Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia
Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia
复制标题
DOI：
10.1056/nejmoa2001316
复制
发表时间：
2020-03-26
影响因子：
158.5
通讯作者：
Feng, Zijian
中科院分区：
文献类型：
--
作者：
Li, Qun;Guan, Xuhua;Feng, Zijian
背景2019年12月和2020年1月，中国湖北省武汉市首次出现新型冠状病毒（2019- ncov）感染的肺炎（NCIP）病例。我们分析了武汉市首批425例确诊病例的数据，以确定NCIP的流行病学特征。方法收集截至2020年1月22日报告的NCIP实验室确诊病例的人口学特征、暴露史和发病时间。我们描述了病例的特征，并估计了主要的流行病学时滞分布。在指数增长初期，我们估计了流行病的倍增时间和基本繁殖数。结果425例确诊NCIP患者中，中位年龄为59岁，56%为男性。在2020年1月1日之前发病的病例中，大多数（55%）与华南海鲜批发市场有关，而在此后发病的病例中，这一比例为8.6%。平均潜伏期为5.2天（95%可信区间[CI]， 4.1 ~ 7.0），分布的第95百分位数为12.5天。在早期阶段，疫情规模每7.4天翻一番。平均连续间隔为7.5天（95% CI, 5.3 ~ 19），基本繁殖数估计为2.2 （95% CI, 1.4 ~ 3.9）。结论根据这一信息，有证据表明，自2019年12月中旬以来，密切接触者之间发生了人际传播。如果其他地方也出现类似情况，就需要作出相当大的努力来减少传播，以控制疫情。应在危险人群中实施预防或减少传播的措施。（国家科技部等资助）作者对中国武汉首批425例新型冠状病毒感染确诊病例进行了流行病学分析。这一分析提供了对该流行病加倍时间和基本繁殖数的估计，并显示了持续的人际传播的明确证据。
BackgroundThe initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP.MethodsWe collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number.ResultsAmong the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9).ConclusionsOn the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)The authors provide an epidemiologic analysis of the first 425 confirmed cases of infection with the novel coronavirus in Wuhan, China. This analysis provides estimates of the epidemic doubling time and the basic reproductive number and shows clear evidence of sustained human-to-human transmission.