Household Transmission of SARS-CoV-2, Zhuhai, China, 2020
Household Transmission of SARS-CoV-2, Zhuhai, China, 2020
复制标题
DOI：
10.1093/cid/ciaa557
复制
发表时间：
2020-10-15
影响因子：
11.8
通讯作者：
Liu, Jing
中科院分区：
文献类型：
--
作者：
Wu, Jian;Huang, Yiying;Liu, Jing
背景为阐明严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）在家庭环境中的传播程度，确定影响传播的危险因素，并估计流行病学模型参数。我们招募了2020年1月至2020年2月在中国珠海的35例确诊指示病例及其148名家庭接触者。所有参与者都接受了采访，并要求完成问卷调查。然后前瞻性跟踪家庭接触者，在21天内进行主动症状监测，并每隔3-7天收集鼻咽和/或口咽拭子。收集流行病学、人口统计学和临床数据（如有）。假设所有这些继发病例均由其指示病例感染，则家庭环境中的继发感染率为32.4%（95%置信区间[CI]：22.4%-44.4%），其中10.4%的继发病例无症状。多因素分析显示，有基础疾病的家庭接触者、直接接触武汉及其周边地区的病史以及与索引患者共用车辆与较高的易感性相关。在指示患者发病后没有采取保护措施的家庭成员似乎增加了SARS-CoV-2感染的风险。家庭内平均潜伏期为4.3 d（95%CI：3.4-5.3 d），平均间隔时间为5.1 d（95%CI：4.3-6.2 d）。在确诊患者后，应立即对2019年冠状病毒病患者进行早期隔离，并优先进行快速接触调查，然后进行积极的症状监测和定期实验室评估，以解决推动持续大流行的潜在决定因素。
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.