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Ji J, Viloria Winnett A, Shelby N, Reyes JA, Schlenker NW, Davich H, Caldera S, Tognazzini C, Goh YY, Feaster M, Ismagilov RF. Index cases first identified by nasal-swab rapid COVID-19 tests had more transmission to household contacts than cases identified by other test types. PLoS One 2023; 18:e0292389. [PMID: 37796850 PMCID: PMC10553276 DOI: 10.1371/journal.pone.0292389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
At-home rapid COVID-19 tests in the U.S. utilize nasal-swab specimens and require high viral loads to reliably give positive results. Longitudinal studies from the onset of infection have found infectious virus can present in oral specimens days before nasal. Detection and initiation of infection-control practices may therefore be delayed when nasal-swab rapid tests are used, resulting in greater transmission to contacts. We assessed whether index cases first identified by rapid nasal-swab COVID-19 tests had more transmission to household contacts than index cases who used other test types (tests with higher analytical sensitivity and/or non-nasal specimen types). In this observational cohort study, 370 individuals from 85 households with a recent COVID-19 case were screened at least daily by RT-qPCR on one or more self-collected upper-respiratory specimen types. A two-level random intercept model was used to assess the association between the infection outcome of household contacts and each covariable (household size, race/ethnicity, age, vaccination status, viral variant, infection-control practices, and whether a rapid nasal-swab test was used to initially identify the household index case). Transmission was quantified by adjusted secondary attack rates (aSAR) and adjusted odds ratios (aOR). An aSAR of 53.6% (95% CI 38.8-68.3%) was observed among households where the index case first tested positive by a rapid nasal-swab COVID-19 test, which was significantly higher than the aSAR for households where the index case utilized another test type (27.2% 95% CI 19.5-35.0%, P = 0.003 pairwise comparisons of predictive margins). We observed an aOR of 4.90 (95% CI 1.65-14.56) for transmission to household contacts when a nasal-swab rapid test was used to identify the index case, compared to other test types. Use of nasal-swab rapid COVID-19 tests for initial detection of infection and initiation of infection control may be less effective at limiting transmission to household contacts than other test types.
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Affiliation(s)
- Jenny Ji
- California Institute of Technology, Pasadena, California, United States of America
| | - Alexander Viloria Winnett
- California Institute of Technology, Pasadena, California, United States of America
- University of California Los Angeles–California Institute of Technology Medical Scientist Training Program, Los Angeles, California, United States of America
| | - Natasha Shelby
- California Institute of Technology, Pasadena, California, United States of America
| | - Jessica A. Reyes
- California Institute of Technology, Pasadena, California, United States of America
| | - Noah W. Schlenker
- California Institute of Technology, Pasadena, California, United States of America
| | - Hannah Davich
- California Institute of Technology, Pasadena, California, United States of America
| | - Saharai Caldera
- California Institute of Technology, Pasadena, California, United States of America
| | - Colten Tognazzini
- Pasadena Public Health Department, Pasadena, California, United States of America
| | - Ying-Ying Goh
- Pasadena Public Health Department, Pasadena, California, United States of America
| | - Matt Feaster
- Pasadena Public Health Department, Pasadena, California, United States of America
| | - Rustem F. Ismagilov
- California Institute of Technology, Pasadena, California, United States of America
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2
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Jay C, Adland E, Csala A, Dold C, Edmans M, Hackstein CP, Jamsen A, Lim N, Longet S, Ogbe A, Sampson O, Skelly D, Spiller OB, Stafford L, Thompson CP, Turtle L, Barnes E, Dunachie S, Carroll M, Klenerman P, Conlon C, Goulder P, Jones LC. Cellular immunity to SARS-CoV-2 following intrafamilial exposure in seronegative family members. Front Immunol 2023; 14:1248658. [PMID: 37711627 PMCID: PMC10497976 DOI: 10.3389/fimmu.2023.1248658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Family studies of antiviral immunity provide an opportunity to assess virus-specific immunity in infected and highly exposed individuals, as well as to examine the dynamics of viral infection within families. Transmission of SARS-CoV-2 between family members represented a major route for viral spread during the early stages of the pandemic, due to the nature of SARS-CoV-2 transmission through close contacts. Methods Here, humoral and cellular immunity is explored in 264 SARS-CoV-2 infected, exposed or unexposed individuals from 81 families in the United Kingdom sampled in the winter of 2020 before widespread vaccination and infection. Results We describe robust cellular and humoral immunity into COVID-19 convalescence, albeit with marked heterogeneity between families and between individuals. T-cell response magnitude is associated with male sex and older age by multiple linear regression. SARS-CoV-2-specific T-cell responses in seronegative individuals are widespread, particularly in adults and in individuals exposed to SARS-CoV-2 through an infected family member. The magnitude of this response is associated with the number of seropositive family members, with a greater number of seropositive individuals within a family leading to stronger T-cell immunity in seronegative individuals. Discussion These results support a model whereby exposure to SARS-CoV-2 promotes T-cell immunity in the absence of an antibody response. The source of these seronegative T-cell responses to SARS-CoV-2 has been suggested as cross-reactive immunity to endemic coronaviruses that is expanded upon SARS-CoV-2 exposure. However, in this study, no association between HCoV-specific immunity and seronegative T-cell immunity to SARS-CoV-2 is identified, suggesting that de novo T-cell immunity may be generated in seronegative SARS-CoV-2 exposed individuals.
