Epidemiology and Clinical Investigation of SARS in Taiwan

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Epidemiology and Clinical Investigation of SARS
in Taiwan

• Speaker Yi-Chun Wu
• Center for Disease Control, Taiwan

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Active Surveillance System

• SARS Reporting System
• Respiratory Syndrome Reporting System
• SARS reported cases were reviewed by SARS
  Advisory Committee

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Case Definition

• Suspected Case of SARS
• After 1 February 2003 with history of -  high
  fever (gt38 C) AND -   cough or breathing
  difficulty with exposures during the 10 days
  prior to onset of symptoms -  close contact
  with a person who is a suspect or probable case
  of SARS -  history of travel or residing , to
  an affected area

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Case Definition

• Probable Case of SARS
• A suspected case with radiographic evidence of
  infiltrates consistent with pneumonia or
  respiratory distress syndrome (RDS) on chest
  X-ray (CXR).
• A suspect case with autopsy findings consistent
  with the pathology of RDS without an identifiable
  cause.

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Cumulative Number of Reported Cases in Taiwan,
updated Apr. 18
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Tracking Travel History and Disease Onset of SARS
Probable Cases
7
3
?
2
3
3
8
The Travel History of Taiwan SARS Cases in
Mainland China
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Demographic Characteristics of SARS Probable
Cases (Age)
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Demographic Characteristics of SARS Probable Cases
Household
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Demographic Characteristics of SARS Probable Cases
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Number of Probable SARS Cases by Exposure
Category and Date of Fever Onset in Taiwan
Travel Household Contact HCW
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Incubation Period of SARS Cases in Taiwan (n5)

• Mean 7.4 days
• Median 7
• Range 4-10

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Symptoms of Probable SARS Cases in Taiwan
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Physical and Lab. Finding of Probable SARS in
Taiwan
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The Correlation of Virology Bacteriology
Studies and SARS Probable Cases in Taiwan
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The Correlation of Virology Bacteriology
Studies and SARS Probable Cases in Taiwan
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Conclusions

• Majority of probable SARS cases in Taiwan were
  imported cases (81.5,22/27 ).
• Active Surveillance and Tracking Contact History
  helps to know where are SARS cases in China
• Early Identification and Isolation is the most
  effective prevention and control measure.

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Conclusions

• The Major Symptom of SARS Cough 100, fever
  100, myalgia 66.7, diarrhea 57.1, sputum
  52.9,dyspnea 50, Nausea/Vomiting and Headache
  are both about 40.
• Lab. Finding of SARS Low Lym. 82.4, WBC
  Normal/Low 70.4, Low Platelet 48.1, High LDH
  71.4, High CPK 11.1.

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Conclusions

• SARS virus PCR () 9/27 (33.3) in Probable
  cases.
• SARS virus Co-infection with other etiological
  agent 4/27 (14.8) in Probable cases.
• Without SARS virus but with other infection 8/27
  (29.7) in Probable cases.

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Acknowledgements

• CDC, USA
• SARS Advisory Committee,Taiwan
• CDC SARS investigation team, Taiwan
• All the hospitals treating SARS cases,Taiwan
• Local Departments of Health, Taiwan

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Thank You for Your Attention!