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Jung Y, Abney SE, Reynolds KA, Gerba CP, Wilson AM. Evaluating infection risks and importance of hand hygiene during the household laundry process using a quantitative microbial risk assessment approach. Am J Infect Control 2023; 51:1377-1383. [PMID: 37271422 DOI: 10.1016/j.ajic.2023.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Contaminated laundry contributes to infectious disease spread in residential and home health care settings. The objectives were to (1) evaluate pathogen transmission risks for individuals doing laundry, and (2) compare hand hygiene timing to reduce risks. METHODS A quantitative microbial risk assessment using experimental data from a laundry washing effectiveness study was applied to estimate infection risks from SARS-CoV-2, rotavirus, norovirus, nontyphoidal Salmonella, and Escherichia coli in 4 laundry scenarios: 1 baseline scenario (no hand hygiene event) and 3 hand hygiene scenarios (scenario 1: after moving dirty clothes to the washing machine, scenario 2: after moving washed clothes to the dryer, and scenario 3: hand hygiene events following scenario 1 and 2). RESULTS The average infection risks for the baseline scenario were all greater than 2 common risk thresholds (1.0×10-6and 1.0×10-4). For all organisms, scenario 1 yielded greater risk reductions (39.95%-99.86%) than scenario 2 (1.35%-55.25%). Scenario 3 further reduced risk, achieving 1.0×10-6(SARS-CoV-2) and 1.0×10-4risk thresholds (norovirus and E. coli). CONCLUSIONS The modeled results suggest individuals should reduce hand-to-facial orifice (eyes, nose, and mouth) contacts and conduct proper hand hygiene when handling contaminated garments. More empirical data are needed to confirm the estimated risks. DATA AVAILABILITY STATEMENT The data and code that support the findings of this study can be retrieved via a Creative Commons Zero v1.0 Universal license in GitHub at https://github.com/yhjung1231/Laundry-QMRAproject-2022.git DOI: http://doi.org/10.5281/zenodo.7122065.
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Affiliation(s)
- Yoonhee Jung
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA.
| | - Sarah E Abney
- García-Robles Fulbright Program, Centro de Investigación Científica de Yucatán, Yucatán, Mexico
| | - Kelly A Reynolds
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA
| | - Charles P Gerba
- Department of Environmental Science, College of Agriculture and Life Sciences, University of Arizona, AZ, USA
| | - Amanda M Wilson
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, AZ, USA
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2
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Stein-Zamir C, Sinai-Zaken O, Zvulun E, Najajra G, Pinto R, Koren S, Shoob H, Abramson N. SARS-CoV-2 infection characteristics among students and staff in a large high school COVID-19 outbreak and secondary transmission in households. INFECTIOUS MEDICINE 2023; 2:36-43. [PMID: 38013775 PMCID: PMC9977694 DOI: 10.1016/j.imj.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023]
Abstract
Background SARS-CoV-2 clinical presentation is associated with the patients' age group. Overall, young individuals present higher proportions of asymptomatic or mild COVID-19 infection, compared to adults. Data on secondary COVID-19 transmission in households, according to the cases' age group, are accumulating. Methods We performed a follow-up cohort study including all COVID-19 real-time polymerase chain reaction (RT-PCR)-confirmed cases (adolescent students and school staff) diagnosed in an epidemiological investigation of a large high school outbreak. We compared the adolescent and adult groups regarding clinical symptoms, time to negative COVID-19 RT-PCR tests, and infection transmission in households. Results The study population included 817 persons. The confirmed COVID-19 RT-PCR outbreak cases (n = 178) were followed (students aged 12-19 years, median age 14 years, n = 153, school staff aged 24-67 years, median age 39 years, n = 25) and the cases' household close contacts (n = 639) were tested. The adolescents had lower symptomatic infection rates, shorter time to negative COVID-19 RT-PCR tests, and lower transmission rates to household members, compared to the adults. The general transmission rate among household contacts was 13.5%, (86/639) ranging from 8.6% in asymptomatic students' contacts to 27.3% in symptomatic staff contacts. COVID-19 transmission rates were significantly higher in contacts of symptomatic cases compared to asymptomatic cases (odds ratio: 2.06, 95% CI 1.26-3.4) and higher in adults compared to adolescents (odds ratio: 2.69, 95% CI 1.43-4.89). Conclusions Adolescents and adults diagnosed in an outbreak investigation differ as to COVID-19 clinical presentation and transmission. As adolescents may show mild or no symptoms, COVID-19 prevention in school settings is challenging. Implementing nonpharmaceutical measures and promoting vaccination programs in eligible staff and students should be considered.
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Affiliation(s)
- Chen Stein-Zamir
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, The Hebrew University and Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Ora Sinai-Zaken
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
| | - Eti Zvulun
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
| | - Ghada Najajra
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
| | - Rinat Pinto
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
| | - Shahar Koren
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
- Faculty of Medicine, The Hebrew University of Jerusalem, The Hebrew University and Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Hanna Shoob
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
| | - Nitza Abramson
- Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel
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3
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Children's SARS-CoV-2 Infection and Their Vaccination. Vaccines (Basel) 2023; 11:vaccines11020418. [PMID: 36851295 PMCID: PMC9962844 DOI: 10.3390/vaccines11020418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
SARS-CoV-2, a novel coronavirus, causes respiratory tract infections and other complications in affected individuals, and has resulted in numerous deaths worldwide. The unprecedented pace of its transmission worldwide, and the resultant heavy burden on healthcare systems everywhere, prompted efforts to have effective therapeutic strategies and vaccination candidates available to the global population. While aged and immunocompromised individuals form a high-risk group for COVID-19 and have severe disease outcome, the rate of infections among children has also increased with the emergence of the Omicron variant. In addition, recent reports of threatening SARS-CoV-2-associated complications in children have brought to the forefront an urgent necessity for vaccination. In this article, we discuss the current scenario of SARS-CoV-2 infections in children with a special focus on the differences in their immune system response as compared to adults. Further, we describe the various available COVID-19 vaccines, including the recent bivalent vaccines for children, in detail, intending to increase willingness for their acceptance.
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4
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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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Li Y, Tan J, Tan S, Zhou Y, Sai B, Dai B, Lu X. Infection rate and factors affecting close contacts of COVID-19 cases: A systematic review. J Evid Based Med 2022; 15:385-397. [PMID: 36513958 PMCID: PMC9877962 DOI: 10.1111/jebm.12508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Contact tracing plays an essential role in mitigating the impact of an epidemic. During the COVID-19 pandemic, studies of those who have been in close contact with confirmed cases offer critical insights to understand the epidemiological characteristics of SARS-CoV-2 better. This study conducts a meta-analysis of existing studies' infection rates and affecting factors. METHODS We searched PubMed, Web of Science and CNKI from the inception to April 30 2022 to identify systematic reviews. Two reviewers independently extracted the data and assessed risk of bias. Meta-analyses were conducted to calculate pooled estimates by using Stata/SE 15.1 software. RESULTS There were 47 studies in the meta-analysis. Among COVID-19 close contacts, older age (RR = 1.94, 95% CI: 1.70, 2.21), contacts in households (RR = 2.83, 95% CI: 2.20, 3.65), and people in close contact with symptomatic infections (RR = 3.62, 95% CI: 1.88, 6.96) were associated with higher infection rates. CONCLUSION On average, each primary infection corresponded to 5.8 close contacts. Among COVID-19 close contacts, older age and contacts in households were associated with higher infection rates, and people in close contact with symptomatic infections had three times higher risk of infection compared to people in close contact with asymptomatic infections. In general, there are significantly more studies from China about close contacts, and the infection rate among close contacts was lower compared to other countries.