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Affiliation(s)
- Cecilia Jay
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Emily Adland
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Anna Csala
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Christina Dold
- Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | - Matthew Edmans
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Anni Jamsen
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nicholas Lim
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Stephanie Longet
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Ane Ogbe
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Oliver Sampson
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, United Kingdom
| | - Donal Skelly
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals, University of Oxford, Oxford, United Kingdom
| | - Owen B. Spiller
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Lizzie Stafford
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Craig P. Thompson
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Lance Turtle
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Ellie Barnes
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Susanna Dunachie
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Miles Carroll
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Paul Klenerman
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals National Health Service (NHS) Foundation Trust, Oxford, United Kingdom
| | - Chris Conlon
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Philip Goulder
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Lucy C. Jones
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, United Kingdom
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3
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Sciaudone M, Cutshaw MK, McClean CM, Lacayo R, Kharabora O, Murray K, Strohminger S, Zivanovich MM, Gurnett R, Markmann AJ, Salgado EM, Bhowmik DR, Castro-Arroyo E, Boyce RM, Aiello AE, Richardson D, Juliano JJ, Bowman NM. Seroepidemiology and risk factors for SARS-CoV-2 infection among household members of food processing and farm workers in North Carolina. IJID REGIONS 2023; 7:164-169. [PMID: 37034427 PMCID: PMC10032047 DOI: 10.1016/j.ijregi.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Background Racial and ethnic minorities have borne a disproportionate burden from coronavirus disease 2019 (COVID-19). Certain essential occupations, including food processing and farm work, employ large numbers of Hispanic migrant workers and have been shown to carry an especially high risk of infection. Methods This observational cohort study measured the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and assessed the risk factors for seropositivity among food processing and farm workers, and members of their households, in North Carolina, USA. Participants completed questionnaires, blood samples were collected, and an enzyme-linked immunosorbent assay was used to assess SARS-CoV-2 seropositivity. Univariate and multi-variate analyses were undertaken to identify risk factors associated with seropositivity, using generalized estimating equations to account for household clustering. Findings Among the 218 participants, 94.5% were Hispanic, and SARS-CoV-2 seropositivity was 50.0%. Most seropositive individuals did not report a history of illness compatible with COVID-19. Attending church, having a prior history of COVID-19, having a seropositive household member, and speaking Spanish as one's primary language were associated with SARS-CoV-2 seropositivity, while preventive behaviours were not. Interpretation These findings underscore the substantial burden of COVID-19 among a population of mostly Hispanic essential workers and their households in rural North Carolina. This study contributes to a large body of evidence showing that Hispanic Americans have suffered a disproportionate burden of COVID-19. This study also highlights the epidemiologic importance of viral transmission within the household.
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Affiliation(s)
- Michael Sciaudone
- Department of Medicine, Section of Infectious Diseases, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Center for Intelligent Molecular Diagnostics, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | | | | | - Roberto Lacayo
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Oksana Kharabora
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Katherine Murray
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Stephen Strohminger
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Miriana Moreno Zivanovich
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rachel Gurnett
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Alena J. Markmann
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Emperatriz Morales Salgado
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - D. Ryan Bhowmik
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Edwin Castro-Arroyo
- Infectious Disease Epidemiology and Ecology Laboratory, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Ross M. Boyce
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Allison E. Aiello
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - David Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California – Irvine, Irvine, California, USA
| | - Jonathan J. Juliano
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Natalie M. Bowman
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Sieber J, Schmidthaler K, Kopanja S, Weseslindtner L, Stiasny K, Götzinger F, Graf A, Krotka P, Hoz J, Schoof A, Dwivedi V, Frischer T, Szépfalusi Z. Limited role of children in transmission of SARS-CoV-2 virus in households-Immunological analysis of 26 familial clusters. Pediatr Allergy Immunol 2023; 34:e13913. [PMID: 36705043 PMCID: PMC10107319 DOI: 10.1111/pai.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/23/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND The impact of children on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. This study provides an insight into distinct patterns of SARS-CoV-2 household transmission in case of pediatric and adult index cases as well as age-dependent susceptibility to SARS-CoV-2 infection. METHODS Immune analysis, medical interviewing, and contact tracing of 26 families with confirmed SARS-CoV-2 infection cases have been conducted. Blood samples were analyzed serologically with the use of a SARS-CoV-2-specific IgG assay and virus neutralization test (VNT). Uni- and multivariable linear regression and mixed effect logistic regression models were used to describe potential risk factors for higher contagiousness and susceptibility to SARS-CoV-2 infection. RESULTS SARS-CoV-2 infection could be confirmed in 67 of 124 family members. Fourteen children and 11 adults could be defined as index cases in their households. Forty of 82 exposed family members were defined as secondarily infected. The mean secondary attack rate in households was 0.48 and was significantly higher in households with adult than with pediatric index cases (0.85 vs 0.19; p < 0.0001). The age (grouped into child and adult) of index case, severity of disease, and occurrence of lower respiratory symptoms in index cases were significantly associated with secondary transmission rates in households. Children seem to be equally susceptible to acquire a SARS-CoV-2 infection as adults, but they suffer milder courses of the disease or remain asymptomatic. CONCLUSION SARS-CoV-2 transmission from infected children to other household members occurred rarely in the first wave of the pandemic, despite close physical contact and the lack of hygienic measures.
