1
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Ghai RR, Straily A, Wineland N, Calogero J, Stobierski MG, Signs K, Blievernicht M, Torres-Mendoza Y, Waltenburg MA, Condrey JA, Blankenship HM, Riner D, Barr N, Schalow M, Goodrich J, Collins C, Ahmad A, Metz JM, Herzegh O, Straka K, Arsnoe DM, Duffiney AG, Shriner SA, Kainulainen MH, Carpenter A, Whitehill F, Wendling NM, Stoddard RA, Retchless AC, Uehara A, Tao Y, Li Y, Zhang J, Tong S, Barton Behravesh C. Epidemiologic and Genomic Evidence for Zoonotic Transmission of SARS-CoV-2 among People and Animals on a Michigan Mink Farm, United States, 2020. Viruses 2023; 15:2436. [PMID: 38140677 PMCID: PMC10747742 DOI: 10.3390/v15122436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Farmed mink are one of few animals in which infection with SARS-CoV-2 has resulted in sustained transmission among a population and spillback from mink to people. In September 2020, mink on a Michigan farm exhibited increased morbidity and mortality rates due to confirmed SARS-CoV-2 infection. We conducted an epidemiologic investigation to identify the source of initial mink exposure, assess the degree of spread within the facility's overall mink population, and evaluate the risk of further viral spread on the farm and in surrounding wildlife habitats. Three farm employees reported symptoms consistent with COVID-19 the same day that increased mortality rates were observed among the mink herd. One of these individuals, and another asymptomatic employee, tested positive for SARS-CoV-2 by real-time reverse transcription PCR (RT-qPCR) 9 days later. All but one mink sampled on the farm were positive for SARS-CoV-2 based on nucleic acid detection from at least one oral, nasal, or rectal swab tested by RT-qPCR (99%). Sequence analysis showed high degrees of similarity between sequences from mink and the two positive farm employees. Epidemiologic and genomic data, including the presence of F486L and N501T mutations believed to arise through mink adaptation, support the hypothesis that the two employees with SARS-CoV-2 nucleic acid detection contracted COVID-19 from mink. However, the specific source of virus introduction onto the farm was not identified. Three companion animals living with mink farm employees and 31 wild animals of six species sampled in the surrounding area were negative for SARS-CoV-2 by RT-qPCR. Results from this investigation support the necessity of a One Health approach to manage the zoonotic spread of SARS-CoV-2 and underscores the critical need for multifaceted public health approaches to prevent the introduction and spread of respiratory viruses on mink farms.
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Affiliation(s)
- Ria R. Ghai
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Anne Straily
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Nora Wineland
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | - Jennifer Calogero
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | | | - Kimberly Signs
- Michigan Department of Health and Human Services, Lansing, MI 48909, USA
| | - Melissa Blievernicht
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | | | | | - Jillian A. Condrey
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | | | - Diana Riner
- Michigan Department of Health and Human Services, Lansing, MI 48909, USA
| | - Nancy Barr
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | - Michele Schalow
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | - Jarold Goodrich
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | - Cheryl Collins
- Michigan Department of Agriculture and Rural Development, Lansing, MI 48933, USA
| | - Ausaf Ahmad
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - John Michael Metz
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Owen Herzegh
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Kelly Straka
- Michigan Department of Natural Resources, Lansing, MI 48909, USA
| | - Dustin M. Arsnoe
- U.S. Department of Agriculture Animal and Plant Health Inspection Service, Washington, DC 20250, USA
| | - Anthony G. Duffiney
- U.S. Department of Agriculture Animal and Plant Health Inspection Service, Washington, DC 20250, USA
| | - Susan A. Shriner
- U.S. Department of Agriculture Animal and Plant Health Inspection Service, Washington, DC 20250, USA
| | | | - Ann Carpenter
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Florence Whitehill
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Natalie M. Wendling
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Robyn A. Stoddard
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Adam C. Retchless
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Anna Uehara
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Ying Tao
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Yan Li
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Jing Zhang
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
| | - Suxiang Tong
- U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA; (R.R.G.)
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2
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Guagliardo SAJ, Quilter LAS, Uehara A, White SB, Talarico S, Tong S, Paden CR, Zhang J, Li Y, Pray I, Novak RT, Fukunaga R, Rodriguez A, Medley AM, Wagner R, Weinberg M, Brown CM, Friedman CR. COVID-19 on the Nile: a cross-sectional investigation of COVID-19 among Nile River cruise travellers returning to the United States, February-March 2020. J Travel Med 2023; 30:taac153. [PMID: 36579822 PMCID: PMC11034880 DOI: 10.1093/jtm/taac153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Early in the pandemic, cruise travel exacerbated the global spread of SARS-CoV-2. We report epidemiologic and molecular findings from an investigation of a cluster of travellers with confirmed COVID-19 returning to the USA from Nile River cruises in Egypt. METHODS State health departments reported data on real-time reverse transcription-polymerase chain reaction-confirmed COVID-19 cases with a history of Nile River cruise travel during February-March 2020 to the Centers for Disease Control and Prevention (CDC). Demographic and epidemiologic data were collected through routine surveillance channels. Sequences were obtained either from state health departments or from the Global Initiative on Sharing Avian Flu Data (GISAID). We conducted descriptive analyses of epidemiologic data and explored phylogenetic relationships between sequences. RESULTS We identified 149 Nile River cruise travellers with confirmed COVID-19 who returned to 67 different US counties in 27 states: among those with complete data, 4.7% (6/128) died and 28.1% (38/135) were hospitalized. These individuals travelled on 20 different Nile River cruise voyages (12 unique vessels). Fifteen community transmission events were identified in four states, with 73.3% (11/15) of these occurring in Wisconsin (as the result of a more detailed contact investigation in that state). Phylogenetic analyses supported the hypothesis that travellers were most likely infected in Egypt, with most sequences in Nextstrain clade 20A 93% (87/94). We observed genetic clustering by Nile River cruise voyage and vessel. CONCLUSIONS Nile River cruise travellers with COVID-19 introduced SARS-CoV-2 over a very large geographic range, facilitating transmission across the USA early in the pandemic. Travellers who participate in cruises, even on small river vessels as investigated in this study, are at increased risk of SARS-CoV-2 exposure. Therefore, history of river cruise travel should be considered in contact tracing and outbreak investigations.
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Affiliation(s)
| | - Laura A. S. Quilter
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna Uehara
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stefanie B. White
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah Talarico
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clinton R. Paden
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jing Zhang
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yan Li
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ian Pray
- Wisconsin Department of Health Services, Madison, WI, USA
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryan T. Novak
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rena Fukunaga
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrea Rodriguez
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alexandra M. Medley
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Riley Wagner
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle Weinberg
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clive M. Brown
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Cindy R. Friedman
- COVID-19 Response Team, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Wang L, Zheng B, Shen Z, Nath ND, Li Y, Walsh T, Li Y, Mitchell WJ, He D, Lee J, Moore S, Tong S, Zhang S, Ma W. Isolation and characterization of mammalian orthoreovirus from bats in the United States. J Med Virol 2023; 95:e28492. [PMID: 36633204 DOI: 10.1002/jmv.28492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Mammalian orthoreovirus (MRV) infects many mammalian species including humans, bats, and domestic animals. To determine the prevalence of MRV in bats in the United States, we screened more than 900 bats of different species collected during 2015-2019 by a real-time reverse-transcription polymerase chain reaction assay; 4.4% bats tested MRV-positive and 13 MRVs were isolated. Sequence and phylogenetic analysis revealed that these isolates belonged to four different strains/genotypes of viruses in Serotypes 1 or 2, which contain genes similar to those of MRVs detected in humans, bats, bovine, and deer. Further characterization showed that these four MRV strains replicated efficiently on human, canine, monkey, ferret, and swine cell lines. The 40/Bat/USA/2018 strain belonging to the Serotype 1 demonstrated the ability to infect and transmit in pigs without prior adaptation. Taken together, this is evidence for different genotypes and serotypes of MRVs circulating in US bats, which can be a mixing vessel of MRVs that may spread to other species, including humans, resulting in cross-species infections.
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Affiliation(s)
- Liping Wang
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.,Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Baoliang Zheng
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Zhenyu Shen
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Nirmalendu Deb Nath
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Yonghai Li
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Timothy Walsh
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Yan Li
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William J Mitchell
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Dongchang He
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Jinhwa Lee
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA
| | - Susan Moore
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, Kansas, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shuping Zhang
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Wenjun Ma
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.,Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, Missouri, USA
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4
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Dunajcik A, Haire K, Thomas JD, Moriarty LF, Springer Y, Villanueva JM, MacNeil A, Silk B, Nemhauser JB, Byrkit R, Taylor M, Queen K, Tong S, Lee J, Batra D, Paden C, Henderson T, Kunkes A, Ojo M, Firestone M, Martin Webb L, Freeland M, Brown CM, Williams T, Allen K, Kauerauf J, Wilson E, Jain S, McDonald E, Silver E, Stous S, Wadford D, Radcliffe R, Marriott C, Owes JP, Bart SM, Sosa LE, Oakeson K, Wodniak N, Shaffner J, Brown Q, Westergaard R, Salinas A, Hallyburton S, Ogale Y, Offutt-Powell T, Bonner K, Tubach S, Van Houten C, Hughes V, Reeb V, Galeazzi C, Khuntia S, McGee S, Hicks JT, Dinesh Patel D, Krueger A, Hughes S, Jeanty F, Wang JC, Lee EH, Assanah-Deane T, Tompkins M, Dougherty K, Naqvi O, Donahue M, Frederick J, Abdalhamid B, Powers AM, Anderson M. Travel history among persons infected with SARS-CoV-2 variants of concern in the United States, December 2020-February 2021. PLOS Glob Public Health 2023; 3:e0001252. [PMID: 36989218 DOI: 10.1371/journal.pgph.0001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/16/2023] [Indexed: 03/30/2023]
Abstract
The first three SARS-CoV-2 phylogenetic lineages classified as variants of concern (VOCs) in the United States (U.S.) from December 15, 2020 to February 28, 2021, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1) lineages, were initially detected internationally. This investigation examined available travel history of coronavirus disease 2019 (COVID-19) cases reported in the U.S. in whom laboratory testing showed one of these initial VOCs. Travel history, demographics, and health outcomes for a convenience sample of persons infected with a SARS-CoV-2 VOC from December 15, 2020 through February 28, 2021 were provided by 35 state and city health departments, and proportion reporting travel was calculated. Of 1,761 confirmed VOC cases analyzed, 1,368 had available data on travel history. Of those with data on travel history, 1,168 (85%) reported no travel preceding laboratory confirmation of SARS-CoV-2 and only 105 (8%) reported international travel during the 30 days preceding a positive SARS-CoV-2 test or symptom onset. International travel was reported by 92/1,304 (7%) of persons infected with the Alpha variant, 7/55 (22%) with Beta, and 5/9 (56%) with Gamma. Of the first three SARS-CoV-2 lineages designated as VOCs in the U.S., international travel was common only among the few Gamma cases. Most persons infected with Alpha and Beta variant reported no travel history, therefore, community transmission of these VOCs was likely common in the U.S. by March 2021. These findings underscore the importance of global surveillance using whole genome sequencing to detect and inform mitigation strategies for emerging SARS-CoV-2 VOCs.
