Ou Jian-ming, Dun Zhe, Li Qin, Qin An-li, Zeng Guang
Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Dec;24(12):1093-5.
An epidemic of severe acute respiratory syndrome (SARS) hit Beijing, China, between March and July 2003 with an attack rate of 1.9 per 10 thousand. (2,521 cases). To control the epidemic of SARS, a total of 30,173 residents were quarantined either in their residence or in quarantine sites. In order to understand the personal need of being quarantined and to estimate the risk of developing SARS during the quarantine period, a survey on the quarantined residents of Haidian District, Beijing, China was carried out.
33 precincts in Haidian District divided into five groups (7 in north, 6 in south, 7 in west, 6 in east and 7 in central of Haidian District) according to the location of the precincts were involved. The director of Center of Disease Control and Prevention of Haidian District was asked to select 1 precinct from each group according to the workload of the precinct quarantine officers. From those 5 precincts we obtained lists of all quarantined persons from the precinct quarantine officers. All quarantinees were asked to complete a self-administered questionnaire. The SARS patients were diagnosed and verified according to the diagnosis criteria released by Chinese Ministry of Health which was equivalent to the SARS 'probable case' definition of WHO. All SARS cases had been reported to the relative authorities.
By May 23, 2003, 5,186 persons had been quarantined in Haidian district, accounting for 0.23% of all residents. 1,028 of sampled quarantined residents completed the questionnaire. Of those who completed the questionnaire, 2.3% (95% CI: 1.5% - 3.5%) developed SARS while under quarantine. The median quarantine period was 14 days (range 1 day to 28 days). 61% of the quarantinees had a direct contact history with SARS patients, and all secondary SARS patients developed through contact to these quarantinees. The remaining 39% quarantinees who did not have a direct contact history with SARS patients had not developed SARS during the period under quarantine. 37% of the quarantees had direct contact during original patients' symptomatic period with an AR of 6.3%. Persons who looked after the illed SARS patient(s) during their symptomatic period, had an highest attack rate of 31% (95% CI: 20% - 44%). 63% (95% CI: 60% - 66%) of the total quarantined persons did not have direct contact with a SARS patient during his/her symptomatic period, with an attack rate of 0% (95% CI: 0% - 0.73%).
Only those persons having direct contact with ill SARS patients need to be under quarantine. The overall cost for quarantine on SARS prevention could be reduced by as much as 63% if the quarantine program was limited to this group. No evidence was found that SARS patient was infective during the incubation period.
2003年3月至7月，严重急性呼吸综合征（SARS）疫情袭击了中国北京，发病率为万分之一点九（共2521例）。为控制SARS疫情，共有30173名居民在其住所或隔离点被隔离。为了解被隔离人员的个人需求，并评估隔离期间感染SARS的风险，对中国北京市海淀区的被隔离居民进行了一项调查。
海淀区的33个街道根据其地理位置分为五组（海淀区北部7个、南部6个、西部7个、东部6个、中部7个）。要求海淀区疾病预防控制中心主任根据街道隔离官员的工作量从每组中选择1个街道。从这5个街道的隔离官员那里获取所有被隔离人员的名单。所有被隔离人员都被要求填写一份自填式问卷。SARS患者根据中国卫生部发布的诊断标准进行诊断和核实，该标准等同于世界卫生组织的“SARS疑似病例”定义。所有SARS病例均已上报相关部门。
截至2003年5月23日，海淀区共有5186人被隔离，占全区居民的0.23%。1028名被抽样的被隔离居民完成了问卷。在完成问卷的人员中，2.3%（95%可信区间：1.5% - 3.5%）在隔离期间感染了SARS。隔离期的中位数为14天（范围1天至28天）。61%的被隔离人员有与SARS患者的直接接触史，所有二代SARS患者均是通过与这些被隔离人员接触而感染的。其余39%没有与SARS患者直接接触史的被隔离人员在隔离期间未感染SARS。37%的被隔离人员在原发病例的症状期有直接接触，感染率为6.3%。在症状期照顾患病SARS患者的人员感染率最高，为31%（95%可信区间：20% - 44%）。63%（95%可信区间：60% - 66%）的被隔离人员在SARS患者症状期未与其直接接触，感染率为0%（95%可信区间：0% - 0.73%）。
只有那些与患病SARS患者有直接接触的人员需要被隔离。如果隔离计划仅限于这一组人员，那么预防SARS的隔离总成本可降低多达63%。未发现有证据表明SARS患者在潜伏期具有传染性。
