Temporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients.
Identifieur interne : 002445 ( PubMed/Checkpoint ); précédent : 002444; suivant : 002446Temporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients.
Auteurs : Ignatius T S. Yu [République populaire de Chine] ; Tze Wai Wong ; Yuk Lan Chiu ; Nelson Lee ; Yuguo LiSource :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2005.
Descripteurs français
- KwdFr :
- MESH :
- 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
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.
DOI: 10.1086/428735
PubMed: 15825024
Affiliations:
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<author><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>
<affiliation wicri:level="4"><nlm:affiliation>Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong, China. iyu@cuhk.edu.hk</nlm:affiliation>
<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>
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<author><name sortKey="Wong, Tze Wai" sort="Wong, Tze Wai" uniqKey="Wong T" first="Tze Wai" last="Wong">Tze Wai Wong</name>
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<author><name sortKey="Chiu, Yuk Lan" sort="Chiu, Yuk Lan" uniqKey="Chiu Y" first="Yuk Lan" last="Chiu">Yuk Lan Chiu</name>
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<author><name sortKey="Lee, Nelson" sort="Lee, Nelson" uniqKey="Lee N" first="Nelson" last="Lee">Nelson Lee</name>
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<author><name sortKey="Li, Yuguo" sort="Li, Yuguo" uniqKey="Li Y" first="Yuguo" last="Li">Yuguo Li</name>
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<author><name sortKey="Chiu, Yuk Lan" sort="Chiu, Yuk Lan" uniqKey="Chiu Y" first="Yuk Lan" last="Chiu">Yuk Lan Chiu</name>
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<term>Disease Outbreaks</term>
<term>Hong Kong (epidemiology)</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>Severe Acute Respiratory Syndrome (transmission)</term>
<term>Time Factors</term>
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<keywords scheme="KwdFr" 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>Hong Kong (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>
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<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Hong Kong</term>
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<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Hong Kong</term>
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<term>Disease Outbreaks</term>
<term>Hospital Design and Construction</term>
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<term>Humans</term>
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<term>Humains</term>
<term>Hôpitaux</term>
<term>Modèles de hasards proportionnels</term>
<term>Études de cohortes</term>
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<front><div type="abstract" xml:lang="en">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.</div>
</front>
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<Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title>
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<ArticleTitle>Temporal-spatial analysis of severe acute respiratory syndrome among hospital inpatients.</ArticleTitle>
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<Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="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.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText>
</Abstract>
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