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Affiliation(s)
- Alicia Dunajcik
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Kambria Haire
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Jennifer D Thomas
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Leah F Moriarty
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Yuri Springer
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Julie M Villanueva
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Adam MacNeil
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Benjamin Silk
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Jeffrey B Nemhauser
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Ramona Byrkit
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Melanie Taylor
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Krista Queen
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Suxiang Tong
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Justin Lee
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Dhwani Batra
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Clinton Paden
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Tiffany Henderson
- Michigan Department of Health and Human Services, Lansing, Michigan, United States of America
| | - Audrey Kunkes
- Georgia Department of Health, Atlanta, Georgia, United States of America
| | - Mojisola Ojo
- New Jersey Department of Health, Trenton, New Jersey, United States of America
| | - Melanie Firestone
- Minnesota Department of Health, St. Paul, Minnesota, United States of America
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
| | - Lindsey Martin Webb
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Melissa Freeland
- Texas Department of State Health Services, Austin, Texas, United States of America
| | - Catherine M Brown
- Massachusetts Department of Public Health, Boston, Massachusetts, United States of America
| | - Thelonious Williams
- Maryland Department of Health, Baltimore, Maryland, United States of America
- CDC Foundation, Atlanta, Georgia, United States of America
| | - Krisandra Allen
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Judy Kauerauf
- Illinois Department of Public Health, Springfield, Illinois, United States of America
| | - Erica Wilson
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, United States of America
| | - Seema Jain
- California Department of Public Health, Richmond, California, United States of America
| | - Eric McDonald
- San Diego County Health and Human Services Agency, San Diego, California, United States of America
| | - Elana Silver
- California Department of Public Health, Richmond, California, United States of America
| | - Sarah Stous
- San Diego County Health and Human Services Agency, San Diego, California, United States of America
| | - Debra Wadford
- California Department of Public Health, Richmond, California, United States of America
| | - Rachel Radcliffe
- South Carolina Department of Health and Environmental Control, Columbia, South Carolina, United States of America
| | - Chandra Marriott
- Pennsylvania Department of Health, Pittsburgh, Pennsylvania, United States of America
| | - Jennifer P Owes
- Alabama Department of Public Health, Montgomery, Alabama, United States of America
| | - Stephen M Bart
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- Connecticut Department of Public Health, Hartford, Connecticut, United States of America
| | - Lynn E Sosa
- Connecticut Department of Public Health, Hartford, Connecticut, United States of America
| | - Kelly Oakeson
- Utah Department of Health, Salt Lake City, Utah, United States of America
| | - Natalie Wodniak
- Virginia Department of Health, Richmond, Virginia, United States of America
| | - Julia Shaffner
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
- Tennessee Department of Health, Nashville, Tennessee, United States of America
| | - Quanta Brown
- Ohio Department of Health, Columbus, Ohio, United States of America
| | - Ryan Westergaard
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Andrea Salinas
- Louisiana Department of Health, New Orleans, Louisiana, United States of America
| | - Sara Hallyburton
- Indiana Department of Health, Indianapolis, Indiana, United States of America
| | - Yasmin Ogale
- Delaware Division of Public Health, Dover, Delaware, United States of America
| | | | - Kimberly Bonner
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- Oregon Health Authority, Portland, Oregon, United States of America
| | - Sheri Tubach
- Kansas Department of Health and Environment, Topeka, Kansas, United States of America
| | - Clay Van Houten
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Victoria Hughes
- Southern Nevada Health District, Las Vegas, Nevada, United States of America
| | - Valerie Reeb
- Iowa Department of Public Health, Des Moines, Iowa, United States of America
| | - Chris Galeazzi
- Iowa Department of Public Health, Des Moines, Iowa, United States of America
| | - Shreya Khuntia
- District of Columbia Department of Health (DC Health), Washington, DC, United States of America
| | - Sasha McGee
- District of Columbia Department of Health (DC Health), Washington, DC, United States of America
| | - Joseph T Hicks
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- New Mexico Department of Health, Santa Fe, New Mexico, United States of America
| | - Dimple Dinesh Patel
- Kentucky Department for Public Health, Frankfort, Kentucky, United States of America
| | - Anna Krueger
- Maine Center for Disease Control and Prevention, Augusta, Maine, United States of America
| | - Scott Hughes
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Fabiana Jeanty
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Jade C Wang
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Ellen H Lee
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Tracey Assanah-Deane
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Megan Tompkins
- Alaska Department of Health and Social Services, Anchorage, Alaska, United States of America
| | - Kendra Dougherty
- Oklahoma State Department of Health, Oklahoma City, Oklahoma, United States of America
| | - Ozair Naqvi
- Oklahoma State Department of Health, Oklahoma City, Oklahoma, United States of America
| | - Matthew Donahue
- Nebraska Department of Health and Human Services, Lincoln, Nebraska, United States of America
| | - Justin Frederick
- Douglas County Health Department, Omaha, Nebraska, United States of America
| | - Baha Abdalhamid
- Nebraska Public Health Lab, Lincoln, Nebraska, United States of America
| | - Ann M Powers
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Mark Anderson
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
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5
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Cossaboom CM, Wendling NM, Lewis NM, Rettler H, Harvey RR, Amman BR, Towner JS, Spengler JR, Erickson R, Burnett C, Young EL, Oakeson K, Carpenter A, Kainulainen MH, Chatterjee P, Flint M, Uehara A, Li Y, Zhang J, Kelleher A, Lynch B, Retchless AC, Tong S, Ahmad A, Bunkley P, Godino C, Herzegh O, Drobeniuc J, Rooney J, Taylor D, Barton Behravesh C. One Health Investigation of SARS-CoV-2 in People and Animals on Multiple Mink Farms in Utah. Viruses 2022; 15:96. [PMID: 36680136 PMCID: PMC9864593 DOI: 10.3390/v15010096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
From July−November 2020, mink (Neogale vison) on 12 Utah farms experienced an increase in mortality rates due to confirmed SARS-CoV-2 infection. We conducted epidemiologic investigations on six farms to identify the source of virus introduction, track cross-species transmission, and assess viral evolution. Interviews were conducted and specimens were collected from persons living or working on participating farms and from multiple animal species. Swabs and sera were tested by SARS-CoV-2 real-time reverse transcription polymerase chain reaction (rRT-PCR) and serological assays, respectively. Whole genome sequencing was attempted for specimens with cycle threshold values <30. Evidence of SARS-CoV-2 infection was detected by rRT-PCR or serology in ≥1 person, farmed mink, dog, and/or feral cat on each farm. Sequence analysis showed high similarity between mink and human sequences on corresponding farms. On farms sampled at multiple time points, mink tested rRT-PCR positive up to 16 weeks post-onset of increased mortality. Workers likely introduced SARS-CoV-2 to mink, and mink transmitted SARS-CoV-2 to other animal species; mink-to-human transmission was not identified. Our findings provide critical evidence to support interventions to prevent and manage SARS-CoV-2 in people and animals on mink farms and emphasizes the importance of a One Health approach to address emerging zoonoses.
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Affiliation(s)
- Caitlin M. Cossaboom
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Natalie M. Wendling
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Nathaniel M. Lewis
- Utah Department of Health and Human Services, Salt Lake City, UT 84116, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Hannah Rettler
- Utah Department of Health and Human Services, Salt Lake City, UT 84116, USA
| | - Robert R. Harvey
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
| | - Brian R. Amman
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jonathan S. Towner
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jessica R. Spengler
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Robert Erickson
- Utah Department of Agriculture and Food, Salt Lake City, UT 84129, USA
| | - Cindy Burnett
- Utah Department of Health and Human Services, Salt Lake City, UT 84116, USA
| | - Erin L. Young
- Utah Public Health Laboratory, Utah Department of Health and Human Services, Salt Lake City, UT 84129, USA
| | - Kelly Oakeson
- Utah Public Health Laboratory, Utah Department of Health and Human Services, Salt Lake City, UT 84129, USA
| | - Ann Carpenter
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Markus H. Kainulainen
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Payel Chatterjee
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Mike Flint
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Anna Uehara
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Yan Li
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jing Zhang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Anna Kelleher
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Brian Lynch
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Adam C. Retchless
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Suxiang Tong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Ausaf Ahmad
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Paige Bunkley
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Claire Godino
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Owen Herzegh
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jan Drobeniuc
- CDC National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jane Rooney
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, Fort Collins, CO 80526, USA
| | - Dean Taylor
- Utah Department of Agriculture and Food, Salt Lake City, UT 84129, USA
| | - Casey Barton Behravesh
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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6
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Dawson P, Worrell MC, Malone S, Fritz SA, McLaughlin HP, Montgomery BK, Boyle M, Gomel A, Hayes S, Maricque B, Lai AM, Neidich JA, Tinker SC, Lee JS, Tong S, Orscheln RC, Charney R, Rebmann T, Mooney J, Rains C, Yoon N, Petit M, Towns K, Goddard C, Schmidt S, Barrios LC, Neatherlin JC, Salzer JS, Newland JG. Modifications to student quarantine policies in K-12 schools implementing multiple COVID-19 prevention strategies restores in-person education without increasing SARS-CoV-2 transmission risk, January-March 2021. PLoS One 2022; 17:e0266292. [PMID: 36264919 PMCID: PMC9584452 DOI: 10.1371/journal.pone.0266292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/15/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To determine whether modified K-12 student quarantine policies that allow some students to continue in-person education during their quarantine period increase schoolwide SARS-CoV-2 transmission risk following the increase in cases in winter 2020-2021. METHODS We conducted a prospective cohort study of COVID-19 cases and close contacts among students and staff (n = 65,621) in 103 Missouri public schools. Participants were offered free, saliva-based RT-PCR testing. The projected number of school-based transmission events among untested close contacts was extrapolated from the percentage of events detected among tested asymptomatic close contacts and summed with the number of detected events for a projected total. An adjusted Cox regression model compared hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy. RESULTS From January-March 2021, a projected 23 (1%) school-based transmission events occurred among 1,636 school close contacts. There was no difference in the adjusted hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy (hazard ratio = 1.00; 95% confidence interval: 0.97-1.03). DISCUSSION School-based SARS-CoV-2 transmission was rare in 103 K-12 schools implementing multiple COVID-19 prevention strategies. Modified student quarantine policies were not associated with increased school incidence of COVID-19. Modifications to student quarantine policies may be a useful strategy for K-12 schools to safely reduce disruptions to in-person education during times of increased COVID-19 community incidence.
