OBJECTIVES: To determine the clinical and radiological features of severe acute respiratory syndrome (SARS) and to evaluate the accuracy of the World Health Organization's guidelines on defining cases of SARS. DESIGN: Prospective observational study. SETTING: A newly set up SARS screening clinic in the emergency department of a university hospital in Hong Kong's New Territories. PARTICIPANTS: 556 hospital staff, patients, and relatives who attended the screening clinic and who had had contact with someone with SARS. MAIN OUTCOME MEASURE: Number of confirmed cases of SARS. RESULTS: Of the 556 people, 141 were admitted to hospital, and 97 had confirmed SARS. Fever, chills, malaise, myalgia, rigor, loss of appetite, vomiting, diarrhoea, and neck pain but not respiratory tract symptoms were significantly more common among the 97 patients than among the other patients. The overall accuracy of the WHO guidelines for identifying suspected SARS was 83% and their negative predictive value was 86% (95% confidence interval 83% to 89%). They had a sensitivity of 26% (17% to 36%) and a specificity of 96% (93% to 97%). CONCLUSIONS: Current WHO guidelines for diagnosing suspected SARS may not be sufficiently sensitive in assessing patients before admission to hospital. Daily follow up, evaluation of non-respiratory, systemic symptoms, and chest radiography would be better screening tools.
OBJECTIVES: To determine the clinical and radiological features of severe acute respiratory syndrome (SARS) and to evaluate the accuracy of the World Health Organization's guidelines on defining cases of SARS. DESIGN: Prospective observational study. SETTING: A newly set up SARS screening clinic in the emergency department of a university hospital in Hong Kong's New Territories. PARTICIPANTS: 556 hospital staff, patients, and relatives who attended the screening clinic and who had had contact with someone with SARS. MAIN OUTCOME MEASURE: Number of confirmed cases of SARS. RESULTS: Of the 556 people, 141 were admitted to hospital, and 97 had confirmed SARS. Fever, chills, malaise, myalgia, rigor, loss of appetite, vomiting, diarrhoea, and neck pain but not respiratory tract symptoms were significantly more common among the 97 patients than among the other patients. The overall accuracy of the WHO guidelines for identifying suspected SARS was 83% and their negative predictive value was 86% (95% confidence interval 83% to 89%). They had a sensitivity of 26% (17% to 36%) and a specificity of 96% (93% to 97%). CONCLUSIONS: Current WHO guidelines for diagnosing suspected SARS may not be sufficiently sensitive in assessing patients before admission to hospital. Daily follow up, evaluation of non-respiratory, systemic symptoms, and chest radiography would be better screening tools.
Authors: Christian Drosten; Stephan Günther; Wolfgang Preiser; Sylvie van der Werf; Hans-Reinhard Brodt; Stephan Becker; Holger Rabenau; Marcus Panning; Larissa Kolesnikova; Ron A M Fouchier; Annemarie Berger; Ana-Maria Burguière; Jindrich Cinatl; Markus Eickmann; Nicolas Escriou; Klaus Grywna; Stefanie Kramme; Jean-Claude Manuguerra; Stefanie Müller; Volker Rickerts; Martin Stürmer; Simon Vieth; Hans-Dieter Klenk; Albert D M E Osterhaus; Herbert Schmitz; Hans Wilhelm Doerr Journal: N Engl J Med Date: 2003-04-10 Impact factor: 91.245
Authors: Nelson Lee; David Hui; Alan Wu; Paul Chan; Peter Cameron; Gavin M Joynt; Anil Ahuja; Man Yee Yung; C B Leung; K F To; S F Lui; C C Szeto; Sydney Chung; Joseph J Y Sung Journal: N Engl J Med Date: 2003-04-07 Impact factor: 91.245
Authors: Kenneth W Tsang; Pak L Ho; Gaik C Ooi; Wilson K Yee; Teresa Wang; Moira Chan-Yeung; Wah K Lam; Wing H Seto; Loretta Y Yam; Thomas M Cheung; Poon C Wong; Bing Lam; Mary S Ip; Jane Chan; Kwok Y Yuen; Kar N Lai Journal: N Engl J Med Date: 2003-03-31 Impact factor: 91.245
Authors: Susan M Poutanen; Donald E Low; Bonnie Henry; Sandy Finkelstein; David Rose; Karen Green; Raymond Tellier; Ryan Draker; Dena Adachi; Melissa Ayers; Adrienne K Chan; Danuta M Skowronski; Irving Salit; Andrew E Simor; Arthur S Slutsky; Patrick W Doyle; Mel Krajden; Martin Petric; Robert C Brunham; Allison J McGeer Journal: N Engl J Med Date: 2003-03-31 Impact factor: 91.245
Authors: Thomas G Ksiazek; Dean Erdman; Cynthia S Goldsmith; Sherif R Zaki; Teresa Peret; Shannon Emery; Suxiang Tong; Carlo Urbani; James A Comer; Wilina Lim; Pierre E Rollin; Scott F Dowell; Ai-Ee Ling; Charles D Humphrey; Wun-Ju Shieh; Jeannette Guarner; Christopher D Paddock; Paul Rota; Barry Fields; Joseph DeRisi; Jyh-Yuan Yang; Nancy Cox; James M Hughes; James W LeDuc; William J Bellini; Larry J Anderson Journal: N Engl J Med Date: 2003-04-10 Impact factor: 91.245
Authors: J S M Peiris; C M Chu; V C C Cheng; K S Chan; I F N Hung; L L M Poon; K I Law; B S F Tang; T Y W Hon; C S Chan; K H Chan; J S C Ng; B J Zheng; W L Ng; R W M Lai; Y Guan; K Y Yuen Journal: Lancet Date: 2003-05-24 Impact factor: 79.321
Authors: Christl A Donnelly; Azra C Ghani; Gabriel M Leung; Anthony J Hedley; Christophe Fraser; Steven Riley; Laith J Abu-Raddad; Lai-Ming Ho; Thuan-Quoc Thach; Patsy Chau; King-Pan Chan; Tai-Hing Lam; Lai-Yin Tse; Thomas Tsang; Shao-Haei Liu; James H B Kong; Edith M C Lau; Neil M Ferguson; Roy M Anderson Journal: Lancet Date: 2003-05-24 Impact factor: 79.321
Authors: Patrick Tang; Marie Louie; Susan E Richardson; Marek Smieja; Andrew E Simor; Frances Jamieson; Margaret Fearon; Susan M Poutanen; Tony Mazzulli; Raymond Tellier; James Mahony; Mark Loeb; Astrid Petrich; Max Chernesky; Allison McGeer; Donald E Low; Elizabeth Phillips; Steven Jones; Nathalie Bastien; Yan Li; Daryl Dick; Allen Grolla; Lisa Fernando; Timothy F Booth; Bonnie Henry; Anita R Rachlis; Larissa M Matukas; David B Rose; Reena Lovinsky; Sharon Walmsley; Wayne L Gold; Sigmund Krajden Journal: CMAJ Date: 2004-01-06 Impact factor: 8.262
Authors: Heng Zhu; Shaohui Hu; Ghil Jona; Xiaowei Zhu; Nate Kreiswirth; Barbara M Willey; Tony Mazzulli; Guozhen Liu; Qifeng Song; Peng Chen; Mark Cameron; Andrea Tyler; Jian Wang; Jie Wen; Weijun Chen; Susan Compton; Michael Snyder Journal: Proc Natl Acad Sci U S A Date: 2006-03-07 Impact factor: 11.205