广州市2003年冬季传染性非典型肺炎流行病学分析

Severe acute respiratory syndrome epidemic in Guangzhou, winter 2003

目的分析传染性非典型肺炎(下称SARS)的流行特点,探讨SARS感染发病的特征,为制定SARS防制策略提供依据.方法用现场流行病学与血清流行病学调查方法,分析广州市2003年冬季SARS流行特征.结果广州市2003年12月16日至2004年1月7日共报告SARS病例4例,男性3例,女性1例,年龄20～40岁;患者病情较轻,无ARDS和死亡;3例患者在发病后5～6 d就可检测出SARS-CoV IgG、IgM抗体;均属本地社区感染病例,其中3例患者与经营果子狸的T、S餐厅有流行病学联系,但病例间无直接的流行病传播关系.257名接触者无一例发病;T及S餐厅129名员工中血清SARS-CoV IgG阳性率为6.20%(8/129),8例SARS-CoV IgG阳性者中1例为报告病例,1例为近期感染轻型病例,1例为2003年初可疑SARS病例,5例为隐性感染者;两餐厅员工的SARS- CoV IgG阳性率明显高于健康对照人群(0.43%)和服务业从业人员(0.29%);T酒家存栏的6只果子狸咽拭子均检出SARS-CoV RNA.结论广州2003年冬季SARS流行强度低、病例病情轻,未显示出有传染性,存在有隐性感染者和轻型病例,SARS-CoV来源与动物(果子狸)密切相关.

Objective Analyzing the epidemiological character of the 4 cases of SARS in Guangzhou winter 2003 and providing the guideline for prevention. Methods Field epidemiology and serological investigation. Results 4 cases of SARS were reported from 16 December 2003 to 7 January 2004 in Guangzhou, 3 male and 1 female, aged from 20 to 40. All were community acquired and infected independently, but 3 of them related to two restaurants served civet cat dish and displayed milder symptoms, no mechanical ventilation and relatively rapid resolution of fever, radiographic findings. No secondary transmission demonstrated. 3 cases were SARS-CoV IgG, IgM positive in early stage. 129 employees in two restaurants tested for SARS-CoV IgG, 8(6.20%) were positive, of which, 1 was the patient, and the rate was higher than that of controls. SARS-CoV RNA was found in samples from 6 civet cats in one of the two restaurants. Conclusion The SARS outbreak in winter 2003 Guangzhou was at the early phase and 4 cases infected independently without secondary transmission. The source of infection of 3 cases was related to wildlife, civet cats.