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Affiliation(s)
- Patrick Dawson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Mary Claire Worrell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
| | - Sara Malone
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Stephanie A. Fritz
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Heather P. McLaughlin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Mary Boyle
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Ashley Gomel
- Saint Louis University, St. Louis, MO, United States of America
| | - Samantha Hayes
- Saint Louis University, St. Louis, MO, United States of America
| | - Brett Maricque
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Albert M. Lai
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Julie A. Neidich
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Sarah C. Tinker
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Justin S. Lee
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Suxiang Tong
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | | | - Rachel C. Orscheln
- Washington University in St. Louis, St. Louis, MO, United States of America
| | - Rachel Charney
- Saint Louis University, St. Louis, MO, United States of America
| | - Terri Rebmann
- Saint Louis University, St. Louis, MO, United States of America
| | | | - Jon Mooney
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Catherine Rains
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Nancy Yoon
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Machelle Petit
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Katie Towns
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Clay Goddard
- Springfield-Greene County Health Department, Springfield, MO, United States of America
| | - Spring Schmidt
- Saint Louis County Department of Public Health, Berkeley, MO, United States of America
| | - Lisa C. Barrios
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - John C. Neatherlin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Johanna S. Salzer
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jason G. Newland
- Washington University in St. Louis, St. Louis, MO, United States of America
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7
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Shragai T, Pratt C, Castro Georgi J, Donnelly MAP, Schwartz NG, Soto R, Chuey M, Chu VT, Marcenac P, Park GW, Ahmad A, Albanese B, Totten SE, Austin B, Bunkley P, Cherney B, Dietrich EA, Figueroa E, Folster JM, Godino C, Herzegh O, Lindell K, Relja B, Sheldon SW, Tong S, Vinjé J, Thornburg NJ, Matanock AM, Hughes LJ, Stringer G, Hudziec M, Beatty ME, Tate JE, Kirking HL, Hsu CH. Household characteristics associated with surface contamination of SARS-CoV-2 and frequency of RT-PCR and viral culture positivity-California and Colorado, 2021. PLoS One 2022; 17:e0274946. [PMID: 36215247 PMCID: PMC9550039 DOI: 10.1371/journal.pone.0274946] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
While risk of fomite transmission of SARS-CoV-2 is considered low, there is limited environmental data within households. This January-April 2021 investigation describes frequency and types of surfaces positive for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) among residences with ≥1 SARS-CoV-2 infection, and associations of household characteristics with surface RT-PCR and viable virus positivity. Of 1232 samples from 124 households, 27.8% (n = 342) were RT-PCR positive with nightstands (44.1%) and pillows (40.9%) most frequently positive. SARS-CoV-2 lineage, documented household transmission, greater number of infected persons, shorter interval between illness onset and sampling, total household symptoms, proportion of infected persons ≤12 years old, and persons exhibiting upper respiratory symptoms or diarrhea were associated with more positive surfaces. Viable virus was isolated from 0.2% (n = 3 samples from one household) of all samples. This investigation suggests that while SARS-CoV-2 on surfaces is common, fomite transmission risk in households is low.
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Affiliation(s)
- Talya Shragai
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Caroline Pratt
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | | | - Marisa A. P. Donnelly
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Noah G. Schwartz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Raymond Soto
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Meagan Chuey
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Victoria T. Chu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Perrine Marcenac
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Geun Woo Park
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ausaf Ahmad
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bernadette Albanese
- Tri-County Health Department, Adams, Arapahoe, and Douglas Counties, Colorado, United States of America
| | - Sarah Elizabeth Totten
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Brett Austin
- Health and Human Services, San Diego County, California, United States of America
| | - Paige Bunkley
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Blake Cherney
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Elizabeth A. Dietrich
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Erica Figueroa
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jennifer M. Folster
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Claire Godino
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Owen Herzegh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristine Lindell
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Boris Relja
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sarah W. Sheldon
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jan Vinjé
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Natalie J. Thornburg
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Almea M. Matanock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Laura J. Hughes
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Meghan Hudziec
- Colorado Department of Public Health and Environment, Glendale, Colorado, United States of America
| | - Mark E. Beatty
- Health and Human Services, San Diego County, California, United States of America
| | - Jacqueline E. Tate
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hannah L. Kirking
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher H. Hsu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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8
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Ngere I, Hunsperger EA, Tong S, Oyugi J, Jaoko W, Harcourt JL, Thornburg NJ, Oyas H, Muturi M, Osoro EM, Gachohi J, Ombok C, Dawa J, Tao Y, Zhang J, Mwasi L, Ochieng C, Mwatondo A, Bodha B, Langat D, Herman-Roloff A, Njenga MK, Widdowson MA, Munyua PM. Outbreak of Middle East Respiratory Syndrome Coronavirus in Camels and Probable Spillover Infection to Humans in Kenya. Viruses 2022; 14:1743. [PMID: 36016365 PMCID: PMC9413448 DOI: 10.3390/v14081743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 12/03/2022] Open
Abstract
The majority of Kenya’s > 3 million camels have antibodies against Middle East respiratory syndrome coronavirus (MERS-CoV), although human infection in Africa is rare. We enrolled 243 camels aged 0−24 months from 33 homesteads in Northern Kenya and followed them between April 2018 to March 2020. We collected and tested camel nasal swabs for MERS-CoV RNA by RT-PCR followed by virus isolation and whole genome sequencing of positive samples. We also documented illnesses (respiratory or other) among the camels. Human camel handlers were also swabbed, screened for respiratory signs, and samples were tested for MERS-CoV by RT-PCR. We recorded 68 illnesses among 58 camels, of which 76.5% (52/68) were respiratory signs and the majority of illnesses (73.5% or 50/68) were recorded in 2019. Overall, 124/4692 (2.6%) camel swabs collected from 83 (34.2%) calves in 15 (45.5%) homesteads between April−September 2019 screened positive, while 22 calves (26.5%) recorded reinfections (second positive swab following ≥ 2 consecutive negative tests). Sequencing revealed a distinct Clade C2 virus that lacked the signature ORF4b deletions of other Clade C viruses. Three previously reported human PCR positive cases clustered with the camel infections in time and place, strongly suggesting sporadic transmission to humans during intense camel outbreaks in Northern Kenya.
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Affiliation(s)
- Isaac Ngere
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Elizabeth A. Hunsperger
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Julius Oyugi
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Walter Jaoko
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
| | - Jennifer L. Harcourt
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Natalie J. Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Harry Oyas
- Kenya Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi P.O. Box 30028 00100, Kenya
| | - Mathew Muturi
- Kenya Ministry of Agriculture, Livestock, Fisheries and Cooperatives, Nairobi P.O. Box 30028 00100, Kenya
- Dahlem Research School, Freie Universität Berlin, Kaiserswerther Str. 16-18, 14195 Berlin, Germany
| | - Eric M. Osoro
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - John Gachohi
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi P.O. Box 62000 00200, Kenya
| | - Cynthia Ombok
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Jeanette Dawa
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Ying Tao
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Jing Zhang
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Lydia Mwasi
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi P.O. Box 54840 00200, Kenya
| | - Caroline Ochieng
- Center for Global Health Research, Kenya Medical Research Institute, Nairobi P.O. Box 54840 00200, Kenya
| | - Athman Mwatondo
- Department of Medical Microbiology and Immunology, University of Nairobi, Nairobi P.O. Box 19676 00100, Kenya
- Kenya Ministry of Health, Nairobi P.O. Box 30016 00100, Kenya
| | - Boku Bodha
- Department of Veterinary and Livestock, County Government of Marsabit, Marsabit 60500, Kenya
| | - Daniel Langat
- Kenya Ministry of Health, Nairobi P.O. Box 30016 00100, Kenya
| | - Amy Herman-Roloff
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - M. Kariuki Njenga
- Washington State University Global Health Program, Washington State University, Nairobi P.O. Box 72938 00200, Kenya
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA 99164, USA
| | - Marc-Alain Widdowson
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
| | - Peninah M. Munyua
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention-Kenya, Nairobi P.O. Box 40241 00621, Kenya
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9
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Sumner KM, Karron RA, Stockwell MS, Dawood FS, Stanford JB, Mellis A, Hacker E, Thind P, Castro MJE, Harris JP, Knoll MD, Schappell E, Hetrich MK, Duque J, Jeddy Z, Altunkaynak K, Poe B, Meece J, Stefanski E, Tong S, Lee JS, Dixon A, Veguilla V, Rolfes MA, Porucznik CA. Impact of age and symptom development on SARS-CoV-2 transmission in households with children—Maryland, New York, and Utah, August 2020–October 2021. Open Forum Infect Dis 2022; 9:ofac390. [PMID: 35991589 PMCID: PMC9384637 DOI: 10.1093/ofid/ofac390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
Households are common places for spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated factors associated with household transmission and acquisition of SARS-CoV-2.
Methods
Households with children ages <18 years were enrolled into prospective, longitudinal cohorts and followed August 2020─August 2021 in Utah, September 2020─August 2021 in New York City, and November 2020─October 2021 in Maryland. Participants self-collected nasal swabs weekly and with onset of acute illness. Swabs were tested for SARS-CoV-2 using reverse-transcription polymerase chain reaction. We assessed factors associated with SARS-CoV-2 acquisition using a multi-level logistic regression adjusted for household size and clustering and SARS-CoV-2 transmission using a logistic regression adjusted for household size.
Results
Among 2,053 people (513 households) enrolled, 180 people (8.8%; in 76 households) tested positive for SARS-CoV-2. Compared to children <12y, odds of acquiring infection were lower for adults ≥18y (adjusted odds ratio[aOR]:0.34, 95% confidence interval[CI]:0.14–0.87); however, this may reflect vaccination status, which protected against SARS-CoV-2 acquisition (aOR:0.17, 95%CI:0.03–0.91). Odds of onward transmission was similar between symptomatic and asymptomatic primary cases (aOR:1.00, 95%CI:0.35–2.93) and did not differ by age (12–17vs. < 12y aOR:1.08, 95%CI:0.20–5.62; ≥18vs. < 12y aOR:1.70, 95%CI:0.52–5.83).
Conclusions
Adults had lower odds of acquiring SARS-CoV-2 compared to children, but this association might be influenced by COVID-19 vaccination, which was primarily available for adults and protective against infection. In contrast, all ages, regardless of symptoms and COVID-19 vaccination, had similar odds of transmitting SARS-CoV-2. Findings underscore the importance of SARS-CoV-2 mitigation measures for persons of all ages.
