Temporal-Spatial Analysis of Severe Acute Respiratory Syndrome among Hospital Inpatients
Identifieur interne : 004960 ( Main/Exploration ); précédent : 004959; suivant : 004961Temporal-Spatial Analysis of Severe Acute Respiratory Syndrome among Hospital Inpatients
Auteurs : Ignatius T. S. Yu [République populaire de Chine, Hong Kong] ; Tze Wai Wong [République populaire de Chine] ; Yuk Lan Chiu [République populaire de Chine] ; Nelson Lee [République populaire de Chine] ; Yuguo Li [République populaire de Chine]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 2005.
Descripteurs français
- KwdFr :
- MESH :
- Pascal (Inist)
- Wicri :
- geographic : Hong Kong.
English descriptors
- KwdEn :
- MESH :
- geographic , epidemiology : Hong Kong.
- transmission : Severe Acute Respiratory Syndrome.
- Cohort Studies, Disease Outbreaks, Hospital Design and Construction, Hospitals, Humans, Proportional Hazards Models, Retrospective Studies, Risk Factors, Time Factors.
Abstract
Background. We report the temporal-spatial spread of severe acute respiratory syndrome (SARS) among inpatients in a hospital ward during a major nosocomial outbreak and discuss possible mechanisms for the outbreak. Methods. All inpatients who had stayed in the same ward as the initial index case patient for any duration before isolation were recruited into a cohort and followed up to document the occurrence of SARS. The normalized concentration of virus-laden aerosols at different locations of the ward was estimated by use of computational fluid dynamics modeling. The attack rates in the various subgroups stratified by bed location were calculated. Multivariate Cox proportional hazards regression was used to document important risk factors. Results. The overall attack rate of SARS was 41% (30 of 74 subjects). It was 65%, 52%, and 18% in the same bay, adjacent bay, and distant bays, respectively (P = .001). Computation fluid dynamics modeling indicated that the normalized concentration of virus-laden aerosols was highest in the same bay and lowest in the distant bays. Cox regression indicated that staying in the ward on 6 or 10 March entailed higher risk, as well as staying in the same or adjacent bays. The epidemic curve showed 2 peaks, and stratified analyses by bed location suggested >1 generation of spread. Conclusions. The temporal-spatial spread of SARS in the ward was consistent with airborne transmission, as modeled by use of computational fluid dynamics. Infected health care workers likely acted as secondary sources in the latter phase of the outbreak.
Url:
- https://api.istex.fr/ark:/67375/HXZ-1HRPVJ8B-6/fulltext.pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107882
DOI: 10.1086/428735
Affiliations:
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Yu</name><affiliation wicri:level="4"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Hong Kong</country><wicri:regionArea>Reprints or correspondence: Dr. Ignatius Yu, Dept. of Community and Family Medicine, 4/F, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong SAR</wicri:regionArea><wicri:noRegion>Hong Kong SAR</wicri:noRegion></affiliation></author><author><name sortKey="Wong, Tze Wai" sort="Wong, Tze Wai" uniqKey="Wong T" first="Tze Wai" last="Wong">Tze Wai Wong</name><affiliation wicri:level="4"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Chiu, Yuk Lan" sort="Chiu, Yuk Lan" uniqKey="Chiu Y" first="Yuk Lan" last="Chiu">Yuk Lan Chiu</name><affiliation wicri:level="4"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong</wicri:regionArea><orgName type="university">Université chinoise de Hong Kong</orgName><placeName><settlement type="city">Sha Tin</settlement></placeName></affiliation></author><author><name sortKey="Lee, Nelson" sort="Lee, Nelson" uniqKey="Lee N" first="Nelson" last="Lee">Nelson Lee</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author><author><name sortKey="Li, Yuguo" sort="Li, Yuguo" uniqKey="Li Y" first="Yuguo" last="Li">Yuguo Li</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Mechanical Engineering, University of Hong Kong, Hong Kong</wicri:regionArea><wicri:noRegion>Hong Kong</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published">2005</date><biblScope