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Affiliation(s)
- Yunxuan Li
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
| | - Jing Tan
- Chinese Evidence‐Based Medicine CenterNational Clinical Research Center for GeriatricsWest China HospitalSichuan UniversityChengduChina
| | - Suoyi Tan
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
| | - Yilong Zhou
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
| | - Bin Sai
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
| | - Bitao Dai
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
| | - Xin Lu
- College of Systems EngineeringNational University of Defense TechnologyChangshaChina
- Department of Global Public HealthKarolinska InstituteStockholmSweden
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6
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Sim JY, Wu PS, Cheng CF, Yiang GT, Yu CH. Characteristics, contacts, and relative risk of SARS-CoV-2 infection among children during school closures. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:1108-1115. [PMID: 35016846 PMCID: PMC8719363 DOI: 10.1016/j.jmii.2021.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/01/2021] [Accepted: 12/25/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Characteristics of children with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Taiwanese households is nascent. We sought to characterize SARS-CoV-2 infection, and estimate the relative risk of infection among children within households during school closures in Taipei and New Taipei City. METHODS We reviewed consecutive children below 18 years presenting to our emergency department from May 18, 2021 to July 12, 2021 who underwent real-time reverse-transcription polymerase chain reaction (rRT-PCR) for SARS-CoV-2 from respiratory swabs. Demographics, symptoms, and contacts were captured from medical records. Household contact was defined as an individual with confirmed COVID-19 living in the same residence as the child. RESULTS Among 56 children with SARS-CoV-2, twenty-five (45%) were male with mean age of 7.9 years. Symptoms were nonspecific, with 29% having fever, 32% having cough, and 48% were asymptomatic. The median cycle threshold (Ct) value of SARS-CoV-2 rRT-PCR was 25 (range 11-38). All 56 children reported 94 contacts with a COVID-19 patient, of which 99% were household contacts. The relative risk of infection was 8.5 (95% CI 5.0-14.7) for children whose parent(s) were COVID-19 patients, and 7.3 (95% CI 4.9-11.0) for children whose household grandparent(s) were patients, as compared to children without respective contacts. Children without COVID-19 contacts were all tested negative. CONCLUSIONS During school closures in Taipei and New Taipei City, children with SARS-CoV-2 infection in our cohort had one or more COVID-19 contacts, mostly within their households. While diagnosing pediatric COVID-19 is challenging as children were often asymptomatic, those without contacts were likely uninfected.
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Affiliation(s)
- Jun Yi Sim
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan
| | - Ping-Sheng Wu
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan,Department of Pediatrics, Buddhist Tzu Chi University College of Medicine, Hualien, Taiwan
| | - Ching-Feng Cheng
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan,Department of Pediatrics, Buddhist Tzu Chi University College of Medicine, Hualien, Taiwan
| | - Giou-Teng Yiang
- Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan,Department of Emergency Medicine, Buddhist Tzu Chi University College of Medicine, Hualien, Taiwan
| | - Chun-Hsien Yu
- Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan,Department of Pediatrics, Buddhist Tzu Chi University College of Medicine, Hualien, Taiwan,Corresponding author. Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian District, New Taipei City 23142, Taiwan
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7
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Frère J, Chatzis O, Cremer K, Merckx J, De Keukeleire M, Renard F, Ribesse N, Minner F, Ruelle J, Kabamba B, Rodriguez-Villalobos H, Bearzatto B, Delforge ML, Henin C, Bureau F, Gillet L, Robert A, Van der Linden D. SARS-CoV-2 Transmission in Belgian French-Speaking Primary Schools: An Epidemiological Pilot Study. Viruses 2022; 14:v14102199. [PMID: 36298754 PMCID: PMC9612207 DOI: 10.3390/v14102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 01/25/2023] Open
Abstract
Schools have been a point of attention during the pandemic, and their closure one of the mitigating measures taken. A better understanding of the dynamics of the transmission of SARS-CoV-2 in elementary education is essential to advise decisionmakers. We conducted an uncontrolled non-interventional prospective study in Belgian French-speaking schools to describe the role of attending asymptomatic children and school staff in the spread of COVID-19 and to estimate the transmission to others. Each participant from selected schools was tested for SARS-CoV-2 using a polymerase chain reaction (PCR) analysis on saliva sample, on a weekly basis, during six consecutive visits. In accordance with recommendations in force at the time, symptomatic individuals were excluded from school, but per the study protocol, being that participants were blinded to PCR results, asymptomatic participants were maintained at school. Among 11 selected schools, 932 pupils and 242 school staff were included between January and May 2021. Overall, 6449 saliva samples were collected, of which 44 came back positive. Most positive samples came from isolated cases. We observed that asymptomatic positive children remaining at school did not lead to increasing numbers of cases or clusters. However, we conducted our study during a period of low prevalence in Belgium. It would be interesting to conduct the same analysis during a high prevalence period.
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Affiliation(s)
- Julie Frère
- Pediatric Infectious Diseases, Pediatric Department, CHU Liège, 4000 Liège, Belgium
| | - Olga Chatzis
- Pediatric Infectious Diseases, Specialized Pediatric Service, Pediatric Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Kelly Cremer
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, UCLouvain, 1200 Brussels, Belgium
| | - Joanna Merckx
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1A2, Canada
| | - Mathilde De Keukeleire
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, UCLouvain, 1200 Brussels, Belgium
| | - Florence Renard
- Office de la Naissance et de l’Enfance (ONE), 1060 Brussels, Belgium
| | - Nathalie Ribesse
- Office de la Naissance et de l’Enfance (ONE), 1060 Brussels, Belgium
| | - Frédéric Minner
- Immunology-Vaccinology Lab of the Faculty of Veterinary Medicine, ULiège, 4000 Liège, Belgium
| | - Jean Ruelle
- Pôle de Microbiologie Médicale (MBLG), UCLouvain, 1200 Brussels, Belgium
- SmartGene Services, EPFL Innovation Park, 1015 Lausanne, Switzerland
| | - Benoit Kabamba
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, UCLouvain, 1200 Brussels, Belgium
- Pôle de Microbiologie Médicale (MBLG), UCLouvain, 1200 Brussels, Belgium
| | - Hector Rodriguez-Villalobos
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, UCLouvain, 1200 Brussels, Belgium
- Department of Microbiology, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Bertrand Bearzatto
- Institut de Recherche Expérimentale et Clinique (IREC), Center for Applied Molecular Technologies (CTMA), UCLouvain, 1200 Brussels, Belgium
| | - Marie-Luce Delforge
- Institut de Biologie Clinique de l’Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Coralie Henin
- Federal Testing Platform for COVID-19, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Fabrice Bureau
- Immunology-Vaccinology Lab of the Faculty of Veterinary Medicine, ULiège, 4000 Liège, Belgium
| | - Laurent Gillet
- Immunology-Vaccinology Lab of the Faculty of Veterinary Medicine, ULiège, 4000 Liège, Belgium
| | - Annie Robert
- Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, UCLouvain, 1200 Brussels, Belgium
| | - Dimitri Van der Linden
- Pediatric Infectious Diseases, Specialized Pediatric Service, Pediatric Department, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
- Correspondence: ; Tel.: +00-32-2764-1714
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8
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Sebastian T, Carlson JJ, Gaensbauer J, Podewils LJ. Epidemiology and Transmission Dynamics of COVID-19 in an Urban Pediatric US Population. Public Health Rep 2022; 137:1013-1022. [PMID: 35786113 PMCID: PMC9357825 DOI: 10.1177/00333549221105232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This analysis summarizes observational epidemiologic data and transmission dynamics of SARS-CoV-2 among people aged <18 years to better characterize the pediatric COVID-19 pandemic. METHODS We conducted a retrospective study of public health surveillance data among children in Denver, Colorado, who were reported to have COVID-19 from March 1, 2020, through September 30, 2021. We used descriptive statistics and bivariate rate ratios (RRs) to describe demographic and clinical characteristics, transmission dynamics, case trends, and ecological associations. RESULTS A total of 9815 children and adolescents who had COVID-19 were reported during the study period. Adolescents aged 14-17 years had the highest incidence rate (IR) per 1000 people (IR = 107.5; 3021 of 28 108). Hispanic/Latino children had a 1.6 times higher rate of infection than non-Hispanic White children (RR = 1.57; 95% CI, 1.50-1.65; P < .001). Few hospitalizations (n = 138, 1.4%) and deaths (n = 3, 0%) occurred. Most children were symptomatic (4487 of 5499, 81.6%). Within household clusters, a large proportion of pediatric cases (n = 6136) were a secondary case (n = 3959, 64.5%), followed by index case (n = 1170, 19.1%) and co-index case (n = 1007, 16.4%). Non-Hispanic White children had an increased risk of being an index or co-index case (RR = 1.14; 95% CI, 1.06-1.23; P < .001), while Hispanic/Latino children had an increased risk of being a secondary case (RR = 1.07; 95% CI, 1.03-1.11; P < .001). From 2020 to 2021, the association between pediatric case rates and neighborhoods with higher poverty and households with ≥3 people decreased. CONCLUSIONS Older children and those identifying as Hispanic/Latino had a disproportionate incidence of disease. A sizable proportion of children were considered index cases or co-index cases. Pediatric prevention strategies, especially vaccinations, are vital for pandemic control.
