File Download
 
Links for fulltext
(May Require Subscription)
 
Supplementary

Article: The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients
  • Basic View
  • Metadata View
  • XML View
TitleThe epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients
 
AuthorsLeung, GM
Medley, AJ
Ho, LM
Chau, P
Wong, IOL
Thach, TQ
Ghani, AC
Donnelly, CA
Fraser, C
Riley, S
Ferguson, NM
Anderson, RM
Tsang, T
Leung, PY
Wong, V
Chan, JCK
Tsui, E
Lo, SV
Lam, TH1
 
Issue Date2004
 
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
 
CitationAnnals Of Internal Medicine, 2004, v. 141 n. 9, p. 662-673 [How to Cite?]
 
AbstractBackground: As yet, no one has written a comprehensive epidemiologic account of a severe acute respiratory syndrome (SARS) outbreak from an affected country. Objective: To provide a comprehensive epidemiologic account of a SARS outbreak from an affected territory. Design: Epidemiologic analysis. Setting: The 2003 Hong Kong SARS outbreak. Participants: All 1755 cases and 302 deaths. Measurements: Sociodemographic characteristics; infection clusters by time, occupation, setting, and workplace; and geospatial relationships were determined. The mean and variance in the time from infection to onset (incubation period) were estimated in a small group of patients with known exposure. The mean and variance in time from onset to admission, from admission to discharge, or from admission to death were calculated. Logistic regression was used to identify important predictors of case fatality. Results: 49.3% of patients were infected in clinics, hospitals, or elderly or nursing homes, and the Amoy Gardens cluster accounted for 18.8% of cases. The ratio of women to men among infected individuals was 5:4. Health care workers accounted for 23.1% of all reported cases. The estimated mean incubation period was 4.6 days (95% CI, 3.8 to 5.8 days). Mean time from symptom onset to hospitalization varied between 2 and 8 days, decreasing over the course of the epidemic. Mean time from onset to death was 23.7 days (CI, 22.0 to 25.3 days), and mean time from onset to discharge was 26.5 days (CI, 25.8 to 27.2 days). Increasing age, male sex, atypical presenting symptoms, presence of comorbid conditions, and high lactate dehydrogenase level on admission were associated with a greater risk for death. Limitations: Estimates of the incubation period relied on statistical assumptions because few patients had known exposure times. Temporal changes in case management as the epidemic progressed, unavailable treatment information, and several potentially important factors that could not be thoroughly analyzed because of the limited sample size complicate interpretation of factors related to case fatality. Conclusions: This analysis of the complete data on the 2003 SARS epidemic in Hong Kong has revealed key epidemiologic features of the epidemic as it evolved.
 
ISSN0003-4819
2012 Impact Factor: 13.976
2012 SCImago Journal Rankings: 5.061
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLeung, GM
 