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Affiliation(s)
- Kelsey M Sumner
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention , Atlanta, GA , USA
| | - Ruth A Karron
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center , New York, NY , USA
| | - Fatimah S Dawood
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
| | - Alexandra Mellis
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Emily Hacker
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
| | - Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - Maria Julia E Castro
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - John Paul Harris
- Division of Child and Adolescent Health, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , New York, NY , USA
| | - Maria Deloria Knoll
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Elizabeth Schappell
- Center for Immunization Research, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | - Marissa K Hetrich
- International Vaccine Access Center, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University , Baltimore, MD , USA
| | | | | | | | | | - Jennifer Meece
- Marshfield Clinic Research Institute , Marshfield, WI , USA
| | | | - Suxiang Tong
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Justin S Lee
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Ashton Dixon
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Vic Veguilla
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Melissa A Rolfes
- Centers for Disease Control and Prevention COVID-19 Response , Atlanta, GA , USA
| | - Christina A Porucznik
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine , Salt Lake City, UT , USA
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10
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McCormick DW, Konkle SL, Magleby R, Chakrabarti AK, Cherney B, Lindell K, Namageyo-Funa A, Visser S, Soto RA, Donnelly MAP, Stringer G, Austin B, Beatty ME, Stous S, Albanese BA, Chu VT, Chuey M, Dietrich EA, Drobeniuc J, Folster JM, Killerby ME, Lehman JA, McDonald EC, Ruffin J, Schwartz NG, Sheldon SW, Sleweon S, Thornburg NJ, Hughes LJ, Petway M, Tong S, Whaley MJ, Kirking HL, Tate JE, Hsu CH, Matanock A. SARS-CoV-2 infection risk among vaccinated and unvaccinated household members during the Alpha variant surge - Denver, Colorado, and San Diego, California, January-April 2021. Vaccine 2022; 40:4845-4855. [PMID: 35803846 PMCID: PMC9250903 DOI: 10.1016/j.vaccine.2022.06.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND COVID-19 vaccination reduces SARS-CoV-2 infection and transmission. However, evidence is emerging on the degree of protection across variants and in high-transmission settings. To better understand the protection afforded by vaccination specifically in a high-transmission setting, we examined household transmission of SARS-CoV-2 during a period of high community incidence with predominant SARS-CoV-2 B.1.1.7 (Alpha) variant, among vaccinated and unvaccinated contacts. METHODS We conducted a household transmission investigation in San Diego County, California, and Denver, Colorado, during January-April 2021. Households were enrolled if they had at least one person with documented SARS-CoV-2 infection. We collected nasopharyngeal swabs, blood, demographic information, and vaccination history from all consenting household members. We compared infection risks (IRs), RT-PCR cycle threshold values, SARS-CoV-2 culture results, and antibody statuses among vaccinated and unvaccinated household contacts. RESULTS We enrolled 493 individuals from 138 households. The SARS-CoV-2 variant was identified from 121/138 households (88%). The most common variants were Alpha (75/121, 62%) and Epsilon (19/121, 16%). There were no households with discordant lineages among household members. One fully vaccinated secondary case was symptomatic (13%); the other 5 were asymptomatic (87%). Among unvaccinated secondary cases, 105/108 (97%) were symptomatic. Among 127 households with a single primary case, the IR for household contacts was 45% (146/322; 95% Confidence Interval [CI] 40-51%). The observed IR was higher in unvaccinated (130/257, 49%, 95% CI 45-57%) than fully vaccinated contacts (6/26, 23%, 95% CI 11-42%). A lower proportion of households with a fully vaccinated primary case had secondary cases (1/5, 20%) than households with an unvaccinated primary case (66/108, 62%). CONCLUSIONS Although SARS-CoV-2 infections in vaccinated household contacts were reported in this high transmission setting, full vaccination protected against SARS-CoV-2 infection. These findings further support the protective effect of COVID-19 vaccination and highlight the need for ongoing vaccination among eligible persons.
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Affiliation(s)
- David W McCormick
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Stacey L Konkle
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reed Magleby
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ayan K Chakrabarti
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Blake Cherney
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristine Lindell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Apophia Namageyo-Funa
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susanna Visser
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Raymond A Soto
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marisa A P Donnelly
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ginger Stringer
- Colorado Department of Public Health and the Environment, Denver, CO, USA
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | | | - Victoria T Chu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Meagan Chuey
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA; County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Elizabeth A Dietrich
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jan Drobeniuc
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer M Folster
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marie E Killerby
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer A Lehman
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, CA, USA
| | - Jasmine Ruffin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Noah G Schwartz
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah W Sheldon
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sadia Sleweon
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natalie J Thornburg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura J Hughes
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marla Petway
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Melissa J Whaley
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Hannah L Kirking
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jacqueline E Tate
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher H Hsu
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Almea Matanock
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Waltenburg MA, Whaley MJ, Chancey RJ, Donnelly MA, Chuey MR, Soto R, Schwartz NG, Chu VT, Sleweon S, McCormick DW, Uehara A, Retchless AC, Tong S, Folster JM, Petway M, Thornburg NJ, Drobeniuc J, Austin B, Hudziec MM, Stringer G, Albanese BA, Totten SE, Matzinger SR, Staples JE, Killerby ME, Hughes LJ, Matanock A, Beatty M, Tate JE, Kirking HL, Hsu CH. Household Transmission and Symptomology of Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant among Children-California and Colorado, 2021. J Pediatr 2022; 247:29-37.e7. [PMID: 35447121 PMCID: PMC9015725 DOI: 10.1016/j.jpeds.2022.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the household secondary infection risk (SIR) of B.1.1.7 (Alpha) and non-Alpha lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. STUDY DESIGN During January to April 2021, we prospectively followed households with a SARS-CoV-2 infection. We collected questionnaires, serial nasopharyngeal swabs for reverse transcription polymerase chain reaction testing and whole genome sequencing, and serial blood samples for serology testing. We calculated SIRs by primary case age (pediatric vs adult), household contact age, and viral lineage. We evaluated risk factors associated with transmission and described symptom profiles among children. RESULTS Among 36 households with pediatric primary cases, 21 (58%) had secondary infections. Among 91 households with adult primary cases, 51 (56%) had secondary infections. SIRs among pediatric and adult primary cases were 45% and 54%, respectively (OR, 0.79; 95% CI, 0.41-1.54). SIRs among pediatric primary cases with Alpha and non-Alpha lineage were 55% and 46%, respectively (OR, 1.52; 95% CI, 0.51-4.53). SIRs among pediatric and adult household contacts were 55% and 49%, respectively (OR, 1.01; 95% CI, 0.68-1.50). Among pediatric contacts, no significant differences in the odds of acquiring infection by demographic or household characteristics were observed. CONCLUSIONS Household transmission of SARS-CoV-2 from children and adult primary cases to household members was frequent. The risk of secondary infection was similar among child and adult household contacts. Among children, household transmission of SARS-CoV-2 and the risk of secondary infection was not influenced by lineage. Continued mitigation strategies (eg, masking, physical distancing, vaccination) are needed to protect at-risk groups regardless of virus lineage circulating in communities.
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Affiliation(s)
- Michelle A. Waltenburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,Reprint requests: Michelle A. Waltenburg, DVM, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329
| | - Melissa J. Whaley
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rebecca J. Chancey
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marisa A.P. Donnelly
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Meagan R. Chuey
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA,County of San Diego Health and Human Services Agency, San Diego, CA
| | - Raymond Soto
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Noah G. Schwartz
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Victoria T. Chu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sadia Sleweon
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - David W. McCormick
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA
| | - Anna Uehara
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Adam C. Retchless
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Suxiang Tong
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer M. Folster
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marla Petway
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natalie J. Thornburg
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jan Drobeniuc
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, CA
| | | | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - Sarah E. Totten
- Colorado Department of Public Health and Environment, Denver, CO
| | | | - J. Erin Staples
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marie E. Killerby
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura J. Hughes
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Almea Matanock
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mark Beatty
- County of San Diego Health and Human Services Agency, San Diego, CA
| | - Jacqueline E. Tate
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Hannah L. Kirking
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Christopher H. Hsu
- Coronavirus Disease 2019 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
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12
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Karron RA, Hetrich MK, Na YB, Knoll MD, Schappell E, Meece J, Hanson E, Tong S, Lee JS, Veguilla V, Dawood FS. Assessment of Clinical and Virological Characteristics of SARS-CoV-2 Infection Among Children Aged 0 to 4 Years and Their Household Members. JAMA Netw Open 2022; 5:e2227348. [PMID: 36044218 PMCID: PMC9434363 DOI: 10.1001/jamanetworkopen.2022.27348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE Few studies have prospectively assessed SARS-CoV-2 community infection in children aged 0 to 4 years. Information about SARS-CoV-2 incidence and clinical and virological features in young children could help guide prevention and mitigation strategies. OBJECTIVE To assess SARS-CoV-2 incidence, clinical and virological features, and symptoms in a prospective household cohort and to compare viral load by age group, symptoms, and SARS-CoV-2 lineage in young children, older children, and adults. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study enrolled 690 participants from 175 Maryland households with 1 or more children aged 0 to 4 years between November 24, 2020, and October 15, 2021. For 8 months after enrollment, participants completed weekly symptom questionnaires and submitted self-collected nasal swabs for SARS-CoV-2 qualitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) testing, quantitative RT-PCR testing, and viral lineage determination. For the analyses, SARS-CoV-2 Alpha and Delta lineages were considered variants of interest or concern. Sera collected at enrollment and at approximately 4 months and 8 months after enrollment were assayed for SARS-CoV-2 spike and nucleocapsid protein antibodies. MAIN OUTCOMES AND MEASURES Incidence, clinical and virological characteristics, and symptoms of SARS-CoV-2 infection by age group and correlations between (1) highest detected viral load and symptom frequency and (2) highest detected viral load and SARS-CoV-2 lineage. RESULTS Among 690 participants (355 [51.4%] female and 335 [48.6%] male), 256 individuals (37.1%) were children aged 0 to 4 years, 100 (14.5%) were children aged 5 to 17 years, and 334 (48.4%) were adults aged 18 to 74 years. A total of 15 participants (2.2%) were Asian, 24 (3.5%) were Black, 603 (87.4%) were White, 43 (6.2%) were multiracial, and 5 (0.7%) were of other races; 33 participants (4.8%) were Hispanic, and 657 (95.2%) were non-Hispanic. Overall, 54 participants (7.8%) had SARS-CoV-2 infection during the surveillance period, including 22 of 256 children (8.6%) aged 0 to 4 years, 11 of 100 children (11.0%) aged 5 to 17 years, and 21 of 334 adults (6.3%). Incidence rates per 1000 person-weeks were 2.25 (95% CI, 1.28-3.65) infections among children aged 0 to 4 years, 3.48 (95% CI, 1.59-6.61) infections among children aged 5 to 17 years, and 1.08 (95% CI, 0.52-1.98) infections among adults. Children aged 0 to 17 years with SARS-CoV-2 infection were more frequently asymptomatic (11 of 30 individuals [36.7%]) compared with adults (3 of 21 individuals [14.3%]), with children aged 0 to 4 years most frequently asymptomatic (7 of 19 individuals [36.8%]). The highest detected viral load did not differ between asymptomatic vs symptomatic individuals overall (median [IQR], 2.8 [1.5-3.3] log10 copies/mL vs 2.8 [1.8-4.4] log10 copies/mL) or by age group (median [IQR] for ages 0-4 years, 2.7 [2.4-4.4] log10 copies/mL; ages 5-17 years: 2.4 [1.1-4.0] log10 copies/mL; ages 18-74 years: 2.9 [1.9-4.6] log10 copies/mL). The number of symptoms was significantly correlated with viral load among adults (R = 0.69; P < .001) but not children (ages 0-4 years: R = 0.02; P = .91; ages 5-17 years: R = 0.18; P = .58). The highest detected viral load was greater among those with Delta variant infections (median [IQR], 4.4 [3.9-5.1] log10 copies/mL) than those with infections from variants not of interest or concern (median [IQR], 1.9 [1.1-3.6] log10 copies/mL; P = .009) or those with Alpha variant infections (median [IQR], 2.6 [2.3-3.4] log10 copies/mL; P = .006). CONCLUSIONS AND RELEVANCE In this study, SARS-CoV-2 infections were frequently asymptomatic among children aged 0 to 4 years; the presence and number of symptoms did not correlate with viral load. These findings suggest that symptom screening may be insufficient to prevent outbreaks involving young children.
