Abstract
We studied the severe acute respiratory syndrome (SARS) outbreak in Taiwan, using the daily case-reporting data from May 5 to June 4 to learn how it had spread so rapidly. Our results indicate that most SARS-infected persons had symptoms and were admitted before their infections were reclassified as probable cases. This finding could indicate efficient admission, slow reclassification process, or both. The high percentage of nosocomial infections in Taiwan suggests that infection from hospitalized patients with suspected, but not yet classified, cases is a major factor in the spread of disease. Delays in reclassification also contributed to the problem. Because accurate diagnostic testing for SARS is currently lacking, intervention measures aimed at more efficient diagnosis, isolation of suspected SARS patients, and reclassification procedures could greatly reduce the number of infections in future outbreaks.
Highlights
We studied the severe acute respiratory syndrome (SARS) outbreak in Taiwan, using the daily case-reporting data from May 5 to June 4 to learn how it had spread so rapidly
We proposed a dynamic model to reflect the actual sequence of events for a reported case-patient in Taiwan, from onset to admission at a hospital as a suspected casepatient to either reclassification as a probable case-patient or removal from the suspected SARS category, and reclassification from probable case to discharged case or fatality
We considered a model with susceptible patients (Sn), hospitalized suspected case-patients (Hn), reported probable SARS case-patients (In), and the accumulated SARS deaths (Dn)
Summary
We studied the severe acute respiratory syndrome (SARS) outbreak in Taiwan, using the daily case-reporting data from May 5 to June 4 to learn how it had spread so rapidly. Our results indicate that most SARS-infected persons had symptoms and were admitted before their infections were reclassified as probable cases. This finding could indicate efficient admission, slow reclassification process, or both. The high percentage of nosocomial infections in Taiwan suggests that infection from hospitalized patients with suspected, but not yet classified, cases is a major factor in the spread of disease. Many questions arose as to how SARS was able to spread so rapidly in Taiwan, a full 2 months after the global alert posted by WHO and >1 month after its passage through Hong Kong, Singapore, and other neighboring countries [4]. We aimed to circumvent problems in answering these questions with a simple mathematical model useful to our understanding of the outbreak
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