dc.contributor.authorMedley, AJ
 
dc.contributor.authorHo, LM
 
dc.contributor.authorChau, P
 
dc.contributor.authorWong, IOL
 
dc.contributor.authorThach, TQ
 
dc.contributor.authorGhani, AC
 
dc.contributor.authorDonnelly, CA
 
dc.contributor.authorFraser, C
 
dc.contributor.authorRiley, S
 
dc.contributor.authorFerguson, NM
 
dc.contributor.authorAnderson, RM
 
dc.contributor.authorTsang, T
 
dc.contributor.authorLeung, PY
 
dc.contributor.authorWong, V
 
dc.contributor.authorChan, JCK
 
dc.contributor.authorTsui, E
 
dc.contributor.authorLo, SV
 
dc.contributor.authorLam, TH
 
dc.date.accessioned2010-09-06T09:19:26Z
 
dc.date.available2010-09-06T09:19:26Z
 
dc.date.issued2004
 
dc.description.abstractBackground: As yet, no one has written a comprehensive epidemiologic account of a severe acute respiratory syndrome (SARS) outbreak from an affected country. Objective: To provide a comprehensive epidemiologic account of a SARS outbreak from an affected territory. Design: Epidemiologic analysis. Setting: The 2003 Hong Kong SARS outbreak. Participants: All 1755 cases and 302 deaths. Measurements: Sociodemographic characteristics; infection clusters by time, occupation, setting, and workplace; and geospatial relationships were determined. The mean and variance in the time from infection to onset (incubation period) were estimated in a small group of patients with known exposure. The mean and variance in time from onset to admission, from admission to discharge, or from admission to death were calculated. Logistic regression was used to identify important predictors of case fatality. Results: 49.3% of patients were infected in clinics, hospitals, or elderly or nursing homes, and the Amoy Gardens cluster accounted for 18.8% of cases. The ratio of women to men among infected individuals was 5:4. Health care workers accounted for 23.1% of all reported cases. The estimated mean incubation period was 4.6 days (95% CI, 3.8 to 5.8 days). Mean time from symptom onset to hospitalization varied between 2 and 8 days, decreasing over the course of the epidemic. Mean time from onset to death was 23.7 days (CI, 22.0 to 25.3 days), and mean time from onset to discharge was 26.5 days (CI, 25.8 to 27.2 days). Increasing age, male sex, atypical presenting symptoms, presence of comorbid conditions, and high lactate dehydrogenase level on admission were associated with a greater risk for death. Limitations: Estimates of the incubation period relied on statistical assumptions because few patients had known exposure times. Temporal changes in case management as the epidemic progressed, unavailable treatment information, and several potentially important factors that could not be thoroughly analyzed because of the limited sample size complicate interpretation of factors related to case fatality. Conclusions: This analysis of the complete data on the 2003 SARS epidemic in Hong Kong has revealed key epidemiologic features of the epidemic as it evolved.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationAnnals Of Internal Medicine, 2004, v. 141 n. 9, p. 662-673 [How to Cite?]
 
dc.identifier.epage673
 
dc.identifier.hkuros96367
 
dc.identifier.issn0003-4819
2012 Impact Factor: 13.976
2012 SCImago Journal Rankings: 5.061
 
dc.identifier.issue9
 
dc.identifier.openurl
 
dc.identifier.pmid15520422
 
dc.identifier.scopuseid_2-s2.0-3242687609
 
dc.identifier.spage662
 
dc.identifier.urihttp://hdl.handle.net/10722/86633
 
dc.identifier.volume141
 
dc.languageeng
 
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAnnals of Internal Medicine
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdult
 
dc.subject.meshAge Distribution
 
dc.subject.meshAged
 
dc.subject.meshCluster Analysis
 
dc.subject.meshDemography
 
dc.subject.meshDisease Outbreaks
 
dc.subject.meshFemale
 
dc.subject.meshHealth Personnel
 
dc.subject.meshHong Kong - epidemiology
 
dc.subject.meshHumans
 
dc.subject.meshInfectious Disease Transmission, Patient-to-Professional
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshOdds Ratio
 