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Affiliation(s)
- Ruth A. Karron
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Marissa K. Hetrich
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Yu Bin Na
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Maria Deloria Knoll
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Elizabeth Schappell
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Jennifer Meece
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | | | - Suxiang Tong
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Justin S. Lee
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Vic Veguilla
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fatimah S. Dawood
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Donovan CV, Worrell MC, Steinberg J, Montgomery BK, Young R, Richardson G, Dawson P, Dinh TH, Botkin N, Fitzpatrick T, Fields A, Rains CM, Fritz S, Malone S, Tong S, Mooney J, Newland JG, Barrios LC, Neatherlin JC, Salzer JS. An Examination of SARS-CoV-2 Transmission Based on Classroom Distancing in Schools With Other Preventive Measures in Place—Missouri, January–March 2021. Public Health Rep 2022; 137:972-979. [PMID: 35848091 PMCID: PMC9357822 DOI: 10.1177/00333549221109003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: Classroom layout plays a central role in maintaining physical distancing as
part of a multicomponent prevention strategy for safe in-person learning
during the COVID-19 pandemic. We conducted a school investigation to assess
layouts and physical distancing in classroom settings with and without
in-school SARS-CoV-2 transmission. Methods: We assessed, measured, and mapped 90 K-12 (kindergarten through grade 12)
classrooms in 3 Missouri public school districts during January–March 2021,
prior to widespread prevalence of the Delta variant; distances between
students, teachers, and people with COVID-19 and their contacts were
analyzed. We used whole-genome sequencing to further evaluate potential
transmission events. Results: The investigation evaluated the classrooms of 34 students and staff members
who were potentially infectious with COVID-19 in a classroom. Of 42 close
contacts (15 tested) who sat within 3 ft of possibly infectious people, 1
(2%) probable transmission event occurred (from a symptomatic student with a
longer exposure period [5 days]); of 122 contacts (23 tested) who sat more
than 3 ft away from possibly infectious people with shorter exposure
periods, no transmission events occurred. Conclusions: Reduced student physical distancing is one component of mitigation strategies
that can allow for increased classroom capacity and support in-person
learning. In the pre–Delta variant period, limited physical distancing
(<6 ft) among students in K-12 schools was not associated with increased
SARS-CoV-2 transmission.
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Affiliation(s)
- Catherine V. Donovan
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Claire Worrell
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jonathan Steinberg
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brock K. Montgomery
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Randall Young
- Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA
| | - Gabriele Richardson
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Patrick Dawson
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thu Ha Dinh
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - Stephanie Fritz
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Sara Malone
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Suxiang Tong
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jon Mooney
- Springfield-Greene County Health Department, Springfield, MO, USA
| | - Jason G. Newland
- Department of Pediatrics, School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Lisa C. Barrios
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John C. Neatherlin
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Johanna S. Salzer
- COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Chu VT, Schwartz NG, Donnelly MAP, Chuey MR, Soto R, Yousaf AR, Schmitt-Matzen EN, Sleweon S, Ruffin J, Thornburg N, Harcourt JL, Tamin A, Kim G, Folster JM, Hughes LJ, Tong S, Stringer G, Albanese BA, Totten SE, Hudziec MM, Matzinger SR, Dietrich EA, Sheldon SW, Stous S, McDonald EC, Austin B, Beatty ME, Staples JE, Killerby ME, Hsu CH, Tate JE, Kirking HL, Matanock A. Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection. JAMA Intern Med 2022; 182:701-709. [PMID: 35486394 PMCID: PMC9055515 DOI: 10.1001/jamainternmed.2022.1827] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE As self-collected home antigen tests become widely available, a better understanding of their performance during the course of SARS-CoV-2 infection is needed. OBJECTIVE To evaluate the diagnostic performance of home antigen tests compared with reverse transcription-polymerase chain reaction (RT-PCR) and viral culture by days from illness onset, as well as user acceptability. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study was conducted from January to May 2021 in San Diego County, California, and metropolitan Denver, Colorado. The convenience sample included adults and children with RT-PCR-confirmed infection who used self-collected home antigen tests for 15 days and underwent at least 1 nasopharyngeal swab for RT-PCR, viral culture, and sequencing. EXPOSURES SARS-CoV-2 infection. MAIN OUTCOMES AND MEASURES The primary outcome was the daily sensitivity of home antigen tests to detect RT-PCR-confirmed cases. Secondary outcomes included the daily percentage of antigen test, RT-PCR, and viral culture results that were positive, and antigen test sensitivity compared with same-day RT-PCR and cultures. Antigen test use errors and acceptability were assessed for a subset of participants. RESULTS This study enrolled 225 persons with RT-PCR-confirmed infection (median [range] age, 29 [1-83] years; 117 female participants [52%]; 10 [4%] Asian, 6 [3%] Black or African American, 50 [22%] Hispanic or Latino, 3 [1%] Native Hawaiian or Other Pacific Islander, 145 [64%] White, and 11 [5%] multiracial individuals) who completed 3044 antigen tests and 642 nasopharyngeal swabs. Antigen test sensitivity was 50% (95% CI, 45%-55%) during the infectious period, 64% (95% CI, 56%-70%) compared with same-day RT-PCR, and 84% (95% CI, 75%-90%) compared with same-day cultures. Antigen test sensitivity peaked 4 days after illness onset at 77% (95% CI, 69%-83%). Antigen test sensitivity improved with a second antigen test 1 to 2 days later, particularly early in the infection. Six days after illness onset, antigen test result positivity was 61% (95% CI, 53%-68%). Almost all (216 [96%]) surveyed individuals reported that they would be more likely to get tested for SARS-CoV-2 infection if home antigen tests were available over the counter. CONCLUSIONS AND RELEVANCE The results of this cohort study of home antigen tests suggest that sensitivity for SARS-CoV-2 was moderate compared with RT-PCR and high compared with viral culture. The results also suggest that symptomatic individuals with an initial negative home antigen test result for SARS-CoV-2 infection should test again 1 to 2 days later because test sensitivity peaked several days after illness onset and improved with repeated testing.
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Affiliation(s)
- Victoria T Chu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Noah G Schwartz
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marisa A P Donnelly
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meagan R Chuey
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia.,County of San Diego Health and Human Services Agency, San Diego, California
| | - Raymond Soto
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anna R Yousaf
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily N Schmitt-Matzen
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sadia Sleweon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jasmine Ruffin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Thornburg
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Harcourt
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gimin Kim
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Folster
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura J Hughes
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Suxiang Tong
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver
| | | | - Sarah E Totten
- Colorado Department of Public Health and Environment, Denver
| | | | | | - Elizabeth A Dietrich
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah W Sheldon
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah Stous
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Eric C McDonald
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Brett Austin
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Mark E Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - J Erin Staples
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marie E Killerby
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher H Hsu
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jacqueline E Tate
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hannah L Kirking
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Almea Matanock
- COVID-19 Response Team, US Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Wendling NM, Carpenter A, Liew A, Ghai RR, Gallardo-Romero N, Stoddard RA, Tao Y, Zhang J, Retchless AC, Ahmad A, Bunkley P, Godino C, Mauldin MR, Varela K, Ritter JM, Hennebelle J, Feldpausch A, Gabel J, Kainulainen MH, Herzegh O, Tong S, Spengler JR, Barton Behravesh C. Transmission of SARS-CoV-2 Delta variant (B.1.617.2) from a fully vaccinated human to a canine in Georgia, July 2021. Zoonoses Public Health 2022; 69:587-592. [PMID: 35426241 PMCID: PMC9115446 DOI: 10.1111/zph.12944] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/16/2022] [Accepted: 03/20/2022] [Indexed: 01/09/2023]
Abstract
SARS‐CoV‐2 infection has been described in a wide range of species, including domestic animals such as dogs and cats. Illness in dogs is usually self‐limiting, and further diagnostics may not be pursued if clinical signs resolve or they respond to empirical treatment. As new variants emerge, the clinical presentation and role in transmission may vary in animals. This report highlights different clinical presentations and immunological responses in two SARS‐CoV‐2 Delta‐variant‐positive dogs with similar exposure to the same fully vaccinated human with a SARS‐CoV‐2 infection and emphasizes the need for active surveillance and additional One Health research on SARS‐CoV‐2 variant infections in companion animals and other species.
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Affiliation(s)
| | - Ann Carpenter
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amanda Liew
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ria R Ghai
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Robyn A Stoddard
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ying Tao
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jing Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Adam C Retchless
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ausaf Ahmad
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paige Bunkley
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Claire Godino
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kate Varela
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jana M Ritter
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Julie Gabel
- Georgia Department of Public Health, Atlanta, Georgia, USA
| | | | - Owen Herzegh
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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16
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Grome HN, Meyer B, Read E, Buchanan M, Cushing A, Sawatzki K, Levinson KJ, Thomas LS, Perry Z, Uehara A, Tao Y, Queen K, Tong S, Ghai R, Fill MM, Jones TF, Schaffner W, Dunn J. SARS-CoV-2 Outbreak among Malayan Tigers and Humans, Tennessee, USA, 2020. Emerg Infect Dis 2022; 28:833-836. [PMID: 35318922 PMCID: PMC8962897 DOI: 10.3201/eid2804.212219] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report an outbreak of severe acute respiratory syndrome coronavirus 2 involving 3 Malayan tigers (Panthera tigris jacksoni) at a zoo in Tennessee, USA. Investigation identified naturally occurring tiger-to-tiger transmission; genetic sequence change occurred with viral passage. We provide epidemiologic, environmental, and genomic sequencing data for animal and human infections.
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17
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Barber RM, Li Q, Levine JM, Ruone SJ, Levine GJ, Kenny P, Tong S, Schatzberg SJ. Screening for Viral Nucleic Acids in the Cerebrospinal Fluid of Dogs With Central Nervous System Inflammation. Front Vet Sci 2022; 9:850510. [PMID: 35400093 PMCID: PMC8987525 DOI: 10.3389/fvets.2022.850510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/16/2022] [Indexed: 01/17/2023] Open
Abstract
Central nervous system (CNS) inflammation is a common cause of neurological dysfunction in dogs. Most dogs with CNS inflammation are diagnosed with presumptive autoimmune disease. A smaller number are diagnosed with an infectious etiology. Additionally, at necropsy, a subset of dogs with CNS inflammation do not fit previously described patterns of autoimmune disease and an infectious cause is not readily identifiable. Because viral infection is a common cause of meningoencephalitis in people, we hypothesize that a subset of dogs presented with CNS inflammation have an occult viral infection either as a direct cause of CNS inflammation or a trigger for autoimmunity. The goal of this research was to screen cerebrospinal fluid from a large number dogs with CNS inflammation for occult viral infection. One hundred seventy-two dogs with neurological dysfunction and cerebrospinal fluid (CSF) pleocytosis were identified. Of these, 42 had meningoencephalitis of unknown origin, six had steroid-responsive meningitis-arteritis, one had eosinophilic meningoencephalitis, five had documented infection, 21 had and undetermined diagnosis, and 97 had a diagnosis not consistent with primary inflammatory disease of the CNS (e.g., neoplasia). CSF samples were subsequently screened with broadly reactive PCR for eight viral groups: adenovirus, bunyavirus, coronavirus, enterovirus, flavivirus, herpesvirus, paramyxovirus, and parechovirus. No viral nucleic acids were detected from 168 cases screened for eight viral groups, which does not support occult viral infection as a cause of CNS inflammation in dogs. La Crosse virus (LACV) nucleic acids were detected from four cases in Georgia. Subclinical infection was supported in two of these cases but LACV could not be ruled-out as a cause of infection in the other two cases, suggesting further research is warranted to determine if LACV is an occult cause of CNS inflammation in dogs.