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Affiliation(s)
- Thresia Sebastian
- Department of Pediatrics, Denver Health
and Hospital Authority, Denver, CO, USA
- Department of Pediatrics, University of
Colorado School of Medicine, Aurora, CO, USA
| | - Jesse J. Carlson
- Public Health Institute at Denver
Health, Denver Health and Hospital Authority, Denver, CO, USA
| | - James Gaensbauer
- Department of Pediatrics, Denver Health
and Hospital Authority, Denver, CO, USA
- Department of Pediatrics, University of
Colorado School of Medicine, Aurora, CO, USA
- Public Health Institute at Denver
Health, Denver Health and Hospital Authority, Denver, CO, USA
- School of Public Health, University of
Colorado Anschutz Medical Campus, Denver, CO, USA
- Department of Pediatrics and Adolescent
Medicine, Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Laura Jean Podewils
- Public Health Institute at Denver
Health, Denver Health and Hospital Authority, Denver, CO, USA
- School of Public Health, University of
Colorado Anschutz Medical Campus, Denver, CO, USA
- Office of Research, Denver Health and
Hospital Authority, Denver, CO, USA
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9
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Abstract
In daycare centres, the close contact of children with other children and employees favours the transmission of infections. The majority of children <6 years attend daycare programmes in Germany, but the role of daycare centres in the SARS-CoV-2 pandemic is unclear. We investigated the transmission risk in daycare centres and the spread of SARS-CoV-2 to associated households. 30 daycare groups with at least one recent laboratory-confirmed SARS-CoV-2 case were enrolled in the study (10/2020–06/2021). Close contact persons within daycare and households were examined over a 12-day period (repeated SARS-CoV-2 PCR tests, genetic sequencing of viruses, symptom diary). Households were interviewed to gain comprehensive information on each outbreak. We determined primary cases for all daycare groups. The number of secondary cases varied considerably between daycare groups. The pooled secondary attack rate (SAR) across all 30 daycare centres was 9.6%. The SAR tended to be higher when the Alpha variant was detected (15.9% vs. 5.1% with evidence of wild type). The household SAR was 53.3%. Exposed daycare children were less likely to get infected with SARS-CoV-2 than employees (7.7% vs. 15.5%). Containment measures in daycare programmes are critical to reduce SARS-CoV-2 transmission, especially to avoid spread to associated households.
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10
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Mild and Asymptomatic Coronavirus Disease in Children, Adolescents, and Household Contacts and Prolonged Viral Excretion. Int J Microbiol 2022; 2022:5625104. [PMID: 35813120 PMCID: PMC9259547 DOI: 10.1155/2022/5625104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/23/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022] Open
Abstract
Problem. The clinical presentation of coronavirus disease (COVID-19) in children remains controversial. This study analyzed viral excretion in children and adolescents with mild-to-moderate disease and their household contacts, who were treated in Jundiaí, Brazil between March and November 2020, before vaccination was available. Method. This was a prospective, observational, and descriptive cohort study. Nasopharyngeal swabs and blood were collected six times at weekly intervals. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) tests and immunoglobulin (Ig) G and IgA assays were used to test for COVID-19. Results. Overall, 419 children and 253 adults were enrolled. There was a significant correlation between qRT-PCR confirmation and the 1 to <5 years age group (
). Serology changes or recent infections were detected significantly in children <6 months (IgG,
; IgA,
) and >5 years of age (IgA,
; IgG,
). The mean and median time-to-positivity (using qRT-PCR) was 17 days, with a minimum of 6 and a maximum of 34. Among adults, the mean and median time-to-positivity was 12.6 and 9 days, respectively, with a minimum of 6 and a maximum of 45. Conclusion. Oligosymptomatic conditions may delay diagnosis and facilitate viral transmission. Pediatric-focused research is required, and specific protective measures for children <6 months of age should be considered.
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11
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Tosif S, Haycroft ER, Sarkar S, Toh ZQ, Do LAH, Donato CM, Selva KJ, Hoq M, Overmars I, Nguyen J, Lee L, Clifford V, Daley A, Mordant FL, McVernon J, Mulholland K, Marcato AJ, Smith MZ, Curtis N, McNab S, Saffery R, Kedzierska K, Subarrao K, Burgner D, Steer A, Bines JE, Sutton P, Licciardi PV, Chung AW, Neeland MR, Crawford NW. Virology and immune dynamics reveal high household transmission of ancestral SARS-CoV-2 strain. Pediatr Allergy Immunol 2022; 33:10.1111/pai.13824. [PMID: 35871459 PMCID: PMC9349415 DOI: 10.1111/pai.13824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Household studies are crucial for understanding the transmission of SARS-CoV-2 infection, which may be underestimated from PCR testing of respiratory samples alone. We aim to combine the assessment of household mitigation measures; nasopharyngeal, saliva, and stool PCR testing; along with mucosal and systemic SARS-CoV-2-specific antibodies, to comprehensively characterize SARS-CoV-2 infection and transmission in households. METHODS Between March and September 2020, we obtained samples from 92 participants in 26 households in Melbourne, Australia, in a 4-week period following the onset of infection with ancestral SARS-CoV-2 variants. RESULTS The secondary attack rate was 36% (24/66) when using nasopharyngeal swab (NPS) PCR positivity alone. However, when respiratory and nonrespiratory samples were combined with antibody responses in blood and saliva, the secondary attack rate was 76% (50/66). SARS-CoV-2 viral load of the index case and household isolation measures were key factors that determine secondary transmission. In 27% (7/26) of households, all family members tested positive by NPS for SARS-CoV-2 and were characterized by lower respiratory Ct values than low transmission families (Median 22.62 vs. 32.91; IQR 17.06-28.67 vs. 30.37-34.24). High transmission families were associated with enhanced plasma antibody responses to multiple SARS-CoV-2 antigens and the presence of neutralizing antibodies. Three distinguishing saliva SARS-CoV-2 antibody features were identified according to age (IgA1 to Spike 1, IgA1 to nucleocapsid protein (NP)), suggesting that adults and children generate distinct mucosal antibody responses during the acute phase of infection. CONCLUSION Utilizing respiratory and nonrespiratory PCR testing, along with the measurement of SARS-CoV-2-specific local and systemic antibodies, provides a more accurate assessment of infection within households and highlights some of the immunological differences in response between children and adults.
