Transmission of SARS in three Chinese hospitals.
OBJECTIVE
To quantify the transmissibility of severe acute respiratory syndrome (SARS) in hospitals in mainland China and to assess the effectiveness of control measures.


METHODS
We report key epidemiological details of three major hospital outbreaks of SARS in mainland China, and estimate the evolution of the effective reproduction number in each of the three hospitals during the course of the outbreaks.


RESULTS
The three successive hospital outbreaks infected 41, 99 and 91 people of whom 37%, 60% and 70% were hospital staff. These cases resulted in 33 deaths, five of which occurred in hospital staff. In a multivariate logistic regression, age and whether or not the case was a healthcare worker (HCW) were found to be significant predictors of mortality. The estimated effective reproduction numbers (95% CI) for the three epidemics peaked at 8 (5, 11), 9 (4, 14) and 12 (7, 17). In all three hospitals the epidemics were rapidly controlled, bringing the reproduction number below one within 25, 10 and 5 days respectively.


CONCLUSIONS
This work shows that in three major hospital epidemics in Beijing and Tianjin substantially higher rates of transmission were initially observed than those seen in the community. In all three cases the hospital epidemics were rapidly brought under control, with the time to successful control becoming shorter in each successive outbreak.
Cooper
Ben S
BS
Health Protection Agency, London, UK. ben.cooper@hpa.org.uk
Fang
Li-Qun
LQ
Zhou
Jie-Ping
JP
Feng
Dan
D
Lv
Hui
H
Wei
Mao-Ti
MT
Wang
Shi-Xin
SX
Cao
Wu-Chun
WC
de Vlas
Sake J
SJ
D000328:Adult; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006282:Health Personnel; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D045169:Severe Acute Respiratory Syndrome / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*