Abstract
During the 2003 outbreak of severe acute respiratory syndrome (SARS) in Taiwan, >150,000 persons were quarantined, 24 of whom were later found to have laboratory-confirmed SARS-coronavirus (SARS-CoV) infection. Since no evidence exists that SARS-CoV is infective before the onset of symptoms and the quarantined persons were exposed but not symptomatic, we thought the quarantine's effectiveness should be investigated. Using the Taiwan quarantine data, we found that the onset-to-diagnosis time of previously quarantined confirmed case-patients was significantly shortened compared to that for those who had not been quarantined. Thus, quarantine for SARS in Taiwan screened potentially infective persons for swift diagnosis and hospitalization after onset, thereby indirectly reducing infections. Full-scale quarantine measures implemented on April 28 led to a significant improvement in onset-to-diagnosis time of all SARS patients, regardless of previous quarantine status. We discuss the temporal effects of quarantine measures and other interventions on detection and isolation as well as the potential usefulness of quarantine in faster identification of persons with SARS and in improving isolation measures.
Highlights
On 16-17 May 2003, the World Health Organization held the first global meeting on the epidemiology of SARS in Geneva, Switzerland
The participants recognized that striking progress had been made in global understanding of the science of SARS, and the coronavirus[1] that is its cause (SARS-CoV), since the first information began to be gathered in March
It was noted that in some cases, late diarrhoea may be related to antibiotic treatment rather than part of the natural history of the disease: given that viral excretion was greatest in stool, diarrhoea could still remain important for infectivity, regardless of its cause.iii
Summary
On 16-17 May 2003, the World Health Organization held the first global meeting on the epidemiology of SARS in Geneva, Switzerland. Seven topics for discussion (see below) were selected on the basis of their importance as epidemiological indicators of the potential impact of the SARS epidemic and the potential for prevention, containment, elimination or eradication Participants presented their findings to a broad audience on Friday May and a smaller group met on Saturday May to review the data and formulate draft recommendations for wider dissemination. Dr Guénäel Rodier (Director, Communicable Disease Surveillance and Response Department, WHO) highlighted the importance of sharing data and experience and the need to reach a consensus on the epidemiology of SARS to enable evidence-based public health action. Discussions at this meeting focused on seven main topics:. It provides a synthesis of our current understanding of the epidemiology of SARS and the priorities for public health research
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