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12
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Blankenberger J, Kaufmann M, Albanese E, Amati R, Anker D, Camerini AL, Chocano-Bedoya P, Cullati S, Cusini A, Fehr J, Harju E, Kohler P, Kriemler S, Michel G, Rodondi N, Rodondi PY, Speierer A, Tancredi S, Puhan MA, Kahlert CR. Is living in a household with children associated with SARS-CoV-2 seropositivity in adults? Results from the Swiss national seroprevalence study Corona Immunitas. BMC Med 2022; 20:233. [PMID: 35725472 PMCID: PMC9207841 DOI: 10.1186/s12916-022-02431-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to determine whether living in a household with children is associated with SARS-CoV-2 seropositivity in adults and investigated interacting factors that may influence this association. METHODS SARS-CoV-2 serology testing was performed in randomly selected individuals from the general population between end of October 2020 and February 2021 in 11 cantons in Switzerland. Data on sociodemographic and household characteristics, employment status, and health-related history was collected using questionnaires. Multivariable logistic regression was used to examine the association of living with children <18 years of age (number, age group) and SARS-CoV-2 seropositivity. Further, we assessed the influence of reported non-household contacts, employment status, and gender. RESULTS Of 2393 working age participants (18-64 years), 413 (17.2%) were seropositive. Our results suggest that living with children and SARS-CoV-2 seropositivity are likely to be associated (unadjusted odds ratio (OR) 1.22, 95% confidence interval [0.98-1.52], adjusted OR 1.25 [0.99-1.58]). A pattern of a positive association was also found for subgroups of children aged 0-11 years (OR 1.21 [0.90-1.60]) and 12-17 years (OR 1.14 [0.78-1.64]). Odds of seropositivity were higher with more children (OR 1.14 per additional child [1.02-1.27]). Men had higher risk of SARS-CoV-2 infection when living with children than women (interaction: OR 1.74 [1.10-2.76]). CONCLUSIONS In adults from the general population living with children seems associated with SARS-CoV-2 seropositivity. However, child-related infection risk is not the same for every subgroup and depends on factors like gender. Further factors determining child-related infection risk need to be identified and causal links investigated. TRIAL REGISTRATION https://www.isrctn.com/ISRCTN18181860 .
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Affiliation(s)
- Jacob Blankenberger
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Daniela Anker
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Anne-Linda Camerini
- Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Patricia Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.,Department of Readaptation and Geriatrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.,Division of Infectious Disease & Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Erika Harju
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases, Kantonsspital Graubünden, Chur, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Luzern, Luzern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Pierre-Yves Rodondi
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
| | - Alexandre Speierer
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Christian R Kahlert
- Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
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13
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Janda A, Engel C, Remppis J, Enkel S, Peter A, Hörber S, Ganzenmueller T, Schober S, Weinstock C, Jacobsen EM, Fabricius D, Zernickel M, Stamminger T, Dietz A, Groß HJ, Bode SFN, Haddad ADM, Elling R, Stich M, Tönshoff B, Henneke P, Debatin KM, Franz AR, Renk H. Role of ABO Blood Group in SARS-CoV-2 Infection in Households. Front Microbiol 2022; 13:857965. [PMID: 35602077 PMCID: PMC9120758 DOI: 10.3389/fmicb.2022.857965] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/28/2022] [Indexed: 12/30/2022] Open
Abstract
An association between certain ABO/Rh blood groups and susceptibility to SARS-CoV-2 infection has been proposed for adults, although this remains controversial. In children and adolescents, the relationship is unclear due to a lack of robust data. Here, we investigated the association of ABO/Rh blood groups and SARS-CoV-2 in a multi-center study comprising 163 households with 281 children and 355 adults and at least one SARS-CoV-2 seropositive individual as determined by three independent assays as a proxy for previous infection. In line with previous findings, we found a higher frequency of blood group A (+ 6%) and a lower frequency of blood group O (−6%) among the SARS-CoV-2 seropositive adults compared to the seronegative ones. This trend was not seen in children. In contrast, SARS-CoV-2 seropositive children had a significantly lower frequency of Rh-positive blood groups. ABO compatibility did not seem to play a role in SARS-CoV-2 transmission within the families. A correction for family clusters was performed and estimated fixed effects of the blood group on the risk of SARS-CoV-2 seropositivity and symptomatic infection were determined. Although we found a different distribution of blood groups in seropositive individuals compared to the reference population, the risk of SARS-CoV-2 seropositivity or symptomatic infection was not increased in children or in adults with blood group A or AB versus O or B. Increasing age was the only parameter positively correlating with the risk of SARS-CoV-2 infection. In conclusion, specific ABO/Rh blood groups and ABO compatibility appear not to predispose for SARS-CoV-2 susceptibility in children.
