Clustering and superspreading potential of SARS-CoV-2 infections in Hong Kong
Clustering and superspreading potential of SARS-CoV-2 infections in Hong Kong
复制标题
DOI：
10.1038/s41591-020-1092-0
复制
发表时间：
2020-09-17
期刊：
影响因子：
82.9
通讯作者：
Cowling, Benjamin J.
中科院分区：
文献类型：
--
作者：
Adam, Dillon C.;Wu, Peng;Cowling, Benjamin J.
超级传播事件（SSE）是严重急性呼吸综合征冠状病毒（SARS-CoV）和中东呼吸综合征冠状病毒（MERS-CoV）感染的先前流行的特征（1-6）。对于SARS-CoV-2，SSE参与传播的程度尚不清楚，但越来越多的证据表明SSE可能是COVID-19的典型特征（7，8）。我们利用2020年1月23日至4月28日期间在香港确诊的1，038例SARS-CoV-2病例的接触者追踪数据，确定并描述了所有本地感染集群。我们在51个集群（n = 309例）中确定了4-7个SSE，并估计19%（95%置信区间，15-24%）的病例播种了80%的本地传播。在控制年龄时，社会环境中的传播与更多的继发性病例相关（P = 0.002）。减少症状发作和病例确认之间的延迟并没有导致继发病例减少（P = 0.98），尽管作为接触者被隔离的个体中断传播的几率为14.4（95%CI，1.9-107.2）。公共卫生当局应将重点放在快速追踪和隔离接触者，沿着实施针对社会环境的限制措施，以降低SSE的风险并抑制SARS-CoV-2传播。一项对公共卫生政策有影响的研究估计，与超级传播事件有关的病例占香港所有SARS-CoV-2本地传播的80%。
Superspreading events (SSEs) have characterized previous epidemics of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infections(1-6). For SARS-CoV-2, the degree to which SSEs are involved in transmission remains unclear, but there is growing evidence that SSEs might be a typical feature of COVID-19(7,8). Using contact tracing data from 1,038 SARS-CoV-2 cases confirmed between 23 January and 28 April 2020 in Hong Kong, we identified and characterized all local clusters of infection. We identified 4-7 SSEs across 51 clusters (n = 309 cases) and estimated that 19% (95% confidence interval, 15-24%) of cases seeded 80% of all local transmission. Transmission in social settings was associated with more secondary cases than households when controlling for age (P = 0.002). Decreasing the delay between symptom onset and case confirmation did not result in fewer secondary cases (P = 0.98), although the odds that an individual being quarantined as a contact interrupted transmission was 14.4 (95% CI, 1.9-107.2). Public health authorities should focus on rapidly tracing and quarantining contacts, along with implementing restrictions targeting social settings to reduce the risk of SSEs and suppress SARS-CoV-2 transmission.Cases linked to superspreading events are estimated to account for 80% of all local transmission of SARS-CoV-2 in Hong Kong in a study with implications for public health policies.