dc.subject.meshSevere Acute Respiratory Syndrome - epidemiology - transmission
 
dc.subject.meshSex Distribution
 
dc.subject.meshTime Factors
 
dc.titleThe epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients
 
dc.typeArticle
 
<?xml encoding="utf-8" version="1.0"?>
<item><contributor.author>Leung, GM</contributor.author>
<contributor.author>Medley, AJ</contributor.author>
<contributor.author>Ho, LM</contributor.author>
<contributor.author>Chau, P</contributor.author>
<contributor.author>Wong, IOL</contributor.author>
<contributor.author>Thach, TQ</contributor.author>
<contributor.author>Ghani, AC</contributor.author>
<contributor.author>Donnelly, CA</contributor.author>
<contributor.author>Fraser, C</contributor.author>
<contributor.author>Riley, S</contributor.author>
<contributor.author>Ferguson, NM</contributor.author>
<contributor.author>Anderson, RM</contributor.author>
<contributor.author>Tsang, T</contributor.author>
<contributor.author>Leung, PY</contributor.author>
<contributor.author>Wong, V</contributor.author>
<contributor.author>Chan, JCK</contributor.author>
<contributor.author>Tsui, E</contributor.author>
<contributor.author>Lo, SV</contributor.author>
<contributor.author>Lam, TH</contributor.author>
<date.accessioned>2010-09-06T09:19:26Z</date.accessioned>
<date.available>2010-09-06T09:19:26Z</date.available>
<date.issued>2004</date.issued>
<identifier.citation>Annals Of Internal Medicine, 2004, v. 141 n. 9, p. 662-673</identifier.citation>
<identifier.issn>0003-4819</identifier.issn>
<identifier.uri>http://hdl.handle.net/10722/86633</identifier.uri>
<description.abstract>Background: As yet, no one has written a comprehensive epidemiologic account of a severe acute respiratory syndrome (SARS) outbreak from an affected country. Objective: To provide a comprehensive epidemiologic account of a SARS outbreak from an affected territory. Design: Epidemiologic analysis. Setting: The 2003 Hong Kong SARS outbreak. Participants: All 1755 cases and 302 deaths. Measurements: Sociodemographic characteristics; infection clusters by time, occupation, setting, and workplace; and geospatial relationships were determined. The mean and variance in the time from infection to onset (incubation period) were estimated in a small group of patients with known exposure. The mean and variance in time from onset to admission, from admission to discharge, or from admission to death were calculated. Logistic regression was used to identify important predictors of case fatality. Results: 49.3% of patients were infected in clinics, hospitals, or elderly or nursing homes, and the Amoy Gardens cluster accounted for 18.8% of cases. The ratio of women to men among infected individuals was 5:4. Health care workers accounted for 23.1% of all reported cases. The estimated mean incubation period was 4.6 days (95% CI, 3.8 to 5.8 days). Mean time from symptom onset to hospitalization varied between 2 and 8 days, decreasing over the course of the epidemic. Mean time from onset to death was 23.7 days (CI, 22.0 to 25.3 days), and mean time from onset to discharge was 26.5 days (CI, 25.8 to 27.2 days). Increasing age, male sex, atypical presenting symptoms, presence of comorbid conditions, and high lactate dehydrogenase level on admission were associated with a greater risk for death. Limitations: Estimates of the incubation period relied on statistical assumptions because few patients had known exposure times. Temporal changes in case management as the epidemic progressed, unavailable treatment information, and several potentially important factors that could not be thoroughly analyzed because of the limited sample size complicate interpretation of factors related to case fatality. Conclusions: This analysis of the complete data on the 2003 SARS epidemic in Hong Kong has revealed key epidemiologic features of the epidemic as it evolved.</description.abstract>
<language>eng</language>
<publisher>American College of Physicians. The Journal&apos;s web site is located at http://www.annals.org</publisher>
<relation.ispartof>Annals of Internal Medicine</relation.ispartof>
<subject.mesh>Adult</subject.mesh>
<subject.mesh>Age Distribution</subject.mesh>
<subject.mesh>Aged</subject.mesh>
<subject.mesh>Cluster Analysis</subject.mesh>
<subject.mesh>Demography</subject.mesh>
<subject.mesh>Disease Outbreaks</subject.mesh>
<subject.mesh>Female</subject.mesh>
<subject.mesh>Health Personnel</subject.mesh>
<subject.mesh>Hong Kong - epidemiology</subject.mesh>
<subject.mesh>Humans</subject.mesh>
<subject.mesh>Infectious Disease Transmission, Patient-to-Professional</subject.mesh>
<subject.mesh>Male</subject.mesh>
<subject.mesh>Middle Aged</subject.mesh>
<subject.mesh>Odds Ratio</subject.mesh>
<subject.mesh>Severe Acute Respiratory Syndrome - epidemiology - transmission</subject.mesh>
<subject.mesh>Sex Distribution</subject.mesh>
<subject.mesh>Time Factors</subject.mesh>
<title>The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: An analysis of all 1755 patients</title>
<type>Article</type>
<identifier.openurl>http://library.hku.hk:4550/resserv?sid=HKU:IR&amp;issn=0003-4819&amp;volume=141&amp;issue=9&amp;spage=662&amp;epage=673&amp;date=2004&amp;atitle=The+epidemiology+of+Severe+Acute+Respiratory+Syndrome+in+the+2003+Hong+Kong+epidemic:+An+analysis+of+all+1755+patients</identifier.openurl>
<description.nature>link_to_subscribed_fulltext</description.nature>
<identifier.pmid>15520422</identifier.pmid>
<identifier.scopus>eid_2-s2.0-3242687609</identifier.scopus>
<identifier.hkuros>96367</identifier.hkuros>
<relation.references>http://www.scopus.com/mlt/select.url?eid=2-s2.0-3242687609&amp;selection=ref&amp;src=s&amp;origin=recordpage</relation.references>
<identifier.volume>141</identifier.volume>
<identifier.issue>9</identifier.issue>
<identifier.spage>662</identifier.spage>
<identifier.epage>673</identifier.epage>
<publisher.place>United States</publisher.place>
</item>
Author Affiliations
  1. The University of Hong Kong