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Affiliation(s)
- Renee M. Barber
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, GA, United States
- *Correspondence: Renee M. Barber
| | - Qiang Li
- Becker Animal Hospital, Veterinary Centers of America, San Antonio, TX, United States
| | - Jonathan M. Levine
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States
| | - Susan J. Ruone
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gwendolyn J. Levine
- Department of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX, United States
| | - Patrick Kenny
- Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, Hertfordshire, United Kingdom
| | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Scott J. Schatzberg
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, GA, United States
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18
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Donnelly MAP, Chuey MR, Soto R, Schwartz NG, Chu VT, Konkle SL, Sleweon S, Ruffin J, Haberling DL, Guagliardo SAJ, Stoddard RA, Anderson RD, Morgan CN, Rossetti R, McCormick DW, Magleby R, Sheldon SW, Dietrich EA, Uehara A, Retchless AC, Tong S, Folster JM, Drobeniuc J, Petway ME, Austin B, Stous S, McDonald E, Jain S, Hudziec MM, Stringer G, Albanese BA, Totten SE, Staples JE, Killerby ME, Hughes L, Matanock A, Beatty M, Tate JE, Kirking HL, Hsu CH. Household transmission of SARS-CoV-2 Alpha variant - United States, 2021. Clin Infect Dis 2022; 75:e122-e132. [PMID: 35147176 PMCID: PMC9047162 DOI: 10.1093/cid/ciac125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In Spring 2021, SARS-CoV-2 B.1.1.7 (Alpha) became the predominant variant in the U.S. Research suggests that Alpha has increased transmissibility compared to non-Alpha lineages. We estimated household secondary infection risk (SIR), assessed characteristics associated with transmission, and compared symptoms of persons with Alpha and non-Alpha infections. METHODS We followed households with SARS-CoV-2 infection for two weeks in San Diego County and metropolitan Denver, January to April 2021. We collected epidemiologic information and biospecimens for serology, RT-PCR, and whole genome sequencing. We stratified SIR and symptoms by lineage, and identified characteristics associated with transmission using Generalized Estimating Equations. RESULTS We investigated 127 households with 322 household contacts; 72 households (56.7%) had member(s) with secondary infections. SIRs were not significantly higher for Alpha (61.0% [95% confidence interval (CI) 52.4-69.0%]) than non-Alpha (55.6% [CI 44.7-65.9%], P = 0.49). In households with Alpha, persons who identified as Asian or Hispanic/Latino had significantly higher SIRs than those who identified as White (P = 0.01 and 0.03, respectively). Close contact (e.g., kissing, hugging) with primary cases was associated with increased transmission for all lineages. Persons with Alpha infection were more likely to report constitutional symptoms than persons with non-Alpha (86.9% vs. 76.8%, P = 0.05). CONCLUSIONS Household SIRs were similar for Alpha and non-Alpha. Comparable SIRs may be due to saturation of transmission risk in households owing to extensive close contact, or true lack of difference in transmission rates. Avoiding close contact within households may reduce SARS-CoV-2 transmission for all lineages among household members.
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Affiliation(s)
- Marisa A P Donnelly
- CDC COVID-19 Response.,Epidemic Intelligence Service, CDC.,California Department of Public Health
| | - Meagan R Chuey
- CDC COVID-19 Response.,Epidemic Intelligence Service, CDC.,County of San Diego Health and Human Services
| | - Raymond Soto
- CDC COVID-19 Response.,Epidemic Intelligence Service, CDC
| | | | - Victoria T Chu
- CDC COVID-19 Response.,Epidemic Intelligence Service, CDC
| | | | | | | | | | | | | | | | | | | | | | - Reed Magleby
- CDC COVID-19 Response.,Epidemic Intelligence Service, CDC
| | | | | | | | | | | | | | | | | | | | - Sarah Stous
- County of San Diego Health and Human Services
| | | | | | | | | | | | | | | | | | | | | | - Mark Beatty
- County of San Diego Health and Human Services
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19
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Grome HN, Meyer B, Read E, Buchanan M, Cushing AC, Levinson KJ, Thomas LS, Perry Z, Queen K, Uehara A, Tong S, Tao Y, Fill MMA, Jones TF, Schaffner W, Dunn JR. 189. Potential Tiger-to-Human Transmission of SARS-CoV-2 at a Tennessee Zoo: A One Health Approach to Outbreak Investigation. Open Forum Infect Dis 2021. [PMCID: PMC8644110 DOI: 10.1093/ofid/ofab466.189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Human-to-feline and airborne transmission among cats of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been described, though documented feline-to-human transmission has not been reported. In October 2020, all 3 Malayan tigers at a Tennessee AZA accredited zoo were diagnosed with symptomatic SARS-CoV-2 infection. We investigated to determine source and prevent further transmission. Methods Tiger nasal swab specimens were tested at the National Veterinary Services Laboratories (NVSL). An environmental assessment at the zoo was completed. We interviewed 18 staff who interacted with the tigers during the 2 weeks before animal symptom onset. Confirmed human cases were defined as persons testing positive for SARS-CoV-2 by RT-PCR during September 28–October 29, with tiger interaction during their 14-day incubation period. Interviewed staff had repeat SARS-CoV-2 RT-PCR and serum IgG testing on October 29. Tigers and staff testing positive had specimens sent to CDC for genomic sequencing. Tiger sequences were compared phylogenetically with 30 geographically associated human cases collected within 2 weeks of the outbreak and > 200 background sequences from TN. Results NVSL confirmed SARS-CoV-2 infection in all 3 tigers. Environmental assessment identified fencing between humans and animals allowing airflow and an open outdoor exhibit observation point above the habitat. Confirmed cases were identified in a tiger keeper and veterinary assistant; both developed symptoms after exposure to symptomatic tigers and one sample was genotyped. Staff did not report known contact with ill visitors. All staff were negative for SARS-CoV-2 IgG. The tigers and most temporally and geographically associated cases had genetic sequences in clade 20G and B.1.2. Tiger sequences were 3-6 single nucleotide polymorphisms different from the positive tiger keeper (Figure). Figure. Whole-genome phylogenetic analysis. ![]()
Whole-genome phylogenetic analysis from a portion of clade 20G showing divergence estimates from SARS-CoV-2 Wuhan-Hu-1 reference genome with sequences from humans living in Tennessee and Malayan tigers sampled during the outbreak investigation in October 2020. Sequence analysis showed 3-6 single nucleotide polymorphisms (SNPs) differences between one human tiger keeper and all three tiger sequences. Differences are indicated by one-step edges (lines) between colored dots (individual SARS-CoV-2 sequenced infections). Numbers indicate unique sequences. Note not all analyzed sequences are shown in this figure. Conclusion Using a One Health approach, we concluded the index tiger was likely infected via transmission from an ill visitor at an exhibit observation point or unidentified asymptomatic staff. Infection spread to the other 2 tigers and tiger-to-human transmission to 2 staff is possible thereafter. The zoo was advised on infection control practices for humans and animals, and no additional cases were identified. Disclosures William Schaffner, MD, VBI Vaccines (Consultant)
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Affiliation(s)
| | - Becky Meyer
- Knox County Health Department, Knoxville, Tennessee
| | - Erin Read
- Knox County Health Department, Knoxville, Tennessee
| | | | | | - Kara J Levinson
- Division of Laboratory Services, TN Department of Health, Nashville, Tennessee
| | - Linda S Thomas
- Division of Laboratory Services, TN Department of Health, Nashville, Tennessee
| | - Zachary Perry
- Division of Laboratory Services, TN Department of Health, Nashville, Tennessee
| | - Krista Queen
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Anna Uehara
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ying Tao
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | | | | | - John R Dunn
- Tennessee Department of Health, Nashville, Tennessee
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20
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Soto R, Hsu C, Chuey M, Donnelly M, Chu VT, Schwartz NG, Tong S, Thornburg NJ, Killerby ME, Staples JE, Kirking HL, Tate J, Matanock A, Stringer G, Albanese B, Beatty M, Hughes LJ. 373. Household transmission of SARS-CoV-2 B.1.1.7 lineage –2 U.S. States, 2021. Open Forum Infect Dis 2021. [PMCID: PMC8643738 DOI: 10.1093/ofid/ofab466.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background In December 2020, B.1.1.7 lineage of SARS-CoV-2 was first detected in the United States and has since become the dominant lineage. Previous investigations involving B.1.1.7 suggested higher rates of transmission relative to non-B.1.1.7 lineages. We conducted a household transmission investigation to determine the secondary infection rates (SIR) of B.1.1.7 and non-B.1.1.7 SARS-CoV-2 lineages. Methods From January–April 2021, we enrolled members of households in San Diego County, CA, and Denver, CO metropolitan area (Tri-County), with a confirmed SARS-CoV-2 infection in a household member with illness onset date in the previous 10 days. CDC investigators visited households at enrollment and 14 days later at closeout to obtain demographic and clinical data and nasopharyngeal (NP) samples on all consenting household members. Interim visits, with collection of NP swabs, occurred if a participant became symptomatic during follow-up. NP samples were tested for SARS-CoV-2 using TaqPath™ RT-PCR test, where failure to amplify the spike protein results in S-Gene target failure (SGTF) may indicate B.1.1.7 lineage. Demographic characteristics and SIR were compared among SGTF and non-SGTF households using two-sided p-values with chi-square tests; 95% confidence intervals (CI) were calculated with Wilson score intervals. Results 552 persons from 151 households were enrolled. 91 (60%) households were classified as SGTF, 57 (38%) non-SGTF, and 3 (2%) indeterminant. SGTF and non-SGTF households had similar sex distribution (49% female and 52% female, respectively; P=0.54) and age (median 30 years, interquartile range (IQR 14–47) and 31 years (IQR 15–45), respectively). Hispanic people accounted for 24% and 32% of enrolled members of SGTF and non-SGTF households, respectively (p=0.04). At least one secondary case occurred in 61% of SGTF and 58% of non-SGTF households (P=0.66). SIR was 52% (95%[CI] 46%-59%) for SGTF and 45% (95% CI 37%-53%) for non-SGTF households (P=0.18). Conclusion SIRs were high in both SGTF and non-SGTF households; our findings did not support an increase in SIR for SGTF relative to non-SGTF households in this setting. Sequence confirmed SARS-CoV-2 samples will provide further information on lineage specific SIRs. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Raymond Soto
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Meagan Chuey
- Centers for Disease Control and Prevention, San Deigo, California
| | | | | | | | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | - Marie E Killerby
- Centers for Disease Control and Prevention, San Deigo, California
| | | | | | - Jacqueline Tate
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Ginger Stringer
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Mark Beatty
- County of San Diego Health and Human Services Agency, San Diego, California
| | - Laura J Hughes
- Centers for Disease Control and Prevention, San Deigo, California
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21
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Wyatt Wilson W, Hatfield KM, Tressler S, Kinsey CB, Zell R, Williams C, Spicer K, Kamal-Ahmed I, Abdalhamid B, Gemechu M, Folster J, Thornburg NJ, Tamin A, Harcourt JL, Queen K, Tong S, Parra G, Jernigan JA, Jernigan JA, Crist MB, Perkins K, Reddy S. 393. Characteristics of SARS-CoV-2 RNA Viral Loads among Nursing Home Residents and Staff with Repeat Positive Tests ≥ 90 Days After Initial Infection: 5 US Jurisdictions, July 2020–March 2021. Open Forum Infect Dis 2021. [PMCID: PMC8690657 DOI: 10.1093/ofid/ofab466.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Background. Understanding the viral load and potential infectivity of individuals in nursing homes (NH) with repeat positive SARS-CoV-2 tests ≥ 90 days after initial infection has important implications for safety related to transmission in this high-risk setting. Methods Methods. We collected epidemiologic data by reviewing records of a convenience sample of NH residents and staff with respiratory specimens who had positive SARS-CoV-2 rRT-PCR test results from July 2020 through March 2021 and had a SARS-CoV-2 infection diagnosed ≥ 90 days prior. No fully vaccinated individuals were included. Each contributed one repeat positive specimen ≥ 90 days after initial, which was sent to CDC and retested using rRT-PCR. Specimens were assessed for replication-competent virus in cell culture if Cycle threshold (Ct) < 34 and sequenced if Ct < 30. Using Ct values as a proxy for viral RNA load, specimens were categorized as high (Ct < 30) or low (if Ct ≥ 30 or rRT-PCR negative at retesting). Continuous variables were compared using Wilcoxon signed-rank tests. Proportions were compared using Chi-squared or Fisher’s exact tests. Results Results. Of 64 unvaccinated individuals with specimens from 61 unique NHs, 14 (22%) were sent for culture and sequencing. Ten of 64 (16%) had a high viral RNA load, of which four (6%) were culture positive and none were known variants of interest or concern (Figure 1). Median days to repeat positive test result were 122 (Interquartile range (IQR): 103–229) and 201 (IQR: 139–254), respectively, for high versus low viral load specimens (p=0.13). More individuals with high viral loads (5/10, 50%) reported COVID-19 symptoms than with a low viral load (1/27, 4%, p=0.003). Most individuals (46/58, 79%) were tested following known or suspected exposures, with no significant differences between high and low viral load (p=0.18). ![]()
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Conclusion In this study, nearly 1 in 6 NH residents and staff with repeat positive tests after 90 days demonstrated high viral RNA loads and viable virus, indicating possible infectivity. While individuals with high RNA viral load may be more likely to be symptomatic, distinguishing asymptomatic individuals who have high viral loads may be difficult with timing since initial infection, other test results, or exposure history alone. Disclosures John A. Jernigan, MD, MS, Nothing to disclose.
