Household Transmission of SARS-CoV-2, Zhuhai, China, 2020
- 11 May 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 71 (16), 2099-2108
- https://doi.org/10.1093/cid/ciaa557
Abstract
Background To illustrate the extent of transmission, identify affecting risk factors and estimate epidemiological modeling parameters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in household setting. Methods We enrolled 35 confirmed index cases and their 148 household contacts, January 2020–February 2020, in Zhuhai, China. All participants were interviewed and asked to complete questionnaires. Household contacts were then prospectively followed active symptom monitoring through the 21-day period and nasopharyngeal and/or oropharyngeal swabs were collected at 3–7 days intervals. Epidemiological, demographic, and clinical data (when available) were collected. Results Assuming that all these secondary cases were infected by their index cases, the second infection rate in household context is 32.4% (95% confidence interval [CI]: 22.4%–44.4%), with 10.4% of secondary cases being asymptomatic. Multivariate analysis showed that household contacts with underlying medical conditions, a history of direct exposure to Wuhan and its surrounding areas, and shared vehicle with an index patient were associated with higher susceptibility. Household members without protective measures after illness onset of the index patient seem to increase the risk for SARS-CoV-2 infection. The median incubation period and serial interval within household were estimated to be 4.3 days (95% CI: 3.4–5.3 days) and 5.1 days (95% CI: 4.3–6.2 days), respectively. Conclusion Early isolation of patients with coronavirus disease 2019 and prioritizing rapid contact investigation, followed by active symptom monitoring and periodic laboratory evaluation, should be initiated immediately after confirming patients to address the underlying determinants driving the continuing pandemic.Keywords
Funding Information
- Natural Science Foundation of Guangdong Province of China (2020A1515011147)
- Fundamental Research Funds
- Central Universities (19ykpy51)
This publication has 19 references indexed in Scilit:
- Clinical Characteristics of Coronavirus Disease 2019 in ChinaThe New England Journal of Medicine, 2020
- Improved Molecular Diagnosis of COVID-19 by the Novel, Highly Sensitive and Specific COVID-19-RdRp/Hel Real-Time Reverse Transcription-PCR Assay Validated In Vitro and with Clinical SpecimensJournal of Clinical Microbiology, 2020
- Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in ChinaJAMA, 2020
- Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected PneumoniaThe New England Journal of Medicine, 2020
- Active Monitoring of Persons Exposed to Patients with Confirmed COVID-19 — United States, January–February 2020Morbidity and Mortality Weekly Report (MMWR), 2020
- Serial interval of novel coronavirus (COVID-19) infectionsInternational Journal of Infectious Diseases, 2020
- Secondary attack rate and superspreading events for SARS-CoV-2The Lancet, 2020
- Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracleJournal of Medical Virology, 2020
- Origin and evolution of pathogenic coronavirusesNature Reviews Microbiology, 2018
- Estimating incubation period distributions with coarse dataStatistics in Medicine, 2009