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OUTBREAK OF SEVERE ACUTE RESPIRATORY SYNDROME IN SOUTHERN TAIWAN, 2003

This study describes the epidemiologic features of the severe acute respiratory syndrome (SARS) outbreak in southern Taiwan in 2003. According to the official files of reported cases of SARS from February 21 to June 19, 2003, there were 586 cases in southern Taiwan. Symptom onset occurred between February 21 and June 19 in reported cases, between March 13 and May 30 in probable cases, and between March 17 and May 23 in polymerase chain reaction (PCR)–positive probable cases. Dates of symptom onset were earliest for six imported cases, followed by 53 cases related to nosocomial infections and 51 cases without known sources of infection. The positive rates of the PCR for these three groups decreased from 50.0% to 28.3% to 3.9% , respectively (P < 0.001, by chi-square test for linear trend). Three other cases resulted from exposure to contaminated hospitals in northern Taiwan, one of which was the index case of the nosocomial infection. Imported cases following nosocomial infection were the major cause of SARS infections in southern Taiwan. Due to the low positive rate of the PCR for SARS coronavirus, and the low positive predictive value of reported cases, the factuality of cases with unknown sources of infection should be further verified.

Received November 25, 2003. Accepted for publication March 25, 2005.

^* Address correspondence to Dr. Shun-Sheng Chen, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung 833 Kaohsiung, Taiwan. E-mail: neuron{at}ms2.hinet.net

Authors’ addresses: Sheng-Nan Lu, Jien-Wei Liu, and Meng-Chih Lin, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan and School of Medicine, Chang Gung University, Taoyuan, Taiwan. Donald Dah-Shyong Jiang and Ih-Jen Su, Department of Health, Center for Disease Control, Taipei, Taiwan. Chao-Long Chen, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, and School of Medicine, Chang Gung University, Taoyuan, Taiwan. Shun-Sheng Chen, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niaosung 833 Kaohsiung, Taiwan, and School of Medicine, Chang Gung University, Taoyuan, Taiwan, Telephone: 886-7-7317123 extension 3301, Fax: 886-7-7322402, E-mail: neuron{at}ms2.hinet.net.