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Affiliation(s)
- W Wyatt Wilson
- Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | | | - Stacy Tressler
- Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, Pennsylvania
| | - Cara Bicking Kinsey
- Bureau of Epidemiology, Pennsylvania Department of Health, Harrisburg, Pennsylvania
| | - Renee Zell
- Epidemiology and Surveillance Branch, DC Department of Health, Washington, District of Columbia
| | - Channyn Williams
- Epidemiology and Surveillance Branch, DC Department of Health, Washington, District of Columbia
| | - Kevin Spicer
- Division of Epidemiology and Health Planning, Kentucky Department of Public Health, Frankfurt, Kentucky
| | - Ishrat Kamal-Ahmed
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, Nebraska
| | | | - Mahlet Gemechu
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, Nebraska
| | - Jennifer Folster
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Azaibi Tamin
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jennifer L Harcourt
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Krista Queen
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Gemma Parra
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - John A Jernigan
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John A Jernigan
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew B Crist
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kiran Perkins
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sujan Reddy
- Centers for Disease Control and Prevention, Atlanta, Georgia
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22
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van Doremalen N, Letko M, Fischer RJ, Bushmaker T, Schulz J, Yinda CK, Seifert SN, Kim NJ, Hemida MG, Kayali G, Park WB, Perera RA, Tamin A, Thornburg NJ, Tong S, Queen K, van Kerkhove MD, Choi YK, Oh MD, Assiri AM, Peiris M, Gerber SI, Munster VJ. Surface‒Aerosol Stability and Pathogenicity of Diverse Middle East Respiratory Syndrome Coronavirus Strains, 2012‒2018. Emerg Infect Dis 2021; 27:3052-3062. [PMID: 34808078 PMCID: PMC8632154 DOI: 10.3201/eid2712.210344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Middle East respiratory syndrome coronavirus (MERS-CoV) infects humans and dromedary camels and is responsible for an ongoing outbreak of severe respiratory illness in humans in the Middle East. Although some mutations found in camel-derived MERS-CoV strains have been characterized, most natural variation found across MERS-CoV isolates remains unstudied. We report on the environmental stability, replication kinetics, and pathogenicity of several diverse isolates of MERS-CoV, as well as isolates of severe acute respiratory syndrome coronavirus 2, to serve as a basis of comparison with other stability studies. Although most MERS-CoV isolates had similar stability and pathogenicity in our experiments, the camel-derived isolate C/KSA/13 had reduced surface stability, and another camel isolate, C/BF/15, had reduced pathogenicity in a small animal model. These results suggest that although betacoronaviruses might have similar environmental stability profiles, individual variation can influence this phenotype, underscoring the need for continual global viral surveillance.
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23
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Bajema KL, Dahl RM, Prill MM, Meites E, Rodriguez-Barradas MC, Marconi VC, Beenhouwer DO, Brown ST, Holodniy M, Lucero-Obusan C, Rivera-Dominguez G, Morones RG, Whitmire A, Goldin EB, Evener SL, Tremarelli M, Tong S, Hall AJ, Schrag SJ, McMorrow M, Kobayashi M, Verani JR, Surie D. Effectiveness of COVID-19 mRNA Vaccines Against COVID-19-Associated Hospitalization - Five Veterans Affairs Medical Centers, United States, February 1-August 6, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1294-1299. [PMID: 34529636 PMCID: PMC8445376 DOI: 10.15585/mmwr.mm7037e3] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
COVID-19 mRNA vaccines (Pfizer-BioNTech and Moderna) have been shown to be highly protective against COVID-19-associated hospitalizations (1-3). Data are limited on the level of protection against hospitalization among disproportionately affected populations in the United States, particularly during periods in which the B.1.617.2 (Delta) variant of SARS-CoV-2, the virus that causes COVID-19, predominates (2). U.S. veterans are older, more racially diverse, and have higher prevalences of underlying medical conditions than persons in the general U.S. population (2,4). CDC assessed the effectiveness of mRNA vaccines against COVID-19-associated hospitalization among 1,175 U.S. veterans aged ≥18 years hospitalized at five Veterans Affairs Medical Centers (VAMCs) during February 1-August 6, 2021. Among these hospitalized persons, 1,093 (93.0%) were men, the median age was 68 years, 574 (48.9%) were non-Hispanic Black (Black), 475 were non-Hispanic White (White), and 522 (44.4%) had a Charlson comorbidity index score of ≥3 (5). Overall adjusted vaccine effectiveness against COVID-19-associated hospitalization was 86.8% (95% confidence interval [CI] = 80.4%-91.1%) and was similar before (February 1-June 30) and during (July 1-August 6) SARS-CoV-2 Delta variant predominance (84.1% versus 89.3%, respectively). Vaccine effectiveness was 79.8% (95% CI = 67.7%-87.4%) among adults aged ≥65 years and 95.1% (95% CI = 89.1%-97.8%) among those aged 18-64 years. COVID-19 mRNA vaccines are highly effective in preventing COVID-19-associated hospitalization in this older, racially diverse population of predominately male U.S. veterans. Additional evaluations of vaccine effectiveness among various age groups are warranted. To prevent COVID-19-related hospitalizations, all eligible persons should receive COVID-19 vaccination.
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Goryoka GW, Cossaboom CM, Gharpure R, Dawson P, Tansey C, Rossow J, Mrotz V, Rooney J, Torchetti M, Loiacono CM, Killian ML, Jenkins-Moore M, Lim A, Poulsen K, Christensen D, Sweet E, Peterson D, Sangster AL, Young EL, Oakeson KF, Taylor D, Price A, Kiphibane T, Klos R, Konkle D, Bhattacharyya S, Dasu T, Chu VT, Lewis NM, Queen K, Zhang J, Uehara A, Dietrich EA, Tong S, Kirking HL, Doty JB, Murrell LS, Spengler JR, Straily A, Wallace R, Barton Behravesh C. One Health Investigation of SARS-CoV-2 Infection and Seropositivity among Pets in Households with Confirmed Human COVID-19 Cases-Utah and Wisconsin, 2020. Viruses 2021; 13:1813. [PMID: 34578394 PMCID: PMC8472995 DOI: 10.3390/v13091813] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/11/2022] Open
Abstract
Approximately 67% of U.S. households have pets. Limited data are available on SARS-CoV-2 in pets. We assessed SARS-CoV-2 infection in pets during a COVID-19 household transmission investigation. Pets from households with ≥1 person with laboratory-confirmed COVID-19 were eligible for inclusion from April-May 2020. We enrolled 37 dogs and 19 cats from 34 households. All oropharyngeal, nasal, and rectal swabs tested negative by rRT-PCR; one dog's fur swabs (2%) tested positive by rRT-PCR at the first sampling. Among 47 pets with serological results, eight (17%) pets (four dogs, four cats) from 6/30 (20%) households had detectable SARS-CoV-2 neutralizing antibodies. In households with a seropositive pet, the proportion of people with laboratory-confirmed COVID-19 was greater (median 79%; range: 40-100%) compared to households with no seropositive pet (median 37%; range: 13-100%) (p = 0.01). Thirty-three pets with serologic results had frequent daily contact (≥1 h) with the index patient before the person's COVID-19 diagnosis. Of these 33 pets, 14 (42%) had decreased contact with the index patient after diagnosis and none were seropositive; of the 19 (58%) pets with continued contact, four (21%) were seropositive. Seropositive pets likely acquired infection after contact with people with COVID-19. People with COVID-19 should restrict contact with pets and other animals.
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Affiliation(s)
- Grace W. Goryoka
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Caitlin M. Cossaboom
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Radhika Gharpure
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Patrick Dawson
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Cassandra Tansey
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - John Rossow
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Victoria Mrotz
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Jane Rooney
- Animal and Plant Health Inspection Service, Veterinary Services, United States Department of Agriculture, 2150 Centre Avenue, Bldg B., Fort Collins, CO 80526, USA;
| | - Mia Torchetti
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service, Veterinary Services, United States Department of Agriculture, 1920 Dayton Ave, Ames, IA 50010, USA; (M.T.); (C.M.L.); (M.L.K.); (M.J.-M.)
| | - Christina M. Loiacono
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service, Veterinary Services, United States Department of Agriculture, 1920 Dayton Ave, Ames, IA 50010, USA; (M.T.); (C.M.L.); (M.L.K.); (M.J.-M.)
| | - Mary L. Killian
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service, Veterinary Services, United States Department of Agriculture, 1920 Dayton Ave, Ames, IA 50010, USA; (M.T.); (C.M.L.); (M.L.K.); (M.J.-M.)
| | - Melinda Jenkins-Moore
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service, Veterinary Services, United States Department of Agriculture, 1920 Dayton Ave, Ames, IA 50010, USA; (M.T.); (C.M.L.); (M.L.K.); (M.J.-M.)
| | - Ailam Lim
- Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison, 445 Easterday Ln, Madison, WI 53706, USA; (A.L.); (K.P.); (D.C.); (E.S.)
| | - Keith Poulsen
- Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison, 445 Easterday Ln, Madison, WI 53706, USA; (A.L.); (K.P.); (D.C.); (E.S.)
