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Duration and distance of exposure are important predictors of transmission among community contacts of Ontario SARS cases
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SUMMARY: We report attack rates and contact-related predictors among community contacts of severe acute respiratory syndrome (SARS) cases from the 2003 Toronto-area outbreak. Community contact data was extracted from public health records for single, well-defined exposures to a SARS case. In total, 8662 community-acquired exposures resulted in 61 probable cases; a crude attack rate of 0·70% [95% confidence interval (CI) 0·54–0·90]. Persons aged 55–69 years were at higher risk of acquiring SARS (1·14%) than those either younger (0·60%) or older (0·70%). In multivariable analysis exposures for at least 30 min at a distance of ⩽1 m increased the likelihood of becoming a SARS case 20·4-fold (95% CI 11·8–35·1). Risk related to duration of illness in the source case at time of exposure was greatest for illness duration of 7–10 days (rate ratio 3·4, 95% CI 1·9–6·1). Longer and closer proximity exposures incurred the highest rate of disease. Separate measures of time and distance from source cases should be added to minimum datasets for the assessment of interventions for SARS and other emerging diseases.
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General population attack rates were low; all but one high-QA-score study reported central estimates ranging from 0 to 5.18% (n=11 from six studies), and one higher estimate at 16.4%.
“General population attack rates were low; all but one high-QA-score study reported central estimates ranging from 0 to 5⋅18%, corresponding to the midpoint of the estimate range captured by Rea and colleagues 53 (n=11 from six studies), and one higher estimate at 16⋅4% (figure 4A).”
From Severe acute respiratory syndrome (SARS) mathematical models and disease parameters: a systematic review (2025) · cites this paper as [53]
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Metadata
- Authors
- REA, E., LAFLÈCHE, J., STALKER, S., GUARDA, B. K., SHAPIRO, H., JOHNSON, I., BONDY, S. J., UPSHUR, R., RUSSELL, M. L., & ELIASZIW, M.
- Affiliations
- Toronto Public Health (CA)
- Simcoe Muskoka District Health Unit (CA)
- University of Toronto (CA)
- University of Calgary (CA)
- Corresponding author
- RUSSELL, M. L.
- Venue
- Epidemiology and Infection
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-01-12
- Volume
- 135
- Issue
- 6
- Pages
- 914-921
- ISSN
- 0950-2688 (ISSN-L)
- 1469-4409
- PMC
- PMC2870656
- OpenAlex
- W2162759163
- Cited by
- 44
- References
- 24
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 7 · 2017: 5 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Infection (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Keywords
- SARS, SARS transmission, community contacts, attack rate, exposure duration, exposure distance, age as risk factor, emerging infectious diseases, contact tracing
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Disease Outbreaks, Environmental Exposure, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Ontario, Risk Factors, Time Factors, Community-Acquired Infections, Severe Acute Respiratory Syndrome
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