OBJECTIVETo analyze the epidemiological features of the index cases of severe acute respiratory syndrome (SARS) occurred in different cities in Guangdong province and to trace for the source of infection.

METHODSStandardized individual case inventory was adopted to conduct investigation on index cases and on persons who had close contact with index cases in Guangdong province. Data on the epidemiological characteristics, secondary cases and the links among index cases were analyzed.

RESULTSBetween November 16, 2002 and April 16, 2003, there had been 13 index cases of SARS including 3 cadres, 3 farmers, 2 retirees, 2 workers and 1 shop attendant, reported from 13 cities in Guangdong province. Between November 2002 and January 2003, there had been 7 cities reported to have identified index cases of SARS with 6 of them being infected in their own cities and 1 imported from Guangzhou city. All of the cases had no close contacts to similar patients but 6 of them later caused 2nd or even 3rd generation cases of SARS. Most cases hit young people (7/13) with a sex ratio of 1:0.6. The fatality rate of index cases was high (4/13).

CONCLUSIONNo evidence showed that there was direct transmission among the index cases. Data regarding the geographical origin of those index cases led to the assumption that the infection had started in six cities of Pearl river delta region and the Hong Kong Special Administrative Region.