Wang Jie-xiu, Feng Hong-you, Liu Dong, Zhang Zhi-lun, Shan Ai-lan, Zhu Xiang-jun, Gao Zhi-gang, Wang Xu-dong, Xia Ying-yi, Chen Qian
Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Jul;24(7):565-9.
To analyze the epidemiologic characteristics of severe acute respiratory syndrome (SARS) and to evaluate the effectiveness on its major control measures in Tianjn.
Adopting two case reports 1 and 2, designed by the Tianjin Centers for Disease Control and Prevention to develop a unified case-tracing table including the map of the distribution of close contacts to SARS patients. With those methods, investigation on patients and their close contacts at hospital wards, families, communities and institutions of the patients were carried out.
From April 13 through May 8, 2003, there were 175 SARS cases including imported ones, were identified with an incidence rate of 1.9 cases per 100,000. Among them, 14 died with a fatality of 8.0%. The whole process of epidemic in Tianjin was less than one month with the following features: (1) 93.7% of the total SARS cases in Tianjin were directly or indirectly transmitted by a super-spreader. (2) 68.6% of the total SARS patients were concentrated in 3 hospitals A, B and C which was menifastated in 'clustering'. Through study on the rest of the SARS patients, results showed that 16.8% of them were transmitted through family close contact and 2.3% due to contact to colleagues. However, 12.6% of the patients were not able to show evidence that they had any contact to a diagnosed SARS patient. At the early stage of the epidemic, a number of medical practitioners were infected, taking up 38.2% of the total SARS cases. Among the total number of 1 975 medical workers who participated in the SARS medical cares and treatments, 3.4% of them got infected. During the outbreak, all index cases and chains of transmission seemed to be clear, with only 3 patients not able to be traced for the source of infection, taking up 2% of the total SARS patients in Tianjin. Among the 10 index cases, only the super spreader and another one index case transmitted the virus to their contacts but the rest of index cases did not cause any secondary infection.
Though SARS is clinically severe and can be spreaded quickly, the epidemic can be under control within a short period of time if chains of SARS transmission are broken down and effective measures as isolation and quarantine against patients as well as underscoring awareness among the publics in a scientific way, being carried out.
分析天津市严重急性呼吸综合征（SARS）的流行病学特征，评估其主要防控措施的效果。
采用天津市疾病预防控制中心设计的两个病例报告表1和表2，制定统一的病例追踪表，包括SARS患者密切接触者分布图。采用这些方法，对医院病房、患者家庭、社区和单位的患者及其密切接触者进行调查。
2003年4月13日至5月8日，共确诊175例SARS病例（包括输入性病例），发病率为1.9/10万。其中14例死亡，病死率为8.0%。天津市疫情全过程不到1个月，具有以下特点：（1）天津市SARS病例总数的93.7%由1名超级传播者直接或间接传播。（2）68.6%的SARS患者集中在A、B、C 3家医院，呈“聚集性”。对其余SARS患者进行研究，结果显示16.8%通过家庭密切接触传播，2.3%因接触同事传播。然而，12.6%的患者无法证明其与确诊SARS患者有过接触。疫情早期，有多名医务人员感染，占SARS病例总数的38.2%。在参与SARS医疗救治的1975名医务人员中，3.4%被感染。疫情暴发期间，所有首例病例和传播链似乎都很清晰，仅有3例患者感染源无法追踪，占天津市SARS患者总数的2%。在10例首例病例中，只有超级传播者和另1例首例病例将病毒传播给了其接触者，其余首例病例未引起任何二代感染。
虽然SARS临床症状严重且传播迅速，但如果切断SARS传播链，实施隔离患者、检疫等有效措施，并科学地强化公众意识，疫情可在短时间内得到控制。
