title: Epidemiologic clues to SARS origin in China.
abstract: An epidemic of severe acute respiratory syndrome (SARS) began in Foshan municipality, Guangdong Province, China, in November 2002. We studied SARS case reports through April 30, 2003, including data from case investigations and a case series analysis of index cases. A total of 1,454 clinically confirmed cases (and 55 deaths) occurred; the epidemic peak was in the first week of February 2003. Healthcare workers accounted for 24% of cases. Clinical signs and symptoms differed between children (<18 years) and older persons (> or =65 years). Several observations support the hypothesis of a wild animal origin for SARS. Cases apparently occurred independently in at least five different municipalities; early case-patients were more likely than later patients to report living near a produce market (odds ratio undefined; lower 95% confidence interval 2.39) but not near a farm; and 9 (39%) of 23 early patients, including 6 who lived or worked in Foshan, were food handlers with probable animal contact.
authors.affiliation: Guangdong Province Center for Disease Control and Prevention, Guangzhou, China.
authors.forename: Rui-Heng
authors.initials: RH
authors.lastname: Xu
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: He
authors.forename: Meiron R
authors.initials: MR
authors.lastname: Evans
authors.forename: Guo-Wen
authors.initials: GW
authors.lastname: Peng
authors.forename: Hume E
authors.initials: HE
authors.lastname: Field
authors.forename: De-Wen
authors.initials: DW
authors.lastname: Yu
authors.forename: Chin-Kei
authors.initials: CK
authors.lastname: Lee
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Luo
authors.forename: Wei-Sheng
authors.initials: WS
authors.lastname: Lin
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.forename: Ling-Hui
authors.initials: LH
authors.lastname: Li
authors.forename: Wen-Jia
authors.initials: WJ
authors.lastname: Liang
authors.forename: Jin-Yan
authors.initials: JY
authors.lastname: Lin
authors.forename: Alan
authors.initials: A
authors.lastname: Schnur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006282:Health Personnel; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012307:Risk Factors; D045473:Severe acute respiratory syndrome-related coronavirus / Q000254:growth & development*; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology* / Q000821:virology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires