SARS in Taiwan 84 were fatal. The Study.pdf

Patient Data, Early SARS Epidemic, Taiwan Po-Ren Hsueh,* Pei-Jer Chen,* Cheng-Hsiang Hsiao,* Shiou-Huei Yeh,? Wern-Cherng Cheng,* Jiun-Ling Wang,* Bor-Luen Chiang,* Shan-Chwen Chang,* Feng-Yee Chang,? Wing-Wai Wong,§ Chuan-Liang Kao,*1 Pan-Chyr Yang,* 1 and the SARS Research Group of National Taiwan University College of Medicine and National Taiwan University Hospital2 Of the first 10 patients in the epidemic of severe acute respiratory syndrome (SARS) in Taiwan, 4 were closely associated with a SARS patient in an airplane. Loose stools or diarrhea, hemophagocytosis syndrome, and high serum levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α associated with lung lesions were found in all 10 patients. In November 2002, severe acute respiratory syndrome(SARS), a highly contagious febrile respiratory illness with a high propensity to spread to a patient’s household members and healthcare workers, emerged and eventually caused worldwide outbreaks (1–9). By late February 2003, SARS was considered an emerging disease (10). Most SARS cases have occurred in China, the Hong Kong Special Administrative Region, Canada, and Taiwan (1–9). As of July 15, 2003, there were 671 probable cases of SARS in Taiwan; 84 were fatal. The Study From March 8 to April 16, 2003, the first 10 patients whose illness met the World Health Organization (WHO) case definition of probable SARS (10) were admitted to National Taiwan University Hospital. Three patients (patients 6, 7, and 8) were transferred to other hospitals after initial evaluation and treatment at the emergency department. All 10 patients were Taiwanese; 7 had recently returned to Taiwan from China (2 from Guangdong Province, 5 from Beijing), 2 were family members, and 1 was a healthcare worker. Among the 10 patients, two clusters involving 9 patients were identified. Transmission among the four patients of cluster A occurred after household contact with the index case-patient (patient 1) or contact with patient 2 i