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Danis K, Epaulard O, Bénet T, Gaymard A, Campoy S, Botelho-Nevers E, Bouscambert-Duchamp M, Spaccaferri G, Ader F, Mailles A, Boudalaa Z, Tolsma V, Berra J, Vaux S, Forestier E, Landelle C, Fougere E, Thabuis A, Berthelot P, Veil R, Levy-Bruhl D, Chidiac C, Lina B, Coignard B, Saura C. Cluster of Coronavirus Disease 2019 (COVID-19) in the French Alps, February 2020. Clin Infect Dis 2020; 71:825-832. [PMID: 32277759 PMCID: PMC7184384 DOI: 10.1093/cid/ciaa424] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/09/2020] [Indexed: 01/18/2023] Open
Abstract
Background On 07/02/2020, French Health authorities were informed of a confirmed case of SARS-CoV-2 coronavirus in an Englishman infected in Singapore who had recently stayed in a chalet in the French Alps. We conducted an investigation to identify secondary cases and interrupt transmission. Methods We defined as a confirmed case a person linked to the chalet with a positive RT-PCR sample for SARS-CoV-2. Results The index case stayed 4 days in the chalet with 10 English tourists and a family of 5 French residents; SARS-CoV-2 was detected in 5 individuals in France, 6 in England (including the index case), and 1 in Spain (overall attack rate in the chalet: 75%). One pediatric case, with picornavirus and influenza A coinfection, visited 3 different schools while symptomatic. One case was asymptomatic, with similar viral load as that of a symptomatic case. Seven days after the first cases were diagnosed, one tertiary case was detected in a symptomatic patient with a positive endotracheal aspirate; all previous and concurrent nasopharyngeal specimens were negative. Additionally, 172 contacts were monitored, including 73 tested negative for SARS-CoV-2. Conclusions The occurrence in this cluster of one asymptomatic case with similar viral load as a symptomatic patient, suggests transmission potential of asymptomatic individuals. The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children. Finally, the dissociation between upper and lower respiratory tract results underscores the need for close monitoring of the clinical evolution of suspect Covid-19 cases.
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Affiliation(s)
- Kostas Danis
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Olivier Epaulard
- Infectious Diseases Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Fédération d'infectiologie multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, Grenoble, France.,Unité Mixte de Recherche 5075 (UMR 5075), Institut de biologie structurale, Grenoble, France
| | - Thomas Bénet
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Alexandre Gaymard
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Séphora Campoy
- Regional Health Agency of Auvergne Rhône Alpes, Lyon, France
| | - Elisabeth Botelho-Nevers
- Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France
| | - Maude Bouscambert-Duchamp
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Guillaume Spaccaferri
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Florence Ader
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France
| | - Alexandra Mailles
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | | | - Violaine Tolsma
- Infectious Diseases Unit, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Julien Berra
- Regional Health Agency of Auvergne Rhône Alpes, Lyon, France
| | - Sophie Vaux
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Emmanuel Forestier
- Infectious Disease Department, Centre Hospitalier Metropole Savoie, Chambery, France
| | - Caroline Landelle
- Service d'Hygiène Hospitalière et de Gestion des Risques, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques, Applications, Grenoble, Unité Mixte de Recherche 5525 (TIMC-IMAG UMR5525), CNRS, Université Grenoble Alpes, Grenoble, France
| | - Erica Fougere
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Alexandra Thabuis
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
| | - Philippe Berthelot
- Infectious Diseases Department, University Hospital of Saint-Etienne, Lyon, France.,Groupe Immunité des Muqueuses et Agents Pathogènes, Université Jean Monnet, Université de Lyon, St-Etienne, France
| | - Raphael Veil
- Public Health Emergency Operations Center, French Ministry of Health, Paris, France
| | - Daniel Levy-Bruhl
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Christian Chidiac
- Infectious and Tropical Disease Department, Croix-Rousse Hospital, University Hospital of Lyon, Lyon, France.,Maladies Infectieuses et Tropicales, Université Claude Bernard Lyon 1 (UCBL1), Unité de formation et de recherche (UFR) Lyon Sud-Charles Mérieux, Lyon, France
| | - Bruno Lina
- Department of Virology, Infective Agents Institute, National Reference Center for Respiratory Viruses North Hospital Network, Lyon, France
| | - Bruno Coignard
- French National Public Health Agency, Department of Infectious Diseases, Saint-Maurice, France
| | - Christine Saura
- French National Public Health Agency, Auvergne-Rhône-Alpes Regional Office, Lyon, France
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