[Study on the epidemiology and measures for control on severe acute respiratory syndrome in Guangzhou city].
OBJECTIVE
To analyze the epidemiological characteristics, related risk factors, measures for its control of severe acute respiratory syndrome (SARS).


METHODS
Data on epidemiological features, pathogens and measures for control were collected and analyzed.


RESULTS
Since Jan 2003, infectious atypical pneumonia (AP) has become epidemic in Guangzhou city. The first autochthonous case was identified on Jan 2nd. Number of cases started to increase since February and reached peak in the early 10 days of February. Hereafter the epidemic tended to decline in March and since early April, the average number of new cases began to decrease, less than 10 per day. Epidemiological studies revealed that the number of cases aged between 20 and 50 was higher than that below the age of 20. Of the total 966 cases, 429 were males versus 537 females. Geographically, the epidemics covered all 13 districts of Guangzhou, but 95% of the cases concentrated in 7 urban districts. As for professional distribution, health care workers accounted for 28.67% of the total cases. There were 36 deaths, aged from 5 to 89, with half of them older than 60. Out of the victims, 38.9% of them had complications as hypertension, diabetes, heart diseases and COPD etc. Data regarding the clustering features of cases showed that there were 42 families having 2 or more cases in one family, while 277 health workers suffered from SARS were concentrated in 28 hospitals. Only one outbreak took place in a public setting but no outbreak was reported in schools. Relevant research also indicated that SARS could be classified as an air-borne infectious disease, transmitted through aerosol and droplets, but close contact also played an important role in the mode of transmission. The disease was highly infectious, suggesting that people who had close contact with patients in the place with poor ventilation was in greater risk of getting infection. The incubation period ranged from 1 to 11 days (mainly from 3 to 8 days), with an average of 5 days. According to our observation, the following measures might be effective such as: early diagnosis, isolation and treatment provided to the patients, and suspected cases under medical observation should also be put in separate places. Improving ventilation and regular disinfection over air and stuff in hospital wards were also recommended. In order to prevent iatrogenic infection, sense on self-protection among health care workers must be strengthened. Patients were not allowed to be visited by any one other than hospital staff.


CONCLUSIONS
SARS is a preventable disease and can be under control. It is of great importance to prevent clustered SARS cases and the prevention of iatrogenic infection is essential.
Wang
Ming
M
Guangzhou Center for Disease Control and Prevention, Guangzhou 510080, China.
Du
Lin
L
Zhou
Duan-hua
DH
Di
Biao
B
Liu
Yu-fei
YF
Qin
Peng-zhe
PZ
Wu
Xin-wei
XW
Chen
Xiao-shuang
XS
Qiu
Ji-chun
JC
Li
Ze-rong
ZR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D016358:Contact Tracing; D004196:Disease Outbreaks; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000517:prevention & control*