广东省2003-2004年SARS的流行与控制

The prevalence of SARS in Guangdong province from 2003 to 2004 and its control

目的分析广东省2003—2004年SARS病例特征、流行因素及控制措施，进一步完善该病预防控制策略和措施。方法用描述流行病学方法对2003—2004年广东省新发SARS病例流行病学及相关因素进行描述和分析。结果2003年8月-2004年6月，广东省共发生4例社区获得性实验室诊断的SARS病例，均未发现有同类病人接触史，也未出现续发病人。其中1例可能因接触果子狸感染，另两例发病前存在接触果子狸的可能，1例感染来源不详。与3例SARS病例相关的两处餐厅从业人员SARS CoV-IgG抗体阳性率6．3％（8／128），从经营果子猩的TDL酒店果子猩笼、厨房RT-PCR检测到SARS基因。野生动物从业人员SARSCoV—IgG抗体阳性率3．3％（46／1390），高于非野生动物从业人员（0／452）。发病后平均3d就诊．平均在发病后5．8d（4-7d）就被隔离，有3例是在发病后5～6d，有1例是在其发病后12d便对其密切接触者实施医学观察等现场控制。采取在广东省范围内禁食、杀灭果子狸等野生动物措施后，没有再出现SARS病例。结论早发现、早报告、早隔离，做好sARS早期预警监测工作是预防控制SARS疫情蔓延的关键，管理可疑的染疫动物是预防再发的有效措施。

The clinical characteristics of patients, epidemiological factors and control measures for SARS prevalence in Guangdong province from 2003 to 2004 were analysed in order to improve the preventive tactics for this illness. The epidemiology and the related factors with the new SARS cases in Guangdong province in 2003-2004 were described and analysed by descriptive method of epidemiology. From August 2003 to June 2004, all together there were 4 community-acquired and laboratory diagnosed cases of SARS in Guangdong provincet all of these cases had no contact history with the same kind of patients, neither occurring the secondary patients. In these 4 eases, one case might be infected through contact with civet cats, 2 cases had the possibility to contact with eevet cats before the onset of illness and the source of infection for the remaining one case was uncertain.. The positive rate of SARS-Cov IgG antibodies in personnels from two refectories with possible contacts with 3 SARS patients was 6.3 % （8/128） rand that of population working with wild animals was higher than that of the non-wild animal occupation [ 3.3% （46/1390） vs 0% （0/452）]. In addition, SARS genes could be detected from cages for civet cats in TGL restaurants managing civet cats by using RT-PCR assay, The mean interval from onset of illness to be diagnosed was 3 days ,and the mean interval from onset of illness to be isolated from community was 5.8 days（4-7 days）. All thoe closely contactd with patients had been tracted and quarantined timely in which quarantine had been performed to all closely contacts 5-6 days after onset of illeness in 3 cases and 12 days in another one case.. In the whole range of Guangdong provine, eating or killing of wild aninals, such as civet cats was prohibited. Under performance of these manoeuvres, no new case of SARS was discovered later on. It is concluded that the critical points in epidemics of SARS to control the spreading of disease consists of the improvement of the early warning surveillance system with core measures of the so called ＂3-early＂ （ early detection, early reort and early isolation） and the management of suspected animals to be infected with SARS virus.