Spatial dynamics of an epidemic of severe acute respiratory syndrome in an urban area.

Wang, Jinfeng; McMichael, Anthony J; Meng, Bin; Becker, Niels G; Han, Weiguo; Glass, Kathryn; Wu, Jilei; Liu, Xuhua; Liu, Jiyuan; Li, Xiaowen; Zheng, Xiaoying

OBJECTIVE To map risk of exposure to severe acute respiratory syndrome (SARS) in an urban area and assess the ability of traditional interventions to control dispersion of the disease. METHODS Data on the Beijing SARS epidemic were used to map spatial clusters of identified contacts and to estimate transmission of SARS using a model with a time-dependent transmission rate. RESULTS The estimated transmission rate decreased dramatically from 20 to 30 April 2003. The total number of cases in the epidemic in Beijing was estimated to be 2521. Hierarchical clustering revealed that risk-exposures were widespread, but clustered in a pattern that is distinctly related to the Beijing urban ring roads. CONCLUSION Traditional control measures can be very effective at reducing transmission of SARS. Spatial patterns of risk-exposures can inform disease surveillance, prediction and control by identifying spatial target areas on which interventions should be focused.