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流行病学
最新更新：2003年世界范围严重急性呼吸道综合征爆发流行
美国医学会杂志 2003 Apr
16;289(15):1918-1920
JAMA 2003 Apr 16;289(15):1918-1920
Update: Outbreak of Severe Acute Respiratory Syndrome--Worldwide,
2003.
严重急性呼吸道综合征
加拿大医学会杂志 2003 Apr
15;168(8):1013
CMAJ 2003 Apr 15;168(8):1013
Severe acute respiratory syndrome.
Hoey J. (www.cdc.gov/ncidod/sars/clinicians.htm).
香港严重急性呼吸道综合征爆发大流行
A Major Outbreak
of Severe Acute Respiratory Syndrome in Hong Kong.
新英格医学杂志2003年4月14日
Lee N, Hui D, Wu
A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB,
To KF, Lui SF, Szeto CC, Chung S, Sung JJ.
本文报道了香港一医院SARS流行期间138例疑似SARS病例的临床特征、实验室检查结果特征及放射检查结果特征。
方法：对2003年3月11日至25日收入威尔士亲王医学隔离病房的疑似患者的统计数据、临床特征、实验室特征及放射检查特征进行单变量及多变量分析，这些患者均与SARS患者或其病房有过暴露接触。
结果：138例中男66例，女72例，其中69例为医护人员。最常见症状包括发热、寒战（73.2%），肌痛(60.9%)；50%以上的患者出现咳嗽及头痛。尚可见淋巴细胞减少(69.6%)、血小板减少(44.8%)以及乳酸脱氢酶（71%）及肌氨酸（32.1%）水平升高。利用胸部CT观察外周气体空间合并（Peripheral
air-space consolidation） 共有32例患者进入重症监护病房ICU，其中5例死亡，死亡病例均兼有其它合并症。
最近更新：世界范围内的SARS爆发流行
MMWR Morb Mortal
Wkly Rep 2003 Mar 28;52(12):241-6, 248
Update: Outbreak of severe acute respiratory syndrome--worldwide,
2003.
CDC continues to support the World Health Organization (WHO)
in the investigation of a multicountry outbreak of unexplained
atypical pneumonia referred to as severe acute respiratory
syndrome (SARS). This report includes summaries of the epidemiologic
investigations and public health responses in several affected
locations where CDC is collaborating with international and
national health authorities. This report also describes an
unusual cluster of cases associated with a hotel in Hong Kong
and identifies the potential etiologic agent of SARS. Epidemiologic
and laboratory investigations of SAPS are ongoing.
2003年世界范围SARS爆发流行
JAMA 2003 Apr 9;289(14):1775-1776
Outbreak of Severe Acute Respiratory Syndrome--Worldwide,
2003.
对SARS流行的应对已加快，但是否及时？
N Engl J Med 2003
Apr 2; [epub ahead of print]
Faster. but Fast Enough? Responding to the Epidemic of Severe
Acute Respiratory Syndrome.
Gerberding JL.
Notice: Because of possible public health implications, this
editorial has been published at www.nejm.org on April 2, 2003.
Click on "PDF of this article" for the full text.
Copyright 2003 Massachusetts Medical Society
香港一系列SARS病例
N Engl J Med 2003
Apr 11; [epub ahead of print]
A Cluster of Cases of Severe Acute Respiratory Syndrome in
Hong Kong.
Tsang KW, Ho PL, Ooi GC, Yee WK, Wang T, Chan-Yeung M, Lam
WK, Seto WH, Yam LY, Cheung TM, Wong PC, Lam B, Ip MS, Chan
J, Yuen KY, Lai KN.
Background Information
on the clinical features of severe acute respiratory syndrome
(SARS) will be of value to physicians caring for patients
suspected of having this disorder. Methods We abstracted the
clinical presentation and course of disease in 10 epidemiologically
linked Chinese patients (5 men and 5 women 38 to 72 years
old) in whom SARS was diagnosed between February 22, 2003,
and March 22, 2003, at our hospitals in Hong Kong, China.
Results Exposure between the source patient and subsequent
patients ranged from minimal to that between patient and health
care provider. The incubation period ranged from 2 to 11 days.
All patients presented with fever (temperature, >38 degrees
C for over 24 hours), and most presented with rigor, dry cough,
dyspnea, malaise, headache, and hypoxemia. Physical examination
of the chest revealed crackles and percussion dullness. Lymphopenia
was observed in nine patients, and most patients had mildly
elevated aminotransferase levels but normal serum creatinine
levels. Serial chest radiographs showed progressive air-space
disease. Two patients died of progressive respiratory failure;
histologic analysis of their lungs showed diffuse alveolar
damage. There was no evidence of infection by Mycoplasma pneumoniae,
Chlamydia pneumoniae, or Legionella pneumophila. All patients
received corticosteroid and ribavirin therapy a mean (+/-SD)
of 9.6+/-5.42 days after the onset of symptoms, and eight
were treated earlier with a combination of beta-lactams and
macrolide for 4+/-1.9 days, with no clinical or radiological
efficacy. Conclusions SARS appears to be infectious in origin.
Fever followed by rapidly progressive respiratory compromise
is the key complex of signs and symptoms from which the syndrome
derives its name. The microbiologic origins of SARS remain
unclear.
Notice: Because of possible public health implications, this
article was published at www.nejm.org on March 31, 2003. It
will appear in the May 15 issue of the Journal. Click on "PDF
of this article" for the full text. Copyright 2003 Massachusetts
Medical Society
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