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严重急性呼吸综合征

Author
Kenneth McIntosh, MD
Section Editor
Martin S Hirsch, MD
Deputy Editor
Anna R Thorner, MD
Translators
向旭东, 主任医师

引言

2003年2月，世界卫生组织(World Health Organization, WHO)报道了中国广东省发生的约300例急性进展性呼吸系统疾患，其中5例死亡。此后1个月，中国香港、越南、新加坡和加拿大报道了类似的病例[1]。截至2003年7月世界范围内暴发结束时，共报道了8096例病例，其中774例死亡，病死率为9.6%[2]。

WHO将该疾病命名为“严重急性呼吸综合征”(severe acute respiratory syndrome, SARS)，初期工作的重点为追踪病例、确定病因、建立诊断性实验室检查、评估治疗方案和实施感染控制策略以防止进一步传播。WHO牵头，联合美国疾病预防控制中心(Centers for Disease Control and Prevention, CDC)和多个国家及地区(主要包括中国、中国香港、越南、新加坡、泰国和加拿大)的卫生部门合作开展了这些工作[3,4]。

在一些SARS患者的样本中检出了一种新型冠状病毒(coronavirus, CoV)，且很快完成了该病毒的基因组测序，其符合Koch法则[5-7]。

目前可从WHO和CDC的网站中获得关于SARS的监测、识别、诊断、报告和公共卫生管理的指南[8-10]。一旦疑诊SARS，无论是散发病例还是群集性病例，都应立即查询上述网站。此外，随着中东呼吸综合征冠状病毒(Middle East respiratory syndrome coronavirus, MERS-CoV)和人类禽流感病例的出现，迅速报告和调查其他方面不能解释的严重急性呼吸系统疾病呈现出前所未有的紧迫感。 (参见“Middle East respiratory syndrome coronavirus: Virology, pathogenesis, and epidemiology”和“Epidemiology, transmission, and pathogenesis of avian influenza”和“Avian influenza A H7N9: Epidemiology, clinical manifestations, and diagnosis”)

SARS的病例定义、流行病学、病因、临床表现、诊断、治疗和预防总结在此。冠状病毒，包括MERS-CoV，将单独详细讨论。 (参见“冠状病毒”和“Middle East respiratory syndrome coronavirus: Virology, pathogenesis, and epidemiology”)

                          

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Literature review current through: 2017-06 . | This topic last updated: 2016-09-20.
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