The SARS epidemic in mainland China: bringing together all epidemiological data

To document and verify the number of cases of severe acute respiratory syndrome (SARS) during the 2002-2003 epidemic in mainland China.

All existing Chinese SARS data sources were integrated in one final database. This involved removing non-probable and duplicate cases, adding cases at the final stage of the outbreak, and collecting missing information.

The resulting database contains a total of 5327 probable SARS cases, of whom 343 died, giving a case fatality ratio (CFR) of 6.4%. While the total number of cases happens to be equal to the original official reports, there are 5 cases overall which did not result in death. When compared with Hong Kong Special Administrative Region of China, China Taiwan, and Singapore, the SARS epidemic in mainland China resulted in a considerably lower CFR, involved relatively younger cases and included fewer health care workers.

To optimise future data collection during large-scale outbreaks of emerging or re-emerging infectious disease, China must further improve the infectious diseases reporting system, enhance collaboration between all levels of disease control, health departments, hospitals and institutes nationally and globally, and train specialized staff working at county centres of disease control.