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目的 分析广州市传染性非典型肺炎的流行特点 ,为有效制定SARS防制策略和方案提供依据。方法 采用现场流行病学与血清流行病学调查相结合的方法 ,对广州市SARS疫情进行总结和分析。结果 广州市共报告SARS病例 12 74例 ,经初步订正后为 10 6 2例 ,死亡 4 3例 ,病死率 4 0 5 % ;有明显接触史或传染性的病例与无明显接触史或传染性的病例比较 ,IgG阳性率有显著性差异 (P <0 0 1) ;可溯源病例比例和IgG阳性率随疫情变化逐月下降 ,但在 3月中旬以前均在 5 0 %以上 ;病人接触者和动物接触者的IgG抗体阳性率 (分别为 10 36 %和 37 5 0 % )明显高于疑似病例和健康对照人群 (分别为 1 95 %和 0 92 % )。结论 广州SARS病例病死率低于全球病死率 ;可能存在临床上症状轻微的不典型病例 ,部分密切接触者可能有隐性感染。可溯源病例的比例和血清抗体阳性率的变动 ,可用于SARS疫情流行态势监测和预测。血清学结果提示 ,引起人类发病的SARS冠状病毒与动物间的冠状病毒在生物学特性上可能并不相同。
Objective To analyze the epidemiological characteristics of SARS in Guangzhou and provide evidence for effective SARS control strategies and programs. Methods A combination of field epidemiology and serological epidemiology was used to summarize and analyze the epidemic situation of SARS in Guangzhou. Results A total of 12 74 cases of SARS cases were reported in Guangzhou. After preliminary revision, 106 cases were found, 43 cases died and the case fatality rate was 40.5%. There was a clear history of exposure or contagion with no history of exposure or contagion (P <0.01). The proportion of traceable cases and the positive rate of IgG declined month by month with the change of epidemic situation, but they were all above 50% before mid-March. Patients with contacts The IgG antibody positive rates of animals in contact with animals (10 36% and 37 5 0% respectively) were significantly higher than those of suspected cases and healthy controls (95% and 92%, respectively). Conclusion The case fatality rate of SARS cases in Guangzhou is lower than the global case fatality rate. There may be atypical cases with mild clinical symptoms. Some close contacts may have latent infection. The proportion of traceable cases and the change of the positive rate of serum antibody can be used to monitor and forecast the SARS epidemic situation. Serological results suggest that the SARS coronavirus and animal-derived coronavirus that cause human disease may not be the same in biological characteristics.