackground: 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% CI 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.
Persistent Identifierhttp://hdl.handle.net/10722/86445
ISSN
2015 Impact Factor: 44.002
2015 SCImago Journal Rankings: 14.638
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorDonnelly, CAen_HK
dc.contributor.authorGhani, ACen_HK
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorHedley, AJen_HK
dc.contributor.authorFraser, Cen_HK
dc.contributor.authorRiley, Sen_HK
dc.contributor.authorAbuRaddad, LJen_HK
dc.contributor.authorHo, LMen_HK
dc.contributor.authorThach, TQen_HK
dc.contributor.authorChau, Pen_HK
dc.contributor.authorChan, KPen_HK
dc.contributor.authorLam, THen_HK
dc.contributor.authorTse, LYen_HK
dc.contributor.authorTsang, Ten_HK
dc.contributor.authorLiu, SHen_HK
dc.contributor.authorKong, JHBen_HK
dc.contributor.authorLau, EMCen_HK
dc.contributor.authorFerguson, NMen_HK
dc.contributor.authorAnderson, RMen_HK
dc.date.accessioned2010-09-06T09:17:08Z-
dc.date.available2010-09-06T09:17:08Z-
dc.date.issued2003en_HK
dc.identifier.citationLancet, 2003, v. 361 n. 9371, p. 1761-1766en_HK
dc.identifier.issn0140-6736en_HK
dc.identifier.urihttp://hdl.handle.net/10722/86445-
dc.description.abstractBackground: 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% CI 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.en_HK
dc.languageengen_HK
dc.publisherThe Lancet Publishing Group. The Journal's web site is located at http://www.elsevier.com/locate/lanceten_HK
dc.relation.ispartofLanceten_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAge Distributionen_HK
dc.subject.meshAgeden_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshDisease Outbreaks - statistics & numerical dataen_HK
dc.subject.meshDisease Progressionen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshInfanten_HK
dc.subject.meshLikelihood Functionsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshQuarantine - methods - statistics & numerical dataen_HK
dc.subject.meshSevere Acute Respiratory Syndrome - diagnosis - epidemiologyen_HK
dc.subject.meshSurvival Rateen_HK
dc.titleEpidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0140-6736&volume=361&spage=1761&epage=1766&date=2003&atitle=Epidemiological+determinants+of+spread+of+causal+agent+of+severe+acute+respiratory+syndrome+in+Hong+Kongen_HK
dc.identifier.emailLeung, GM: gmleung@hku.hken_HK
dc.identifier.emailHedley, AJ: hrmrajh@hkucc.hku.hken_HK
dc.identifier.emailRiley, S: steven.riley@hku.hken_HK
dc.identifier.emailHo, LM: lmho@hkucc.hku.hken_HK
dc.identifier.emailThach, TQ: thach@hku.hken_HK
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authorityHedley, AJ=rp00357en_HK
dc.identifier.authorityRiley, S=rp00511en_HK
dc.identifier.authorityHo, LM=rp00360en_HK
dc.identifier.authorityThach, TQ=rp00450en_HK
dc.identifier.authorityLam, TH=rp00326en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0140-6736(03)13410-1en_HK
dc.identifier.pmid12781533-
dc.identifier.scopuseid_2-s2.0-0038024613en_HK
dc.identifier.hkuros76635en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0038024613&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume361en_HK
dc.identifier.issue9371en_HK
dc.identifier.spage1761en_HK
dc.identifier.epage1766en_HK
dc.identifier.isiWOS:000183074800006-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridDonnelly, CA=35468127900en_HK
dc.identifier.scopusauthoridGhani, AC=7006814439en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridHedley, AJ=7102584095en_HK
dc.identifier.scopusauthoridFraser, C=35460815100en_HK
dc.identifier.scopusauthoridRiley, S=7102619416en_HK
dc.identifier.scopusauthoridAbuRaddad, LJ=14032724700en_HK
dc.identifier.scopusauthoridHo, LM=7402955625en_HK
dc.identifier.scopusauthoridThach, TQ=6602850066en_HK
dc.identifier.scopusauthoridChau, P=7102266397en_HK
dc.identifier.scopusauthoridChan, KP=27171298000en_HK
dc.identifier.scopusauthoridLam, TH=7202522876en_HK
dc.identifier.scopusauthoridTse, LY=7004824041en_HK
dc.identifier.scopusauthoridTsang, T=7101832378en_HK
dc.identifier.scopusauthoridLiu, SH=24171816800en_HK
dc.identifier.scopusauthoridKong, JHB=8632041300en_HK
dc.identifier.scopusauthoridLau, EMC=7103086055en_HK
dc.identifier.scopusauthoridFerguson, NM=7103246319en_HK
dc.identifier.scopusauthoridAnderson, RM=7408244444en_HK
dc.identifier.citeulike6791666-

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