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Affiliation(s)
- Ales Janda
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Corinna Engel
- Center for Pediatric Clinical Studies, University Children's Hospital Tübingen, Tübingen, Germany
| | | | - Sigrid Enkel
- Center for Clinical Transfusion Medicine Tübingen, Tübingen, Germany
| | - Andreas Peter
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Sebastian Hörber
- Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany
| | - Tina Ganzenmueller
- Institute for Medical Virology and Epidemiology of Viral Diseases, University Hospital Tübingen, Tübingen, Germany
| | - Sarah Schober
- University Children's Hospital Tübingen, Tübingen, Germany
| | - Christof Weinstock
- Department of Transfusion Medicine, Ulm University, Ulm, Germany.,Institute for Clinical Transfusion Medicine and Immunogenetics, Ulm, Germany.,Red Cross Blood Service Baden-Württemberg-Hessen, Ulm, Germany
| | - Eva-Maria Jacobsen
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Dorit Fabricius
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Maria Zernickel
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | | | - Andrea Dietz
- Institute of Virology, Ulm University Medical Center, Ulm, Germany
| | - Hans-Jürgen Groß
- Institute of Clinical Chemistry, Ulm University Medical Center, Ulm, Germany
| | - Sebastian F N Bode
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Anneke D M Haddad
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Roland Elling
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Stich
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Burkhard Tönshoff
- Department of Pediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Henneke
- Center for Pediatrics and Adolescent Medicine, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute for Immunodeficiency, Medical Center Freiburg, Germany and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Axel R Franz
- Center for Pediatric Clinical Studies, University Children's Hospital Tübingen, Tübingen, Germany.,University Children's Hospital Tübingen, Tübingen, Germany
| | - Hanna Renk
- University Children's Hospital Tübingen, Tübingen, Germany
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14
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Comess S, Wang H, Holmes S, Donnat C. Statistical Modeling for Practical Pooled Testing During the COVID-19 Pandemic. Stat Sci 2022. [DOI: 10.1214/22-sts857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Saskia Comess
- Saskia Comess is a PhD student, Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, California
| | - Hannah Wang
- Hannah Wang is a resident physician, Department of Anatomic and Clinical Pathology, Stanford University School of Medicine, Stanford, California
| | - Susan Holmes
- Susan Holmes is a Professor, Department of Statistics, Stanford University, Stanford, California
| | - Claire Donnat
- Claire Donnat is an Assistant Professor, Department of Statistics, The University of Chicago, Chicago, Illinois
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15
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McLean HQ, Grijalva CG, Hanson KE, Zhu Y, Deyoe JE, Meece JK, Halasa NB, Chappell JD, Mellis AM, Reed C, Belongia EA, Talbot HK, Rolfes MA. Household Transmission and Clinical Features of SARS-CoV-2 Infections. Pediatrics 2022; 149:e2021054178. [PMID: 35194642 PMCID: PMC9097956 DOI: 10.1542/peds.2021-054178] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Examine age differences in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risk from primary cases and infection risk among household contacts and symptoms among those with SARS-CoV-2 infection. METHODS People with SARS-CoV-2 infection in Nashville, Tennessee and central and western Wisconsin and their household contacts were followed daily for 14 days to ascertain symptoms and secondary transmission events. Households were enrolled between April 2020 and April 2021. Secondary infection risks (SIR) by age of the primary case and contacts were estimated using generalized estimating equations. RESULTS The 226 primary cases were followed by 198 (49%) secondary SARS-CoV-2 infections among 404 household contacts. Age group-specific SIR among contacts ranged from 36% to 53%, with no differences by age. SIR was lower in primary cases age 12 to 17 years than from primary cases 18 to 49 years (risk ratio [RR] 0.42; 95% confidence interval [CI] 0.19-0.91). SIR was 55% and 45%, respectively, among primary case-contact pairs in the same versus different age group (RR 1.47; 95% CI 0.98-2.22). SIR was highest among primary case-contact pairs age ≥65 years (76%) and 5 to 11 years (69%). Among secondary SARS-CoV-2 infections, 19% were asymptomatic; there was no difference in the frequency of asymptomatic infections by age group. CONCLUSIONS Both children and adults can transmit and are susceptible to SARS-CoV-2 infection. SIR did not vary by age, but further research is needed to understand age-related differences in probability of transmission from primary cases by age.
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Affiliation(s)
- Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | | | - Kayla E Hanson
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | - Yuwei Zhu
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jessica E Deyoe
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - Carrie Reed
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee
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16
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David J, Bragazzi NL, Scarabel F, McCarthy Z, Wu J. Non-pharmaceutical intervention levels to reduce the COVID-19 attack ratio among children. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211863. [PMID: 35308622 PMCID: PMC8924746 DOI: 10.1098/rsos.211863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/25/2022] [Indexed: 05/03/2023]
Abstract
The attack ratio in a subpopulation is defined as the total number of infections over the total number of individuals in this subpopulation. Using a methodology based on an age-stratified transmission dynamics model, we estimated the attack ratio of COVID-19 among children (individuals 0-11 years) when a large proportion of individuals eligible for vaccination (age 12 and above) are vaccinated to contain the epidemic among this subpopulation, or the effective herd immunity (with additional physical distancing measures). We describe the relationship between the attack ratio among children, the time to remove infected individuals from the transmission chain and the children-to-children daily contact rate while considering the increased transmissibility of virus variants (using the Delta variant as an example). We illustrate the generality and applicability of the methodology established by performing an analysis of the attack ratio of COVID-19 among children in the population of Canada and in its province of Ontario. The clinical attack ratio, defined as the number of symptomatic infections over the total population, can be informed from the attack ratio and both can be reduced substantially via a combination of reduced social mixing and rapid testing and isolation of the children.
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Affiliation(s)
- Jummy David
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
| | - Nicola Luigi Bragazzi
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
| | - Francesca Scarabel
- Department of Mathematics, The University of Manchester, Manchester, UK
- Joint UNIversities Pandemic and Epidemiological Research (JUNIPER), UK
- CDLab - Computational Dynamics Laboratory, Department of Mathematics, Computer Science and Physics, University of Udine, Italy
| | - Zachary McCarthy
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
| | - Jianhong Wu
- Fields-CQAM Laboratory of Mathematics for Public Health (MfPH), York University, Toronto, Ontario, Canada
- Laboratory for Industrial and Applied Mathematics, York University, Toronto, Ontario, Canada
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17
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Audu RA, Stafford KA, Steinhardt L, Musa ZA, Iriemenam N, Ilori E, Blanco N, Mitchell A, Hamada Y, Moloney M, Iwara E, Abimiku A, Ige FA, William NE, Igumbor E, Ochu C, Omoare AA, Okunoye O, Greby SM, Rangaka MX, Copas A, Dalhatu I, Abubakar I, McCracken S, Alagi M, Mba N, Anthony A, Okoye M, Okoi C, Ezechi OC, Salako BL, Ihekweazu C. Seroprevalence of SARS-CoV-2 in four states of Nigeria in October 2020: A population-based household survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000363. [PMID: 36962359 PMCID: PMC10022353 DOI: 10.1371/journal.pgph.0000363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/31/2022] [Indexed: 04/25/2023]
Abstract
The observed epidemiology of SARS-CoV-2 in sub-Saharan Africa has varied greatly from that in Europe and the United States, with much lower reported incidence. Population-based studies are needed to estimate true cumulative incidence of SARS-CoV-2 to inform public health interventions. This study estimated SARS-CoV-2 seroprevalence in four selected states in Nigeria in October 2020. We implemented a two-stage cluster sample household survey in four Nigerian states (Enugu, Gombe, Lagos, and Nasarawa) to estimate age-stratified prevalence of SARS-CoV-2 antibodies. All individuals in sampled households were eligible for interview, blood draw, and nasal/oropharyngeal swab collection. We additionally tested participants for current/recent malaria infection. Seroprevalence estimates were calculated accounting for the complex survey design. Across all four states, 10,629 (96·5%) of 11,015 interviewed individuals provided blood samples. The seroprevalence of SARS-CoV-2 antibodies was 25·2% (95% CI 21·8-28·6) in Enugu State, 9·3% (95% CI 7·0-11·5) in Gombe State, 23·3% (95% CI 20·5-26·4) in Lagos State, and 18·0% (95% CI 14·4-21·6) in Nasarawa State. Prevalence of current/recent malaria infection ranged from 2·8% in Lagos to 45·8% in Gombe and was not significantly related to SARS-CoV-2 seroprevalence. The prevalence of active SARS-CoV-2 infection in the four states during the survey period was 0·2% (95% CI 0·1-0·4). Approximately eight months after the first reported COVID-19 case in Nigeria, seroprevalence indicated infection levels 194 times higher than the 24,198 officially reported COVID-19 cases across the four states; however, most of the population remained susceptible to COVID-19 in October 2020.