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Affiliation(s)
- Justyna Sieber
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria.,Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
| | - Klara Schmidthaler
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Sonja Kopanja
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Florian Götzinger
- Department of Paediatrics and Adolescent Medicine, Klinik Ottakring, Vienna, Austria
| | - Alexandra Graf
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Pavla Krotka
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria
| | - Jakub Hoz
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Anja Schoof
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Varsha Dwivedi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | | | - Zsolt Szépfalusi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
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5
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Davis SK, Selva KJ, Lopez E, Haycroft ER, Lee WS, Wheatley AK, Juno JA, Adair A, Pymm P, Redmond SJ, Gherardin NA, Godfrey DI, Tham W, Kent SJ, Chung AW. Heterologous SARS-CoV-2 IgA neutralising antibody responses in convalescent plasma. Clin Transl Immunology 2022; 11:e1424. [PMID: 36299410 PMCID: PMC9588388 DOI: 10.1002/cti2.1424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/21/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Following infection with SARS-CoV-2, virus-specific antibodies are generated, which can both neutralise virions and clear infection via Fc effector functions. The importance of IgG antibodies for protection and control of SARS-CoV-2 has been extensively reported. By comparison, other antibody isotypes including IgA have been poorly characterised. METHODS Here, we characterised plasma IgA from 41 early convalescent COVID-19 subjects for neutralisation and Fc effector functions. RESULTS Convalescent plasma IgA from > 60% of the cohort had the capacity to inhibit the interaction between wild-type RBD and ACE2. Furthermore, a third of the cohort induced stronger IgA-mediated ACE2 inhibition than matched IgG when tested at equivalent concentrations. Plasma IgA and IgG from this cohort broadly recognised similar RBD epitopes and had similar capacities to inhibit ACE2 from binding to 22 of the 23 prevalent RBD mutations assessed. However, plasma IgA was largely incapable of mediating antibody-dependent phagocytosis in comparison with plasma IgG. CONCLUSION Overall, convalescent plasma IgA contributed to the neutralising antibody response of wild-type SARS-CoV-2 RBD and various RBD mutations. However, this response displayed large heterogeneity and was less potent than IgG.
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Affiliation(s)
- Samantha K Davis
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Kevin John Selva
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Ester Lopez
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Ebene R Haycroft
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Wen Shi Lee
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia,The Walter and Eliza Hall Institute of Medical ResearchMelbourneVICAustralia
| | - Adam K Wheatley
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Jennifer A Juno
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Amy Adair
- The Walter and Eliza Hall Institute of Medical ResearchMelbourneVICAustralia
| | - Phillip Pymm
- The Walter and Eliza Hall Institute of Medical ResearchMelbourneVICAustralia
| | - Samuel J Redmond
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Nicholas A Gherardin
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Dale I Godfrey
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
| | - Wai‐Hong Tham
- The Walter and Eliza Hall Institute of Medical ResearchMelbourneVICAustralia
| | - Stephen J Kent
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia,Melbourne Sexual Health Centre and Department of Infectious DiseasesAlfred Hospital and Central Clinical SchoolMonash UniversityMelbourneVICAustralia
| | - Amy W Chung
- Department of Microbiology and ImmunologyThe Peter Doherty Institute for Infection and ImmunityUniversity of MelbourneMelbourneVICAustralia
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6
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Porter AF, Sherry N, Andersson P, Johnson SA, Duchene S, Howden BP. New rules for genomics-informed COVID-19 responses-Lessons learned from the first waves of the Omicron variant in Australia. PLoS Genet 2022; 18:e1010415. [PMID: 36227810 PMCID: PMC9560517 DOI: 10.1371/journal.pgen.1010415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ashleigh F. Porter
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Norelle Sherry
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Patiyan Andersson
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Sandra A. Johnson
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Sebastian Duchene
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Benjamin P. Howden
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
- Microbiological Diagnostic Unit Public Health Laboratory, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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