Clinical analysis of the first community-acquired sporadic Severe acute respiratory syndrome case in China in 2004

Objective To investigate the epidemiological, clinical and pathogenic characteristics and the prognosis of the first community-acquired sporadic SARS case in China in 2004. Methods Epidemiological and clinical data of the patient were analysed retrospectively. SARS-IgM and IgG antibodies were detected by ELISA and indirect immunofluorescence assay(IFA). SARS-CoV RNA was detected by fluorescence PCR. Results The patient got a fever without known reason on December 16, 2003, which lasted for 8 days. He had slight cough and shortness of breath. His leucocyte and CD3 +、CD4 +、CD8 + T lymphocytes in peripheral blood decreased apparently . Infiltrates and consolidation on chest radiography could be seen in both lungs. There was no epidemiological evidence before the onset of his illness. His 81 close and social contacts had no demonstration of illness. He was claimed as a suspected SARS patient on December 27, 2003 and diagnosed as confirmed SARS case on January 5, 2004. The patient totally recovered after general and anti-symptomatic therapy. SARS-IgM positive seroconversion and 4-folds titer increase were seen. SARS-IgG was detected within one week of the onset of the illness, with the titer increased shortly by more than 4-folds. SARS-CoV RNA was positive in pharyngo-swabs. Neutralization antibody was shown to be positive. Conclusions The first community-acquired sporadic SARS case in China was reported since the control of the SARS outbreak in 2003. The source of its infection is not known. All the people contacting him were not infected. Compared with those seen in 2003, this patient was clinically milder and recovered more quickly. SARS antibodies become positive earlier than those in the patients of 2003.