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Affiliation(s)
| | - Kristen A Stafford
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Zaidat A Musa
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Nnaemeka Iriemenam
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Natalia Blanco
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Andrew Mitchell
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Yohhei Hamada
- Institute for Global Health, University College London, London, United Kingdom
| | - Mirna Moloney
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Emem Iwara
- Center for International Health, Education and Biosecurity, University of Maryland, Baltimore, Abuja, Nigeria
| | - Alash'le Abimiku
- Center for International Health, Education and Biosecurity, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | | | | | - Ehimario Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of Western Cape, Cape Town, South Africa
| | - Chinwe Ochu
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Olumide Okunoye
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Stacie M Greby
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | - Andrew Copas
- Institute for Global Health, University College London, London, United Kingdom
| | - Ibrahim Dalhatu
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, United Kingdom
| | - Stephen McCracken
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Matthias Alagi
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - McPaul Okoye
- Division of Global HIV/AIDS and Tuberculosis, Center for Global Health, United States Centers for Disease Control and Prevention, Abuja, Nigeria
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18
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Viner R, Waddington C, Mytton O, Booy R, Cruz J, Ward J, Ladhani S, Panovska-Griffiths J, Bonell C, Melendez-Torres GJ. Transmission of SARS-CoV-2 by children and young people in households and schools: a meta-analysis of population-based and contact-tracing studies. J Infect 2021; 84:361-382. [PMID: 34953911 PMCID: PMC8694793 DOI: 10.1016/j.jinf.2021.12.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 12/23/2022]
Abstract
Background The role of children and young people (CYP) in transmission of SARS-CoV-2 in household and educational settings remains unclear. We undertook a systematic review and meta-analysis of contact-tracing and population-based studies at low risk of bias. Methods We searched 4 electronic databases on 28 July 2021 for contact-tracing studies and population-based studies informative about transmission of SARS-CoV-2 from 0-19 year olds in household or educational settings. We excluded studies at high risk of bias, including from under-ascertainment of asymptomatic infections. We undertook multilevel random effects meta-analyses of secondary attack rates (SAR: contact-tracing studies) and school infection prevalence, and used meta-regression to examine the impact of community SARS-CoV-2 incidence on school infection prevalence. Findings 4529 abstracts were reviewed, resulting in 37 included studies (16 contact-tracing; 19 population studies; 2 mixed studies). The pooled relative transmissibility of CYP compared with adults was 0.92 (0.68, 1.26) in adjusted household studies. The pooled SAR from CYP was lower (p=0.002) in school studies 0.7% (0.2, 2.7) than household studies (7.6% (3.6, 15.9) . There was no difference in SAR from CYP to child or adult contacts. School population studies showed some evidence of clustering in classes within schools. School infection prevalence was associated with contemporary community 14-day incidence (OR 1.003 (1.001, 1.004), p<0.001). Interpretation We found no difference in transmission of SARS-CoV-2 from CYP compared with adults within household settings. SAR were markedly lower in school compared with household settings, suggesting that household transmission is more important than school transmission in this pandemic. School infection prevalence was associated with community infection incidence, supporting hypotheses that school infections broadly reflect community infections. These findings are important for guiding policy decisions on shielding, vaccination school and operations during the pandemic.
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Affiliation(s)
- Russell Viner
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London.
| | | | | | | | - Joana Cruz
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London
| | - Joseph Ward
- Population, Policy and Practice, UCL Great Ormond St. Institute of Child Health, London
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19
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Lordan R, Prior S, Hennessy E, Naik A, Ghosh S, Paschos GK, Skarke C, Barekat K, Hollingsworth T, Juska S, Mazaleuskaya LL, Teegarden S, Glascock AL, Anderson S, Meng H, Tang SY, Weljie A, Bottalico L, Ricciotti E, Cherfane P, Mrcela A, Grant G, Poole K, Mayer N, Waring M, Adang L, Becker J, Fries S, FitzGerald GA, Grosser T. Considerations for the Safe Operation of Schools During the Coronavirus Pandemic. Front Public Health 2021; 9:751451. [PMID: 34976917 PMCID: PMC8716382 DOI: 10.3389/fpubh.2021.751451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/18/2021] [Indexed: 12/25/2022] Open
Abstract
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, providing safe in-person schooling has been a dynamic process balancing evolving community disease burden, scientific information, and local regulatory requirements with the mandate for education. Considerations include the health risks of SARS-CoV-2 infection and its post-acute sequelae, the impact of remote learning or periods of quarantine on education and well-being of children, and the contribution of schools to viral circulation in the community. The risk for infections that may occur within schools is related to the incidence of SARS-CoV-2 infections within the local community. Thus, persistent suppression of viral circulation in the community through effective public health measures including vaccination is critical to in-person schooling. Evidence suggests that the likelihood of transmission of SARS-CoV-2 within schools can be minimized if mitigation strategies are rationally combined. This article reviews evidence-based approaches and practices for the continual operation of in-person schooling.
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Affiliation(s)
- Ronan Lordan
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Samantha Prior
- Faculty of Science & Engineering, University of Limerick, Limerick, Ireland
| | - Elizabeth Hennessy
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Amruta Naik
- Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Soumita Ghosh
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Georgios K. Paschos
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Carsten Skarke
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kayla Barekat
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Taylor Hollingsworth
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sydney Juska
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Liudmila L. Mazaleuskaya
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sarah Teegarden
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Abigail L. Glascock
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sean Anderson
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Hu Meng
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Soon-Yew Tang
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Aalim Weljie
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Lisa Bottalico
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Emanuela Ricciotti
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Perla Cherfane
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Antonijo Mrcela
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Gregory Grant
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Kristen Poole
- Department of English, University of Delaware, Newark, DE, United States
| | - Natalie Mayer
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Waring
- Department of Civil, Architectural and Environmental Engineering, Drexel University, Philadelphia, PA, United States
| | - Laura Adang
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Julie Becker
- Division of Public Health, University of the Sciences, Philadelphia, PA, United States
| | - Susanne Fries
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Garret A. FitzGerald
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Tilo Grosser
- Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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20
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Stich M, Elling R, Renk H, Janda A, Garbade SF, Müller B, Kräusslich HG, Fabricius D, Zernickel M, Meissner P, Huzly D, Grulich-Henn J, Haddad A, Görne T, Spielberger B, Fritsch L, Nieters A, Hengel H, Dietz AN, Stamminger T, Ganzenmueller T, Ruetalo N, Peter A, Remppis J, Iftner T, Jeltsch K, Waterboer T, Franz AR, Hoffmann GF, Engel C, Debatin KM, Tönshoff B, Henneke P. Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Households with Children, Southwest Germany, May-August 2020. Emerg Infect Dis 2021; 27:3009-3019. [PMID: 34695369 PMCID: PMC8632156 DOI: 10.3201/eid2712.210978] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Resolving the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in households with members from different generations is crucial for containing the current pandemic. We conducted a large-scale, multicenter, cross-sectional seroepidemiologic household transmission study in southwest Germany during May 11-August 1, 2020. We included 1,625 study participants from 405 households that each had ≥1 child and 1 reverse transcription PCR-confirmed SARS-CoV-2-infected index case-patient. The overall secondary attack rate was 31.6% and was significantly higher in exposed adults (37.5%) than in children (24.6%-29.2%; p = <0.015); the rate was also significantly higher when the index case-patient was >60 years of age (72.9%; p = 0.039). Other risk factors for infectiousness of the index case-patient were SARS-CoV-2-seropositivity (odds ratio [OR] 27.8, 95% CI 8.26-93.5), fever (OR 1.93, 95% CI 1.14-3.31), and cough (OR 2.07, 95% CI 1.21-3.53). Secondary infections in household contacts generate a substantial disease burden.
