Epidemiology and Infection

Table of Contents - 2007 - Volume 135, Issue 03  


SARS transmission in Vietnam outside of the health-care setting

P. A. TUAN a1 1 , P. HORBY a2c1 1 , P. N. DINH a1 1 , L. T. Q. MAI a1 1 , M. ZAMBON a3 1 , J. SHAH a4 1 , V. Q. HUY a5 1 , S. BLOOM a4 1 , R. GOPAL a3 1 , J. COMER a4 1 and A. PLANT a6 1
a1 National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
a2 World Health Organization, Hanoi, Vietnam
a3 Health Protection Agency, London, UK
a4 Centers for Disease Control and Prevention, Atlanta, GA, USA
a5 French Hospital, Hanoi, Vietnam
a6 Curtin University of Technology, Australia

Article author query
tuan pa   [PubMed][Google Scholar] 
horby p   [PubMed][Google Scholar] 
dinh pn   [PubMed][Google Scholar] 
mai lt   [PubMed][Google Scholar] 
zambon m   [PubMed][Google Scholar] 
shah j   [PubMed][Google Scholar] 
huy vq   [PubMed][Google Scholar] 
bloom s   [PubMed][Google Scholar] 
gopal r   [PubMed][Google Scholar] 
comer j   [PubMed][Google Scholar] 
plant a   [PubMed][Google Scholar] 

Abstract

To evaluate the risk of transmission of SARS coronavirus outside of the health-care setting, close household and community contacts of laboratory-confirmed SARS cases were identified and followed up for clinical and laboratory evidence of SARS infection. Individual- and household-level risk factors for transmission were investigated. Nine persons with serological evidence of SARS infection were identified amongst 212 close contacts of 45 laboratory- confirmed SARS cases (secondary attack rate 4·2%, 95% CI 1·5–7). In this cohort, the average number of secondary infections caused by a single infectious case was 0·2. Two community contacts with laboratory evidence of SARS coronavirus infection had mild or sub-clinical infection, representing 3% (2/65) of Vietnamese SARS cases. There was no evidence of transmission of infection before symptom onset. Physically caring for a symptomatic laboratory-confirmed SARS case was the only independent risk factor for SARS transmission (OR 5·78, 95% CI 1·23–24·24).

(Accepted May 24 2006)
(Published Online July 26 2006)


Correspondence:
c1 Medical Epidemiologist, Communicable Disease Surveillance and Response, World Health Organization, 63 Tran Hung Dao Street, Hoan Kiem District, Hanoi, Vietnam. (Email: peter.horby@gmail.com)

Footnotes

1 on behalf of the WHO SARS Investigation Team in Vietnam. The WHO SARS Investigation Team is listed in the Appendix.


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