Severe acute respiratory syndrome, Beijing, 2003.

Wannian Liang,Zejun Liu,Daniel P Chin,Xiong He,Zonghan Zhu,Jiyong Guo,Weigong Zhou,Anne Schuchat

doi:10.3201/eid1001.030553

Abstract

The largest outbreak of severe acute respiratory syndrome (SARS) struck Beijing in spring 2003. Multiple importations of SARS to Beijing initiated transmission in several healthcare facilities. Beijing’s outbreak began March 5; by late April, daily hospital admissions for SARS exceeded 100 for several days; 2,521 cases of probable SARS occurred. Attack rates were highest in those 20–39 years of age; 1% of cases occurred in children <10 years. The case-fatality rate was highest among patients >65 years (27.7% vs. 4.8% for those 20–64 years, p < 0.001). Healthcare workers accounted for 16% of probable cases. The proportion of case-patients without known contact to a SARS patient increased significantly in May. Implementation of early detection, isolation, contact tracing, quarantine, triage of case-patients to designated SARS hospitals, and community mobilization ended the outbreak.

Highlights

The largest outbreak of severe acute respiratory syndrome (SARS) struck Beijing in spring 2003
Importation Phase The earliest cases in Beijing occurred in persons who were infected with SARS in Guangdong and Hong Kong
Index Case 1 The first apparent case of SARS in Beijing was identified on March 5 in a 27-year-old businesswoman in whom symptoms developed on February 22 while she was traveling in Guangdong (Figure 1)

Summary

Introduction

The largest outbreak of severe acute respiratory syndrome (SARS) struck Beijing in spring 2003. Multiple importations of SARS to Beijing initiated transmission in several healthcare facilities. Beijing’s outbreak began March 5; by late April, daily hospital admissions for SARS exceeded 100 for several days; 2,521 cases of probable SARS occurred. In contrast to Toronto, where the entire outbreak originated from a single importation [6], Beijing’s outbreak involved multiple distinct imported cases, and transmission from index cases was amplified within several healthcare facilities. Widespread transmission came under control after Beijing municipal authorities aggressively implemented measures to enhance detection, isolate case-patients, and trace contacts to minimize further opportunities for transmission in community and institutional settings. This report summarizes the descriptive epidemiology of Beijing’s outbreak and the emergency interventions that were implemented to control the local situation

Methods

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Conclusion