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Affiliation(s)
| | | | | | | | - Sven F. Garbade
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Barbara Müller
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Hans-Georg Kräusslich
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Dorit Fabricius
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Maria Zernickel
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Peter Meissner
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Daniela Huzly
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Jürgen Grulich-Henn
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Anneke Haddad
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Tessa Görne
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Benedikt Spielberger
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Linus Fritsch
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Alexandra Nieters
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Hartmut Hengel
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Andrea N. Dietz
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Thomas Stamminger
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Tina Ganzenmueller
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Natalia Ruetalo
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Andreas Peter
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Jonathan Remppis
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Thomas Iftner
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Kathrin Jeltsch
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Tim Waterboer
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Axel R. Franz
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
| | - Georg Friedrich Hoffmann
- Heidelberg University Hospital, Heidelberg, Germany (M. Stich, S.F. Garbade, B. Müller, H.-G. Kräusslich, J. Grulich-Henn, K. Jeltsch, G.F. Hoffmann, B. Tönshoff)
- University Medical Centre and Faculty of Medicine Freiburg, Freiburg, Germany (R. Elling, D. Huzly, A. Haddad, T. Görne, B. Spielberger, L. Fritsch, A. Nieters, H. Hengel, P. Henneke)
- University Hospital and Faculty of Medicine Tübingen, Tübingen, Germany (H. Renk, T. Ganzenmueller, N. Ruetalo, A. Peter, J. Remppis, T. Iftner, A.R. Franz, C. Engel)
- Ulm University Medical Center, Ulm, Germany (A. Janda, D. Fabricius, M. Zernickel, P. Meissner, A.N. Dietz, T. Stamminger, K.-M. Debatin)
- German Cancer Research Center (DKFZ), Heidelberg (T. Waterboer)
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Julin CH, Robertson AH, Hungnes O, Tunheim G, Bekkevold T, Laake I, Aune IF, Killengreen MF, Strand TR, Rykkvin R, Dorenberg DH, Stene-Johansen K, Berg ES, Bodin JE, Oftung F, Steens A, Næss LM. Household Transmission of SARS-CoV-2: A Prospective Longitudinal Study Showing Higher Viral Load and Increased Transmissibility of the Alpha Variant Compared to Previous Strains. Microorganisms 2021; 9:2371. [PMID: 34835495 PMCID: PMC8622435 DOI: 10.3390/microorganisms9112371] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/23/2022] Open
Abstract
We studied the secondary attack rate (SAR), risk factors, and precautionary practices of household transmission in a prospective, longitudinal study. We further compared transmission between the Alpha (B.1.1.7) variant and non-Variant of Concern (non-VOC) viruses. From May 2020 throughout April 2021, we recruited 70 confirmed COVID-19 cases with 146 household contacts. Participants donated biological samples eight times over 6 weeks and answered questionnaires. SARS-CoV-2 infection was detected by real-time RT-PCR. Whole genome sequencing and droplet digital PCR were used to establish virus variant and viral load. SARS-CoV-2 transmission occurred in 60% of the households, and the overall SAR for household contacts was 50%. The SAR was significantly higher for the Alpha variant (78%) compared with non-VOC viruses (43%) and was associated with a higher viral load. SAR was higher in household contacts aged ≥40 years (69%) than in younger contacts (40-47%), and for contacts of primary cases with loss of taste/smell. Children had lower viral loads and were more often asymptomatic than adults. Sleeping separately from the primary case reduced the risk of transmission. In conclusion, we found substantial household transmission, particularly for the Alpha variant. Precautionary practices seem to reduce SAR, but preventing household transmission may become difficult with more contagious variants, depending on vaccine use and effectiveness.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lisbeth Meyer Næss
- Division of Infection Control, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway; (C.H.J.); (A.H.R.); (O.H.); (G.T.); (T.B.); (I.L.); (I.F.A.); (M.F.K.); (T.R.S.); (R.R.); (D.H.D.); (K.S.-J.); (E.S.B.); (J.E.B.); (F.O.); (A.S.)
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22
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Loss J, Kuger S, Buchholz U, Lehfeld AS, Varnaccia G, Haas W, Jordan S, Kalicki B, Schienkiewitz A, Rauschenbach T. [SARS-CoV-2 incidence, transmission, and containment measures in daycare centers during the COVID-19 pandemic-findings from the Corona Daycare Study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1581-1591. [PMID: 34731294 PMCID: PMC8564588 DOI: 10.1007/s00103-021-03449-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/07/2021] [Indexed: 11/24/2022]
Abstract
Hintergrund Kindertageseinrichtungen (Kitas) spielen eine wichtige gesellschaftspolitische Rolle; gleichzeitig begünstigt der enge Kontakt der Kinder in Kitagruppen untereinander und mit Beschäftigten die Übertragung von Infektionen. In der COVID-19-Pandemie ergaben sich die Fragen, wie Infektionsgeschehen in Kitas verlaufen, welche Rolle Kitakinder in der Pandemie spielen und welche Schutz- und Hygienemaßnahmen in Kitas umgesetzt werden. Von 06/2020 bis 12/2021 wird die „Corona-KiTa-Studie“ durchgeführt, in der pädagogische und infektionsepidemiologische Themen gemeinsam bearbeitet werden. Methoden In der Studie werden Daten aus unterschiedlichen Quellen erhoben. Es werden amtliche Meldedaten sowie wöchentliche Angaben von Kitas im sog. KiTa-Register kontinuierlich ausgewertet. Zudem werden SARS-CoV-2-Ausbrüche in Kitas vor Ort durch wiederholte Probengewinnung und Befragungen untersucht. Ergebnisse Das SARS-CoV-2-Infektionsgeschehen in Kitas bzw. bei Kindern im Kitaalter war von 03/2020 bis 05/2021 sehr dynamisch. In der 2. und 3. Pandemiewelle stiegen SARS-CoV-2-Ausbrüche in Kitas deutlich an, begleitet von einer erheblichen Zunahme an Kita- und Gruppenschließungen. Zuletzt erhöhte sich der Anteil der betroffenen Kinder bei den Ausbrüchen kontinuierlich. Allerdings ergab die erste Untersuchung von SARS-CoV-2-Ausbrüchen (n = 28), dass bei kindlichen Indexfällen im Schnitt nur ein Bruchteil der Kitakontakte (6,8 %) angesteckt wurde. Die Übertragungshäufigkeiten unterschieden sich zwischen einzelnen Kitas deutlich. Diskussion Die Zusammenführung von regelmäßig erhobenen Melde- und Befragungsdaten sowie Ausbruchsuntersuchungen ermöglicht ein vielschichtiges Monitoring des Infektionsgeschehens in Kitas, dessen Ergebnisse in Empfehlungen für Public-Health-Maßnahmen einfließen können.
