从四起SARS爆发案例分析SARS的流行病学特征

目的探索SARS的可能来源、流行特征、传播途径与预防对策。方法对广西的2起早期SARS案例进行流行病学调查,对北京某家庭SARS案例和报刊介绍的北京一宗SARS案例收集有关流行病学资料,用流行病学方法和因素分布理论结合免疫学原理对其传播链进行解剖分析和演绎推理。结果广西的两宗早期病例分别存在动物或野生动物接触史。4起爆发案例均呈家庭和特殊职业聚集性,其二代病例以近距离飞沫和密切接触传播为主,但也可能存在血传播和性传播。结论SARS很可能为自然疫源性疾病,除传播途径为近距离飞沫和密切接触传播外,显性感染者的潜伏期或隐性感染可通过性传播而形成隐匿传播。SARS的预防策略为禁止捕杀野生动物,加强疫情报告与监测,做到早发现、早报告、早隔离、早治疗、早调查处理,同时做好医护人员防护和避免院内交叉感染以及切断隐匿传播途径的综合性预防措施。

An analysis on SARS epidemiological characteristics from four outbreaks

Objective To illustrate SARS pathogen host,epidemiological characteristics and its transmission route.Methods Two SARS outbreaks occurred in Guangxi and another two outbreaks in Beijing were analysed.Results Both the first cases of two original outbreaks in Guangxi had the animal or wild animal contact history.All of the four outbreaks had family gathering feature.Droplet and intimate contact were the main transmission route of the secondary cases,but sexual transmission probably had existed.Conclusions SARS was possible a zoonises,which probably comes from wild animal.Bloodborn and sexual transmission may play an important role besides droplet and intimate contact during the SARS epidemic.The strategy for SARS prevention and control included prohibitting hunting wildlife,strengthening surveillance,finding,reporting isolating and treating cases timely, while protecting medical staff for avoiding cross infection,and condom use to prevent potential transmission route.