广东省SARS家庭聚集性病例流行病学分析

Epidemiological analysis on the family-clustered SARS cases in Guandong

目的 了解广东省传染性非典型肺炎 (SARS)家庭聚集性病例的流行病学特征 ,探讨家庭因素在本病传播方面的作用。方法 采用统一个案调查表 ,用描述性流行病学方法对广东省SARS家庭聚集性病例进行分析。结果 截至 5月 1 5日止 ,在广东省 1 5 1 2例SARS病例中 ,6 0户家庭出现聚集性病例 ,共 1 91例 ,占全省病例总数的1 2 6 %。家庭聚集性病例的病死率为 9 9% ,高于全省平均病死率 (3 7% ) (P <0 0 1 )。家庭聚集性病例主要发生在2 0 0 3年 1月至 3月 ,占家庭聚集性病例总数的 90 6 % (1 73/ 1 91 )。病例以 30～ 4 9岁青壮年为主 ,占 5 2 9% (1 0 1 / 1 91 ) ;职业以干部职员为主 ,占 1 3 6 % (2 6 / 1 91 ) ,其次为饮食、服务人员 ,占 1 2 6 % (2 4 / 1 91 )。 4 1 7%家庭的首发病例在发病前两周有明确或可疑接触史。在 1 2 9例家庭聚集二代感染病例中可能因陪护或探病感染发病的有 4 2户 ,共 92例 ,占71 3%。首发病例与二代病例发病时间间隔中位数为 7d。结论 家庭聚集性病例的病死率较高 ,家庭聚集性病例有较大比例可能在医院内感染 ,但家庭密切接触也是造成疫情传播的原因之一 。

Objective To understand the epidemiological characteristics of the family clustered SARS cases in Guangdong province, and to reveal the determinants on the disease transmission. Methods The epidemiological characteristics of the family clustered SARS cases in Guangdong Province were investigated by uniform questionnaires. Results As of 15 May 2003, a total of 191 family clustered SARS cases with 60 families involved, accounting for 12.6% of all SARS cases, were reported. About 90.6 % (173/191) of the cases occurred from January to March 2003. The mortality(9.9%) of them was higher than the general SARS specific mortality (3.7%, P <0.01). About 52.9 %( 101/191) of the cases aged 30-49 and 13.6%(26/191)of the cases were health care workers, followed by food preparing staffs, accounting for 12.6 % (24/191). The first cases from 41.7% of the involved families had apparent or suspect exposure. 91 secondary cases from 42 families may be infected during patient accompanying or visiting, accounting for 71.3%. The median of the time interval between the first case and the secondary cases was 7 days. Conclusion: Family clustered cases had the comparatively higher mortality, and family based infection was mainly obtained in hospital.