unit="vol">40</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" 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(épidémiologie)</term><term>Humains</term><term>Hôpitaux</term><term>Modèles de hasards proportionnels</term><term>Syndrome respiratoire aigu sévère (transmission)</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Hong Kong</term></keywords><keywords scheme="MESH" qualifier="transmission" xml:lang="en"><term>Severe Acute Respiratory Syndrome</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Hong Kong</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cohort Studies</term><term>Disease Outbreaks</term><term>Hospital Design and Construction</term><term>Hospitals</term><term>Humans</term><term>Proportional Hazards Models</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Time Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Conception et construction d'hôpitaux</term><term>Facteurs de risque</term><term>Facteurs temps</term><term>Flambées de maladies</term><term>Humains</term><term>Hôpitaux</term><term>Modèles de hasards proportionnels</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hôpital</term><term>Syndrome respiratoire aigu sévère</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Hong Kong</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Background. We report the temporal-spatial spread of severe acute respiratory syndrome (SARS) among inpatients in a hospital ward during a major nosocomial outbreak and discuss possible mechanisms for the outbreak. Methods. All inpatients who had stayed in the same ward as the initial index case patient for any duration before isolation were recruited into a cohort and followed up to document the occurrence of SARS. The normalized concentration of virus-laden aerosols at different locations of the ward was estimated by use of computational fluid dynamics modeling. The attack rates in the various subgroups stratified by bed location were calculated. Multivariate Cox proportional hazards regression was used to document important risk factors. Results. The overall attack rate of SARS was 41% (30 of 74 subjects). It was 65%, 52%, and 18% in the same bay, adjacent bay, and distant bays, respectively (P = .001). Computation fluid dynamics modeling indicated that the normalized concentration of virus-laden aerosols was highest in the same bay and lowest in the distant bays. Cox regression indicated that staying in the ward on 6 or 10 March entailed higher risk, as well as staying in the same or adjacent bays. The epidemic curve showed 2 peaks, and stratified analyses by bed location suggested >1 generation of spread. Conclusions. The temporal-spatial spread of SARS in the ward was consistent with airborne transmission, as modeled by use of computational fluid dynamics. Infected health care workers likely acted as secondary sources in the latter phase of the outbreak.</div></front></TEI><affiliations><list><country><li>Hong Kong</li><li>République populaire de Chine</li></country><settlement><li>Sha Tin</li></settlement><orgName><li>Université chinoise de Hong Kong</li></orgName></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Yu, Ignatius T S" sort="Yu, Ignatius T S" uniqKey="Yu I" first="Ignatius T. S." last="Yu">Ignatius T. S. Yu</name></noRegion><name sortKey="Chiu, Yuk Lan" sort="Chiu, Yuk Lan" uniqKey="Chiu Y" first="Yuk Lan" last="Chiu">Yuk Lan Chiu</name><name sortKey="Lee, Nelson" sort="Lee, Nelson" uniqKey="Lee N" first="Nelson" last="Lee">Nelson Lee</name><name sortKey="Li, Yuguo" sort="Li, Yuguo" uniqKey="Li Y" first="Yuguo" last="Li">Yuguo Li</name><name sortKey="Wong, Tze Wai" sort="Wong, Tze Wai" uniqKey="Wong T" first="Tze Wai" last="Wong">Tze Wai Wong</name></country><country name="Hong Kong"><noRegion><name sortKey="Yu, Ignatius T S" sort="Yu, Ignatius T S" uniqKey="Yu I" first="Ignatius T. S." last="Yu">Ignatius T. S. Yu</name></noRegion><name sortKey="Yu, Ignatius T S" sort="Yu, Ignatius T S" uniqKey="Yu I" first="Ignatius T. S." last="Yu">Ignatius T. S. Yu</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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