Epidemiologic clues to SARS origin in China.
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.
Xu
Rui-Heng
RH
Guangdong Province Center for Disease Control and Prevention, Guangzhou, China.
He
Jian-Feng
JF
Evans
Meiron R
MR
Peng
Guo-Wen
GW
Field
Hume E
HE
Yu
De-Wen
DW
Lee
Chin-Kei
CK
Luo
Hui-Min
HM
Lin
Wei-Sheng
WS
Lin
Peng
P
Li
Ling-Hui
LH
Liang
Wen-Jia
WJ
Lin
Jin-Yan
JY
Schnur
Alan
A
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