广东省SARS聚集性病例流行病学分析

Epidemiological analysis on SARS clustered cases in Guangdong province

目的 分析广东省传染性非典型肺炎 (SARS)聚集性病例的流行特征、临床表现等 ,为有效控制该病的流行提供对策、依据与参考。方法 采用描述性分析方法对广东省SARS聚集性病例进行三间分析、潜伏期以及传染力变化的分析。结果 截至 2 0 0 3年 6月 6日止 ,广东省 1 5个地级市共报告SARS病例 1 5 1 1例 ,发生聚集性性病例 4 83例 ,占总病例数的 31 9%。其中医院聚集性病例 30 9例 ,占聚集性病例的 6 4 0 % ;社区聚集性病例 1 74例 ,占 36 0 %(其中家庭聚集性病例 1 6 5例 ,公共场所聚集性病例 9例 )。聚集性病例发病的时间高峰在 2月上、中旬 ,其中医院聚集性病例的发病时间有一个最高峰和两个小高峰 ,最高峰为 2月上旬至 2月中旬 ,医务人员共发病 1 5 7例 ,占医院聚集性病例总数的 5 0 8% ,两个小高峰为 3月中旬和 4月上旬。聚集性病例分布于 1 1个地级市 ,医院聚集性病例主要集中于广州 (2 5 9例 )、江门 (2 0例 )、中山 (1 3例 ) 3个市 ,共发病 2 92例 ,占 94 .5 % (2 92 /30 9)。年龄分布以 2 0～ 4 9岁组发病数较多 ,占 81 1 6 %。分析 91例聚集性病例 ,其潜伏期为 1～ 1 2d ,中位数为 4 5d。分析 32 6例病例的临床表现主要为发热 (1 0 0 0 % )和干咳 (32 6 % )。分析有明确传播链的 2

Objective To understand the epidemiological characteristics and clinical manifestations of clustered SARS cases in Guangdong province.Methods Descriptive epidemiological method was used to analyze the data of clustered SARS cases collected with uniformed questionnaire.Results A total of 1511 cumulative SARS cases were reported by 6 June 2003 in 15 cities in Guangdong and 483 were clustered cases accounting for 31.9% of total cases. Of 483 clustered cases, 64.0% (309) in hospital and 36.0% (165 in families and 9 in public place) in community. The peak of cluster cases (onset date) appeared in the period of 1～20 February. There were 157 hospital clustered cases in this period. Total number of Hospital cases was 292, mainly in Guangzhou (259 ), Jiangmen (20 ), Zhongshan (13 ), altogether accounting for 94 5%(292/309). 81.16% of them aged 20～49. The mean incubation period of the cluster was 4.5 days (ranging 1～12). Clinical symptoms, fever (100%), dry cough (32.6%). Case fatality in 1st,2 nd,3 rd,and 4 th generation cases were 45.5%(10/22),3.77%(8/212),0(0/53) and 0(0/1) respectively. As far as epidemicity is concerned, 22 of 1st (22) and10 in 2nd (212) could forward transmission of infection.Conclusion The clustered SARS cases mainly occurred in the early stage of the outbreak and mainly in hospital HCWs.Health care worker nosocomial infection control is a critical point in the epidemic control.