The severe acute respiratory syndrome epidemic in mainland China dissected
Identifieur interne : 002818 ( Ncbi/Merge ); précédent : 002817; suivant : 002819The severe acute respiratory syndrome epidemic in mainland China dissected
Auteurs : Wu-Chun Cao [République populaire de Chine] ; Sake J. De Vlas [Pays-Bas] ; Jan Hendrik Richardus [Pays-Bas]Source :
- Infectious Disease Reports [ 2036-7430 ] ; 2011.
Abstract
This paper provides a review of a recently published series of studies that give a detailed and comprehensive documentation of the severe acute respiratory syndrome (SARS) epidemic in mainland China, which severely struck the country in the spring of 2003. The epidemic spanned a large geographical extent but clustered in two areas: first in Guangdong Province, and about 3 months later in Beijing with its surrounding areas. Reanalysis of all available epidemiological data resulted in a total of 5327 probable cases of SARS, of whom 343 died. The resulting case fatality ratio (CFR) of 6.4% was less than half of that in other SARS-affected countries or areas, and this difference could only partly be explained by younger age of patients and higher number of community acquired infections. Analysis of the impact of interventions demonstrated that strong political commitment and a centrally coordinated response was the most important factor to control SARS in mainland China, whereas the most stringent control measures were all initiated when the epidemic was already dying down. The long-term economic consequence of the epidemic was limited, much consumption was merely postponed, but for Beijing irrecoverable losses to the tourist sector were considerable. An important finding from a cohort study was that many former SARS patients currently suffer from avascular osteonecrosis, as a consequence of the treatment with corticosteroids during their infection. The SARS epidemic provided valuable information and lessons relevant in controlling outbreaks of newly emerging infectious diseases, and has led to fundamental reforms of the Chinese health system. In particular, a comprehensive nationwide internet-based disease reporting system was established.
Url:
DOI: 10.4081/idr.2011.e2
PubMed: 24470901
PubMed Central: 3892599
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PMC:3892599Le document en format XML
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<front><div type="abstract" xml:lang="en"><p>This paper provides a review of a recently published series of studies that give a detailed and comprehensive documentation of the severe acute respiratory syndrome (SARS) epidemic in mainland China, which severely struck the country in the spring of 2003. The epidemic spanned a large geographical extent but clustered in two areas: first in Guangdong Province, and about 3 months later in Beijing with its surrounding areas. Reanalysis of all available epidemiological data resulted in a total of 5327 probable cases of SARS, of whom 343 died. The resulting case fatality ratio (CFR) of 6.4% was less than half of that in other SARS-affected countries or areas, and this difference could only partly be explained by younger age of patients and higher number of community acquired infections. Analysis of the impact of interventions demonstrated that strong political commitment and a centrally coordinated response was the most important factor to control SARS in mainland China, whereas the most stringent control measures were all initiated when the epidemic was already dying down. The long-term economic consequence of the epidemic was limited, much consumption was merely postponed, but for Beijing irrecoverable losses to the tourist sector were considerable. An important finding from a cohort study was that many former SARS patients currently suffer from avascular osteonecrosis, as a consequence of the treatment with corticosteroids during their infection. The SARS epidemic provided valuable information and lessons relevant in controlling outbreaks of newly emerging infectious diseases, and has led to fundamental reforms of the Chinese health system. In particular, a comprehensive nationwide internet-based disease reporting system was established.</p>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Infect Dis Rep</journal-id>
<journal-id journal-id-type="iso-abbrev">Infect Dis Rep</journal-id>
<journal-id journal-id-type="publisher-id">IDR</journal-id>
<journal-title-group><journal-title>Infectious Disease Reports</journal-title>
</journal-title-group>
<issn pub-type="ppub">2036-7430</issn>
<issn pub-type="epub">2036-7449</issn>
<publisher><publisher-name>PAGEPress Publications</publisher-name>
<publisher-loc>Pavia, Italy</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24470901</article-id>
<article-id pub-id-type="pmc">3892599</article-id>
<article-id pub-id-type="publisher-id">idr.2011.e2</article-id>
<article-id pub-id-type="doi">10.4081/idr.2011.e2</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>The severe acute respiratory syndrome epidemic in mainland China dissected</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Cao</surname>
<given-names>Wu-Chun</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Vlas</surname>
<given-names>Sake J.</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Richardus</surname>
<given-names>Jan Hendrik</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogens and Biosecurity, Beijing, P.R. China;</aff>
<aff id="A2"><label>2</label>
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands</aff>
<author-notes><corresp id="FN1">Correspondence: Prof. Dr. Jan Hendrik Richardus, <addr-line>Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.</addr-line>
Fax: <fax>+31.10.7038474.</fax>
E-mail: <email>j.richardus@erasmusmc.nl</email>
</corresp>
<fn id="FN2" fn-type="con"><p>Contributions: the authors were project leaders of the project “Effective and Acceptable Strategies for the Control of SARS and new emerging infections in China and Europe” and have made substantial contributions to conception and design, acquisition of data, analysis and interpretation of data. They have been involved in drafting the article or revising it critically for important intellectual content, and all authors have given final approval of the version to be published.</p>
</fn>
<fn id="FN3" fn-type="conflict"><p>Conflict of interest: the authors report no conflicts of interest.</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>18</day>
<month>2</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="collection"><day>08</day>
<month>3</month>
<year>2011</year>
</pub-date>
<volume>3</volume>
<issue>1</issue>
<elocation-id>e2</elocation-id>
<history><date date-type="received"><day>06</day>
<month>4</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>08</day>
<month>2</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>©Copyright W-C. Cao et al., 2011</copyright-statement>
<copyright-year>2011</copyright-year>
<license license-type="open-access"><license-p>This work is licensed under a Creative Commons Attribution 3.0 License (by-nc 3.0).</license-p>
<license-p>Licensee PAGEPress, Italy</license-p>
</license>
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<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="idr-2011-1-e2.pdf"></self-uri>
<abstract><p>This paper provides a review of a recently published series of studies that give a detailed and comprehensive documentation of the severe acute respiratory syndrome (SARS) epidemic in mainland China, which severely struck the country in the spring of 2003. The epidemic spanned a large geographical extent but clustered in two areas: first in Guangdong Province, and about 3 months later in Beijing with its surrounding areas. Reanalysis of all available epidemiological data resulted in a total of 5327 probable cases of SARS, of whom 343 died. The resulting case fatality ratio (CFR) of 6.4% was less than half of that in other SARS-affected countries or areas, and this difference could only partly be explained by younger age of patients and higher number of community acquired infections. Analysis of the impact of interventions demonstrated that strong political commitment and a centrally coordinated response was the most important factor to control SARS in mainland China, whereas the most stringent control measures were all initiated when the epidemic was already dying down. The long-term economic consequence of the epidemic was limited, much consumption was merely postponed, but for Beijing irrecoverable losses to the tourist sector were considerable. An important finding from a cohort study was that many former SARS patients currently suffer from avascular osteonecrosis, as a consequence of the treatment with corticosteroids during their infection. The SARS epidemic provided valuable information and lessons relevant in controlling outbreaks of newly emerging infectious diseases, and has led to fundamental reforms of the Chinese health system. In particular, a comprehensive nationwide internet-based disease reporting system was established.</p>
</abstract>
<kwd-group><title>Key words:</title>
<kwd>severe acute respiratory syndrome</kwd>
<kwd>China</kwd>
<kwd>case fatality ratio</kwd>
<kwd>avascular necrosis</kwd>
<kwd>epidemic preparedness.</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
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<li>République populaire de Chine</li>
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<settlement><li>Pékin</li>
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