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OBJECTIVESTo investigate the transmission process of severe acute respiratory syndrome (SARS) and to evaluate the infectiveness of SARS patients in different periods of disease epidemics.

METHODSStandardized questionnaire was used to conduct case investigation and contact tracing by combining the field investigation and telephone interview. Transmission process, infectivity, transmission chain and contact history of SARS were studied through data analyses.

RESULTSOn 25th March 2003, a 91 year old man was admitted to Hospital J in Beijing with stroke and fever. He died on 30th March. From 31st March, there was an outbreak of SARS among his contacts in the family and in the hospital he was admitted to. Contacts would include his relatives, other co-patients and health care workers in the Hospital J. Chinese Field Epidemiology Training Program trainees conducted an investigation of the outbreak. Among the 207 contacts of the index cases through different generations, there were 36 cases of SARS (attack rate 17%) patients with one death. There were 12 cases having directly contact with the index case and 13 cases with one secondary case. The transmission chains of this outbreak could clearly be depicted. All the cases had close contacts during the symptomatic period of their index patients. Among the relatives, 85% of the cases had 3 - 5-day contact with their index patients after the onset of the illnesses. There was no significant difference between the two attack rates-70% for whose who had contact with the patient before and after illness onset) and 67% for those who only had contact after the onset of the illness. Out of the 44 social acquaintances and 38 of the family members who had contacts with the index patients during the incubation period, no one was found ill. Among the close contacts at the hospital who had no protection when providing care to the patient, the attack rate was found over 80%.

CONCLUSIONSAll the secondary cases of this outbreak had a history of direct and close contacts to the index patients after the onset of the illness. There was no evidence indicating that SARS cases were infectious during their incubation period.

Aged ; Aged, 80 and over ; China ; epidemiology ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Severe Acute Respiratory Syndrome ; epidemiology ; prevention & control ; transmission

8.Application of vacuum sealing drainage in treating large avulsion injuries of limbs.

Zhou YE ; Bei-lei ZHAN ; Yun-zhong ZHAN ; Jun QIAN

China Journal of Orthopaedics and Traumatology 2011;24(9):742-744

OBJECTIVETo investigate the therapeutic effectes of vacuum sealing drainage (VSD) technique and reattachment of avulsed skin in treating avulsion injuries of limbs.

METHODSA retrospective analysis was done on 25 patients suffering from avulsion injuries of limbs, who were treated with vacuum sealing drainage and reattachment of the avulsed skin. Among the patients, 19 patients were male and 6 patients were female, ranging in age from 21 years to 57 years, with an average of 41 years. After debridement, the patients got reattachment of skin graft with subdermal vascular network or split-thickness skin graft, and the wound surface was covered with polyvinyl sponge. VSD was removed after 7 to 14 days. The color, survival rate and sensory function of the skin were observed after operation.

RESULTSAll the wounds infection was controlled with VSD. The skin survival rate was more than 96% in 16 cases, more than 90% in 7 cases, and skin edge of 2 cases had little necrosis but rehabilitated after dress-changing. The reattached skins had almost normal skin color, soft and abrasion resistant, satisfactory sensory function, and no compression ulcer was observed after 4 weeks.

CONCLUSIONVSD combined with graft with subdermal vascular network or split-thickness skin graft helps to promote wound drainage, reattachment of skin, and decrease infection. It is an effective method in treating avulsion injuries of limbs.

Adult ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Vacuum ; Young Adult