Posted on 04/07/2003 2:45:20 PM PDT by craig_eddy
A Major Outbreak of Severe Acute Respiratory Syndrome in Hong Kong
Nelson Lee, M.D., David Hui, M.D., Alan Wu, M.D., Paul Chan, M.D., Peter Cameron, M.D., Gavin M. Joynt, M.D., Anil Ahuja, M.D., Man Yee Yung, B.Sc., C.B. Leung, M.D., K.F. To, M.D., S.F. Lui, M.D., C.C. Szeto, M.D., Sydney Chung, M.D., and Joseph J.Y. Sung, M.D.
ABSTRACT
Background There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. We report the clinical, laboratory, and radiologic features of 138 cases of suspected SARS during a hospital outbreak in Hong Kong.
Methods From March 11 to 25, 2003, all patients with suspected SARS after exposure to an index patient or ward were admitted to the isolation wards of the Prince of Wales Hospital. Their demographic, clinical, laboratory, and radiologic characteristics were analyzed. Clinical end points included the need for intensive care and death. Univariate and multivariate analyses were performed.
Results There were 66 male patients and 72 female patients in this cohort, 69 of whom were health care workers. The most common symptoms included fever (in 100 percent of the patients); chills, rigors, or both (73.2 percent); and myalgia (60.9 percent). Cough and headache were also reported in more than 50 percent of the patients. Other common findings were lymphopenia (in 69.6 percent), thrombocytopenia (44.8 percent), and elevated lactase dehydrogenase and creatine kinase levels (71.0 percent and 32.1 percent, respectively). Peripheral air-space consolidation was commonly observed on thoracic computed tomographic scanning. A total of 32 patients (23.2 percent) were admitted to the intensive care unit; 5 patients died, all of whom had coexisting conditions. In a multivariate analysis, the independent predictors of an adverse outcome were advanced age (odds ratio per decade of life, 1.80; 95 percent confidence interval, 1.16 to 2.81; P=0.009), a high peak lactate dehydrogenase level (odds ratio per 100 U per liter, 2.09; 95 percent confidence interval, 1.28 to 3.42; P=0.003), and a high absolute neutrophil count on presentation (odds ratio, 1.60; 95 percent confidence interval, 1.03 to 2.50; P=0.04).
Conclusions SARS is a serious respiratory illness that led to significant morbidity and mortality in our cohort.
Notice: Because of possible public health implications, this article has been published at www.nejm.org on April 7, 2003.
Click on "PDF of this article" for the full text.
Not much you can do about your age. But is it possible to do anything about the other two variables?
I think these are more likely markers, or predictors, rather than causes of poor outcome.
Hoping for the best, health officials see stability in mystery illness numbers
Looks like we are up to 135 cases state-side.
Better health care here?
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