广东省13市传染性非典型肺炎首发病例流行病学分析

An epidemiological study on the index cases of severe acute respiratory syndrome occurred in different cities among Guangdong province

目的 分析广东省首例传染性非典型肺炎病例 (SARS)的流行病学特征 ,为追溯传染源提供科学依据。方法 采用统一的个案调查表对广东省SARS首发病例进行调查 ,同时对其密切接触者进行流行病学调查 ,分析首发病例流行病学特征、续发病例情况及各市首发病例之间的联系。结果 2 0 0 2年 11月 16日至 2 0 0 3年 4月 16日 ,广东省有 13个地级市报告发生SARS(依次为佛山、河源、中山、江门、广州、深圳、肇庆、东莞、汕头、惠州、汕尾、湛江、韶关等市 )。对 13个市的首发病例进行分析 :13例首发病例中 ,厨师和干部各有 3例 ,农民、退休人员、工人各 2例、商业人员 1例 ;男女比为 1∶0 .6 ,年龄在 18～ 84岁之间 ,30～ 5 0岁组占 77% (10 /13) ;死亡 4例。 2 0 0 0年 11月至 2 0 0 3年 1月期间 ,7个市报告的首发病例中 ,6例为本市感染病例 ,1例怀疑为从广州输入病例 ,均无明确同类病例接触史 ,其中有 6例引起二代或三代病例 ;2 0 0 3年 2月无新发病市 ;2 0 0 3年 3月～ 4月 16日 ,6市报告新发病例 ,2例为本市感染发病 ,3例感染地为香港、1例感染地为广州 ,5例有明确的同类病例密切接触史 ,只有 2例引起第二代病例。结论 未发现 13例首发病例间存在相互传播的线索。

Objective To analyze the epidemiological features of the index cases of severe acute respiratory syndrome (SARS) occurred in different cities in Guangdong province and to trace for the source of infection. Methods Standardized individual case inventory was adopted to conduct investigation on index cases and on persons who had close contact with index cases in Guangdong province. Data on the epidemiological characteristics,secondary cases and the links among index cases were analyzed. Results Between November 16,2002 and April 16,2003,there had been 13 index cases of SARS including 3 cadres,3 farmers,2 retirees,2 workers and 1 shop attendant,reported from 13 cities in Guangdong province. Between November 2002 and January 2003,there had been 7 cities reported to have identified index cases of SARS with 6 of them being infected in their own cities and 1 imported from Guangzhou city. All of the cases had no close contacts to similar patients but 6 of them later caused 2nd or even 3rd generation cases of SARS. Most cases hit young people (7/13) with a sex ratio of 1∶0.6 . The fatality rate of index cases was high (4/13). Conclusion No evidence showed that there was direct transmission among the index cases. Data regarding the geographical origin of those index cases led to the assumption that the infection had started in six cities of Pearl river delta region and the Hong Kong Special Administrative Region.