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Article: A comparative epidemiologic analysis of SARS in Hong Kong, Beijing and Taiwan

TitleA comparative epidemiologic analysis of SARS in Hong Kong, Beijing and Taiwan
Authors
Issue Date2010
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/
Citation
BMC Infectious Diseases, 2010, v. 10, article no. 50 How to Cite?
AbstractBackground: The 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak infected 8,422 individuals leading to 916 deaths around the world. However, there have been few epidemiological studies of SARS comparing epidemiologic features across regions. The aim of this study is to identify similarities and differences in SARS epidemiology in three populations with similar host and viral genotype.Methods: We present a comparative epidemiologic analysis of SARS, based on an integrated dataset with 3,336 SARS patients from Hong Kong, Beijing and Taiwan, epidemiological and clinical characteristics such as incubation, onset-to-admission, onset-to-discharge and onset-to-death periods, case fatality ratios (CFRs) and presenting symptoms are described and compared between regions. We further explored the influence of demographic and clinical variables on the apparently large differences in CFRs between the three regions.Results: All three regions showed similar incubation periods and progressive shortening of the onset-to-admission interval through the epidemic. Adjusted for sex, health care worker status and nosocomial setting, older age was associated with a higher fatality, with adjusted odds ratio (AOR): 2.10 (95% confidence interval: 1.45, 3.04) for those aged 51-60; AOR: 4.57 (95% confidence interval: 3.32, 7.30) for those aged above 60 compared to those aged 41-50 years. Presence of pre-existing comorbid conditions was also associated with greater mortality (AOR: 1.74; 95% confidence interval: 1.36, 2.21).Conclusion: The large discrepancy in crude fatality ratios across the three regions can only be partly explained by epidemiological and clinical heterogeneities. Our findings underline the importance of a common data collection platform, especially in an emerging epidemic, in order to identify and explain consistencies and differences in the eventual clinical and public health outcomes of infectious disease outbreaks, which is becoming increasingly important in our highly interconnected world. © 2010 Lau et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/92560
ISSN
2015 Impact Factor: 2.69
2015 SCImago Journal Rankings: 1.510
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Hong Kong Special Administrative Region GovernmentHKU-AA-17
University of Hong Kong
Taiwan Center for Disease Control SARS Research Fund
UK Medical Research Council
EUSP22-CT-2004-511066
Funding Information:

The authors thank all their colleagues in the Hong Kong Department of Health, the Hong Kong Hospital Authority, the 301, 302 and 309 hospitals in Beijing, and the Taiwan Center for Disease Control and National Health Research Institutes in Taiwan who were involved with the public health control of the SARS epidemics and data collection and processing. We thank Dr Baoxing Fan and colleagues at 301 Hospital of the PLA, Beijing, for abstracting and sharing the data on Beijing SARS patients as part of the SARSTRANS international collaboration. We also thank Steve Chan, Keith Tin and Pauline Woo for technical assistance. This work was supported in part through a commissioned research grant from the Research Fund for the Control of Infectious Diseases of the Health, Welfare, and Food Bureau of the Hong Kong Special Administrative Region Government (grant no. HKU-AA-17); by the University of Hong Kong SARS Research Fund; by the Taiwan Center for Disease Control SARS Research Fund; by the UK Medical Research Council; and by the EU Sixth Framework Programme for research for policy support (contract SP22-CT-2004-511066).

References

 

DC FieldValueLanguage
dc.contributor.authorLau, EHYen_HK
dc.contributor.authorHsiung, CAen_HK
dc.contributor.authorCowling, BJen_HK
dc.contributor.authorChen, CHen_HK
dc.contributor.authorHo, LMen_HK
dc.contributor.authorTsang, Ten_HK
dc.contributor.authorChang, CWen_HK
dc.contributor.authorDonnelly, CAen_HK
dc.contributor.authorLeung, GMen_HK
dc.date.accessioned2010-09-17T10:50:07Z-
dc.date.available2010-09-17T10:50:07Z-
dc.date.issued2010en_HK
dc.identifier.citationBMC Infectious Diseases, 2010, v. 10, article no. 50en_HK
dc.identifier.issn1471-2334en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92560-
dc.description.abstractBackground: The 2002-2003 Severe Acute Respiratory Syndrome (SARS) outbreak infected 8,422 individuals leading to 916 deaths around the world. However, there have been few epidemiological studies of SARS comparing epidemiologic features across regions. The aim of this study is to identify similarities and differences in SARS epidemiology in three populations with similar host and viral genotype.Methods: We present a comparative epidemiologic analysis of SARS, based on an integrated dataset with 3,336 SARS patients from Hong Kong, Beijing and Taiwan, epidemiological and clinical characteristics such as incubation, onset-to-admission, onset-to-discharge and onset-to-death periods, case fatality ratios (CFRs) and presenting symptoms are described and compared between regions. We further explored the influence of demographic and clinical variables on the apparently large differences in CFRs between the three regions.Results: All three regions showed similar incubation periods and progressive shortening of the onset-to-admission interval through the epidemic. Adjusted for sex, health care worker status and nosocomial setting, older age was associated with a higher fatality, with adjusted odds ratio (AOR): 2.10 (95% confidence interval: 1.45, 3.04) for those aged 51-60; AOR: 4.57 (95% confidence interval: 3.32, 7.30) for those aged above 60 compared to those aged 41-50 years. Presence of pre-existing comorbid conditions was also associated with greater mortality (AOR: 1.74; 95% confidence interval: 1.36, 2.21).Conclusion: The large discrepancy in crude fatality ratios across the three regions can only be partly explained by epidemiological and clinical heterogeneities. Our findings underline the importance of a common data collection platform, especially in an emerging epidemic, in order to identify and explain consistencies and differences in the eventual clinical and public health outcomes of infectious disease outbreaks, which is becoming increasingly important in our highly interconnected world. © 2010 Lau et al; licensee BioMed Central Ltd.en_HK
dc.languageengen_HK
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/en_HK
dc.relation.ispartofBMC Infectious Diseasesen_HK
dc.titleA comparative epidemiologic analysis of SARS in Hong Kong, Beijing and Taiwanen_HK
dc.typeArticleen_HK
dc.identifier.emailLau, EHY:ehylau@hku.hken_HK
dc.identifier.emailCowling, BJ:bcowling@hku.hken_HK
dc.identifier.emailHo, LM:lmho@hkucc.hku.hken_HK
dc.identifier.emailLeung, GM:gmleung@hku.hken_HK
dc.identifier.authorityLau, EHY=rp01349en_HK
dc.identifier.authorityCowling, BJ=rp01326en_HK
dc.identifier.authorityHo, LM=rp00360en_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1471-2334-10-50en_HK
dc.identifier.pmid20205928-
dc.identifier.pmcidPMC2846944-
dc.identifier.scopuseid_2-s2.0-77951147148en_HK
dc.identifier.hkuros169585en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77951147148&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volumev. 10, article no. 50en_US
dc.identifier.isiWOS:000276390900003-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLau, EHY=7103086074en_HK
dc.identifier.scopusauthoridHsiung, CA=7006014026en_HK
dc.identifier.scopusauthoridCowling, BJ=8644765500en_HK
dc.identifier.scopusauthoridChen, CH=19638684600en_HK
dc.identifier.scopusauthoridHo, LM=7402955625en_HK
dc.identifier.scopusauthoridTsang, T=7101832378en_HK
dc.identifier.scopusauthoridChang, CW=26434115600en_HK
dc.identifier.scopusauthoridDonnelly, CA=35468127900en_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.citeulike6771443-

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