SARS Transmission, Risk Factors, and Prevention in Hong Kong

We analyzed information obtained from 1,192 patients with probable severe acute respiratory syndrome (SARS) reported in Hong Kong. Among them, 26.6% were hospital workers, 16.1% were members of the same household as SARS patients and had probable secondary infections, 14.3% were Amoy Gardens residents, 4.9% were inpatients, and 9.9% were contacts of SARS patients who were not family members. The remaining 347 case-patients (29.1%) had undefined sources of infection. Excluding those <16 years of age, 330 patients with cases from "undefined" sources were used in a 1:2 matched case-control study. Multivariate analysis of this case-control study showed that having visited mainland China, hospitals, or the Amoy Gardens were risk factors (odds ratio [OR] 1.95 to 7.63). In addition, frequent mask use in public venues, frequent hand washing, and disinfecting the living quarters were significant protective factors (OR 0.36 to 0.58). In Hong Kong, therefore, community-acquired infection did not make up most transmissions, and public health measures have contributed substantially to the control of the SARS epidemic.