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Affiliation(s)
- Julika Loss
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
| | - Susanne Kuger
- Zentrum für Dauerbeobachtung und Methoden, Deutsches Jugendinstitut, München, Deutschland
| | - Udo Buchholz
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Ann-Sophie Lehfeld
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Gianni Varnaccia
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Walter Haas
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland
| | - Susanne Jordan
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Bernhard Kalicki
- Abteilung Kinder und Kinderbetreuung, Deutsches Jugendinstitut, München, Deutschland
| | - Anja Schienkiewitz
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
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23
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Household transmission of SARS-CoV-2: a prospective observational study in Bosnia and Herzegovina, August-December 2020. Int J Infect Dis 2021; 112:352-361. [PMID: 34600136 PMCID: PMC8479489 DOI: 10.1016/j.ijid.2021.09.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022] Open
Abstract
The overall severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) secondary attack rate in this study was 17%. Adults were more likely to be secondary cases than children. Particular care should be taken if primary cases present with cough and rhinorrhoea. Kissing a SARS-CoV-2 case or sharing a meal with a SARS-CoV-2 case increased the risk of infection. Reducing contact in the household immediately is key to prevent onward transmission.
Background The secondary attack rate (SAR) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was estimated, and the risk factors for infection among members of households with a coronavirus disease 2019 (COVID-19) index case were identified to inform preventive measures. Methods Between 3 August and 19 December 2020, a household transmission study was implemented based on a standardized World Health Organization protocol. Laboratory-confirmed cases of SARS-CoV-2 infection were recruited through the federal COVID-19 database. Trained contact tracers interviewed index cases and household members to collect information on demographic, clinical and behavioural factors. Contacts were followed up for 28 days to identify secondary infections. SAR was estimated and odds ratios (OR) were calculated for risk factors for transmission. Results In total, 383 households and 793 contacts were included in this study. The overall SAR was 17% [95% confidence interval (CI) 14–21]. Contacts had higher risk for infection if the primary case had both cough and runny nose (OR 4.31, 95% CI 1.60–11.63), if the contact was aged 18–49 years (OR 4.67, 95% CI 1.83–11.93), if the contact kissed the primary case (OR 3.16, 95% CI 1.19–8.43), or if the contact shared a meal with the primary case (OR 3.10, 95% CI 1.17–8.27). Conclusions These results add to the global literature by providing evidence from a middle-income setting. Standard preventive measures in households with positive cases remain critical to reduce transmission.
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Kuczborska K, Książyk J. Prevalence and Course of SARS-CoV-2 Infection among Immunocompromised Children Hospitalised in the Tertiary Referral Hospital in Poland. J Clin Med 2021; 10:4556. [PMID: 34640570 PMCID: PMC8509507 DOI: 10.3390/jcm10194556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of this retrospective study was the assessment of the prevalence, clinical characteristics, and the comparison of the course of SARS-CoV-2 infection in children with and without immunodeficiency that were admitted to the COVID-19 Subunit of the tertiary referral hospital in Warsaw, Poland. We analysed 313 children hospitalised in the COVID-19 Subunit. The analysis was performed on the total study group and subgroups of children with and without immunodeficiency. In each group, clinical data and laboratory test results were analysed. Of the 68 children with isolated fevers, only seven (11.76%) were diagnosed with COVID-19, whereas among those with the accompanying features of respiratory or gastrointestinal infection, only one (3.23%) and ten (16.95%) patients tested positive, respectively. In both groups, the course of the infection was mainly asymptomatic or mild. The children with immunodeficiencies had lower white blood cell and lymphocyte counts, lower haemoglobin levels, and higher urea levels but did not differ in other biochemical variables. To conclude, the most frequently reported symptoms of COVID-19 indicate that this disease among children is only a small percentage. In both groups, the responses to the infection were comparable in terms of the mild clinical symptoms and the laboratory test results. Therefore, SARS-CoV-2 infection should not alter the chronic treatment of underlying diseases.
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Affiliation(s)
- Karolina Kuczborska
- Department of Pediatrics, Nutrition and Metabolic Disorders, Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
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25
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Weinert S, Thronicke A, Hinse M, Schad F, Matthes H. School Teachers' Self-Reported Fear and Risk Perception during the COVID-19 Pandemic-A Nationwide Survey in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9218. [PMID: 34501807 PMCID: PMC8430488 DOI: 10.3390/ijerph18179218] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/24/2022]
Abstract
With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers' risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited to take part in a cross-sectional COVID-19-specific online survey. Descriptive statistical analysis was performed. Factors associated with teachers' fears of contracting the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were evaluated with an adjusted multivariable regression analysis. The median age of the 6753 participating teachers was 43 years, and 77% were female. Most teachers worked in high schools (29%) and elementary schools (26%). The majority of participants (73%) feared contracting SARS-CoV-2 at school, while 77% intended to receive their COVID-19 vaccination. Ninety-eight percent considered students to pose the greatest risk. Female and younger teachers were significantly more anxious to get infected and teachers who opposed the re-opening of schools had significantly higher odds of being more anxious (p < 0.001). To the authors' knowledge, this is the first study to describe teachers' risk perception of COVID-19 and their attitudes towards vaccinations in a nationwide survey. The anxiety correlates with the COVID-19 protection measures demanded and appears to be a driving factor rather than rational logic.
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Affiliation(s)
- Stefanie Weinert
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; (A.T.); (M.H.); (H.M.)
| | - Anja Thronicke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; (A.T.); (M.H.); (H.M.)
- Research Institute Havelhöhe (FIH), Department Network Oncology, Kladower Damm 221, Berlin, Germany;
| | - Maximilian Hinse
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; (A.T.); (M.H.); (H.M.)
| | - Friedemann Schad
- Research Institute Havelhöhe (FIH), Department Network Oncology, Kladower Damm 221, Berlin, Germany;
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Harald Matthes
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; (A.T.); (M.H.); (H.M.)
- Research Institute Havelhöhe (FIH), Department Network Oncology, Kladower Damm 221, Berlin, Germany;
- Medical Clinic for Gastroenterology, Infectiology and Rheumatology CBF, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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McLean HQ, Grijalva CG, Hanson KE, Zhu YG, Deyoe JE, Meece JK, Halasa NB, Chappell JD, Mellis A, Reed C, Belongia EA, Talbot HK, Rolfes MA. Household Transmission and Clinical Features of SARS-CoV-2 Infections by Age in 2 US Communities. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 34426817 PMCID: PMC8382134 DOI: 10.1101/2021.08.16.21262121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES. Examine age differences in SARS-CoV-2 transmission risk from primary cases and infection risk among household contacts, and symptoms among those with SARS-CoV-2 infection. METHODS. People with SARS-CoV-2 infection in Nashville, Tennessee and central and western Wisconsin and their household contacts were followed daily for 14 days to ascertain symptoms and secondary transmission events. Households were enrolled between April 2020 and April 2021. Secondary infection risks (SIR) by age of the primary case and contacts were estimated using generalized estimating equations. RESULTS. The 226 primary cases were followed by 198 (49%) secondary SARS-CoV-2 infections among 404 household contacts. Age group-specific SIR among contacts ranged from 36% to 53%, with no differences by age. SIR was lower from primary cases aged 12–17 years than from primary cases 18–49 years (risk ratio [RR] 0.42; 95% confidence interval [CI] 0.19–0.91). SIR was 55% and 45%, respectively, among primary case-contact pairs in the same versus different age group (RR 1.47; 95% CI 0.98–2.22). SIR was highest among primary case-contacts pairs aged ≥65 years (76%) and 5–11 years (69%). Among secondary SARS-CoV-2 infections, 19% were asymptomatic; there was no difference in the frequency of asymptomatic infections by age group. CONCLUSIONS. Both children and adults can transmit and are susceptible to SARS-CoV-2 infection. SIR did not vary by age, but further research is needed to understand age-related differences in probability of transmission from primary cases by age.
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