| | - Dan Christensen
- Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison, 445 Easterday Ln, Madison, WI 53706, USA; (A.L.); (K.P.); (D.C.); (E.S.)
| | - Emma Sweet
- Wisconsin Veterinary Diagnostic Laboratory, University of Wisconsin-Madison, 445 Easterday Ln, Madison, WI 53706, USA; (A.L.); (K.P.); (D.C.); (E.S.)
| | - Dallin Peterson
- Utah Department of Health, 288 N 1460 W, Salt Lake City, UT 84116, USA; (D.P.); (A.L.S.); (E.L.Y.); (K.F.O.)
| | - Anna L. Sangster
- Utah Department of Health, 288 N 1460 W, Salt Lake City, UT 84116, USA; (D.P.); (A.L.S.); (E.L.Y.); (K.F.O.)
| | - Erin L. Young
- Utah Department of Health, 288 N 1460 W, Salt Lake City, UT 84116, USA; (D.P.); (A.L.S.); (E.L.Y.); (K.F.O.)
| | - Kelly F. Oakeson
- Utah Department of Health, 288 N 1460 W, Salt Lake City, UT 84116, USA; (D.P.); (A.L.S.); (E.L.Y.); (K.F.O.)
| | - Dean Taylor
- Utah Department of Agriculture and Food, 350 N Redwood Rd, Salt Lake City, UT 84116, USA; (D.T.); (A.P.)
| | - Amanda Price
- Utah Department of Agriculture and Food, 350 N Redwood Rd, Salt Lake City, UT 84116, USA; (D.T.); (A.P.)
| | - Tair Kiphibane
- Salt Lake County Health Department, 788 Woodoak Ln, Murray, UT 84107, USA;
| | - Rachel Klos
- Wisconsin Department of Health Services, 1 W Wilson St, Madison, WI 53703, USA;
| | - Darlene Konkle
- Wisconsin Department of Agriculture, Trade and Consumer Protection, 2811 Agriculture Dr, Madison, WI 53718, USA;
| | - Sanjib Bhattacharyya
- City of Milwaukee Health Department Laboratory, 841 N Broadway, Milwaukee, WI 53202, USA; (S.B.); (T.D.)
| | - Trivikram Dasu
- City of Milwaukee Health Department Laboratory, 841 N Broadway, Milwaukee, WI 53202, USA; (S.B.); (T.D.)
| | - Victoria T. Chu
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Nathaniel M. Lewis
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Krista Queen
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Jing Zhang
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Anna Uehara
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Elizabeth A. Dietrich
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Suxiang Tong
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Hannah L. Kirking
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Jeffrey B. Doty
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Laura S. Murrell
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Jessica R. Spengler
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Anne Straily
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Ryan Wallace
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
| | - Casey Barton Behravesh
- Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, USA; (C.M.C.); (R.G.); (P.D.); (C.T.); (J.R.); (V.M.); (V.T.C.); (N.M.L.); (K.Q.); (J.Z.); (A.U.); (E.A.D.); (S.T.); (H.L.K.); (J.B.D.); (L.S.M.); (J.R.S.); (A.S.); (R.W.); (C.B.B.)
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Thompson MG, Burgess JL, Naleway AL, Tyner H, Yoon SK, Meece J, Olsho LEW, Caban-Martinez AJ, Fowlkes AL, Lutrick K, Groom HC, Dunnigan K, Odean MJ, Hegmann K, Stefanski E, Edwards LJ, Schaefer-Solle N, Grant L, Ellingson K, Kuntz JL, Zunie T, Thiese MS, Ivacic L, Wesley MG, Mayo Lamberte J, Sun X, Smith ME, Phillips AL, Groover KD, Yoo YM, Gerald J, Brown RT, Herring MK, Joseph G, Beitel S, Morrill TC, Mak J, Rivers P, Poe BP, Lynch B, Zhou Y, Zhang J, Kelleher A, Li Y, Dickerson M, Hanson E, Guenther K, Tong S, Bateman A, Reisdorf E, Barnes J, Azziz-Baumgartner E, Hunt DR, Arvay ML, Kutty P, Fry AM, Gaglani M. Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines. N Engl J Med 2021; 385:320-329. [PMID: 34192428 PMCID: PMC8262622 DOI: 10.1056/nejmoa2107058] [Citation(s) in RCA: 315] [Impact Index Per Article: 105.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Information is limited regarding the effectiveness of the two-dose messenger RNA (mRNA) vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) in preventing infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and in attenuating coronavirus disease 2019 (Covid-19) when administered in real-world conditions. METHODS We conducted a prospective cohort study involving 3975 health care personnel, first responders, and other essential and frontline workers. From December 14, 2020, to April 10, 2021, the participants completed weekly SARS-CoV-2 testing by providing mid-turbinate nasal swabs for qualitative and quantitative reverse-transcriptase-polymerase-chain-reaction (RT-PCR) analysis. The formula for calculating vaccine effectiveness was 100% × (1 - hazard ratio for SARS-CoV-2 infection in vaccinated vs. unvaccinated participants), with adjustments for the propensity to be vaccinated, study site, occupation, and local viral circulation. RESULTS SARS-CoV-2 was detected in 204 participants (5%), of whom 5 were fully vaccinated (≥14 days after dose 2), 11 partially vaccinated (≥14 days after dose 1 and <14 days after dose 2), and 156 unvaccinated; the 32 participants with indeterminate vaccination status (<14 days after dose 1) were excluded. Adjusted vaccine effectiveness was 91% (95% confidence interval [CI], 76 to 97) with full vaccination and 81% (95% CI, 64 to 90) with partial vaccination. Among participants with SARS-CoV-2 infection, the mean viral RNA load was 40% lower (95% CI, 16 to 57) in partially or fully vaccinated participants than in unvaccinated participants. In addition, the risk of febrile symptoms was 58% lower (relative risk, 0.42; 95% CI, 0.18 to 0.98) and the duration of illness was shorter, with 2.3 fewer days spent sick in bed (95% CI, 0.8 to 3.7). CONCLUSIONS Authorized mRNA vaccines were highly effective among working-age adults in preventing SARS-CoV-2 infection when administered in real-world conditions, and the vaccines attenuated the viral RNA load, risk of febrile symptoms, and duration of illness among those who had breakthrough infection despite vaccination. (Funded by the National Center for Immunization and Respiratory Diseases and the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Mark G Thompson
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Jefferey L Burgess
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Allison L Naleway
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Harmony Tyner
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Sarang K Yoon
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Jennifer Meece
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Lauren E W Olsho
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Alberto J Caban-Martinez
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Ashley L Fowlkes
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Karen Lutrick
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Holly C Groom
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Kayan Dunnigan
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Marilyn J Odean
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Kurt Hegmann
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Elisha Stefanski
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Laura J Edwards
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Natasha Schaefer-Solle
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Lauren Grant
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Katherine Ellingson
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Jennifer L Kuntz
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Tnelda Zunie
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Matthew S Thiese
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Lynn Ivacic
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Meredith G Wesley
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Julie Mayo Lamberte
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Xiaoxiao Sun
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Michael E Smith
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Andrew L Phillips
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Kimberly D Groover
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Young M Yoo
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Joseph Gerald
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Rachel T Brown
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Meghan K Herring
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Gregory Joseph
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Shawn Beitel
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Tyler C Morrill
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Josephine Mak
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Patrick Rivers
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Brandon P Poe
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Brian Lynch
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Yingtao Zhou
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Jing Zhang
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Anna Kelleher
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Yan Li
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Monica Dickerson
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Erika Hanson
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Kyley Guenther
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Suxiang Tong
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Allen Bateman
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Erik Reisdorf
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - John Barnes
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Eduardo Azziz-Baumgartner
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Danielle R Hunt
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Melissa L Arvay
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Preeta Kutty
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Alicia M Fry
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
| | - Manjusha Gaglani
- From the Centers for Disease Control and Prevention COVID-19 Response Team, Atlanta (M.G.T., A.L.F., L.G., J.M.L., Y.M.Y., G.J., J. Mak, B.L., Y.Z., J.Z., A.K., Y.L., M.D., S.T., J.B., E.A.-B., M.L.A., P.K., A.M.F.); the Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (J.L.B., K.L., K.E., X.S., J.G., S.B., P.R.); Kaiser Permanente Northwest Center for Health Research, Portland, OR (A.L.N., H.C.G., J.L.K.); the Whiteside Institute for Clinical Research (M.J.O.), St. Luke's Regional Health Care System (H.T., M.J.O.), Duluth, MN; University of Utah, Salt Lake City (S.K.Y., K.H., M.S.T., A.L.P., R.T.B.); the Marshfield Clinic Research Institute, Marshfield (J. Meece, E.S., L.I.), and the Wisconsin State Laboratory of Hygiene, Madison (E.H., K.G., A.B., E.R.) - both in Wisconsin; Abt Associates, Rockville, MD (L.E.W.O., L.J.E., M.G.W., K.D.G., M.K.H., T.C.M., B.P.P., D.R.H.); the Leonard M. Miller School of Medicine, University of Miami, Miami (A.J.C.-M., N.S.-S.); and Baylor Scott and White Health, Dallas (K.D., T.Z., M.E.S., M.G.), and Texas A&M University College of Medicine, Bryan (M.G.) - both in Texas
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26
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Villarino E, Deng X, Kemper CA, Jorden MA, Bonin B, Rudman SL, Han GS, Yu G, Wang C, Federman S, Bushnell B, Wadford DA, Lin W, Tao Y, Paden CR, Bhatnagar J, MacCannell T, Tong S, Batson J, Chiu CY. Introduction, Transmission Dynamics, and Fate of Early Severe Acute Respiratory Syndrome Coronavirus 2 Lineages in Santa Clara County, California. J Infect Dis 2021; 224:207-217. [PMID: 33893501 PMCID: PMC8135363 DOI: 10.1093/infdis/jiab199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/19/2021] [Indexed: 11/12/2022] Open
Abstract
We combined viral genome sequencing with contact tracing to investigate introduction and evolution of severe acute respiratory syndrome coronavirus 2 lineages in Santa Clara County, California, from 27 January to 21 March 2020. From 558 persons with coronavirus disease 2019, 101 genomes from 143 available clinical samples comprised 17 lineages, including SCC1 (n = 41), WA1 (n = 9; including the first 2 reported deaths in the United States, with postmortem diagnosis), D614G (n = 4), ancestral Wuhan Hu-1 (n = 21), and 13 others (n = 26). Public health intervention may have curtailed the persistence of lineages that appeared transiently during February and March. By August, only D614G lineages introduced after 21 March were circulating in Santa Clara County.
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Affiliation(s)
- Elsa Villarino
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Xianding Deng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Carol A Kemper
- El Camino Hospital, Mountain View and Los Gatos, California, USA
| | - Michelle A Jorden
- Office of the Medical Examiner-Coroner, County of Santa Clara, San Jose, California, USA
| | - Brandon Bonin
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Sarah L Rudman
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - George S Han
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Guixia Yu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Scot Federman
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA
| | - Brian Bushnell
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | | | - Debra A Wadford
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA
| | - Wen Lin
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Ying Tao
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Clinton R Paden
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julu Bhatnagar
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tara MacCannell
- County of Santa Clara Public Health Department, San Jose, California, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joshua Batson
- Chan Zuckerberg Biohub, San Francisco, California, USA.,The Public Health Company, Goleta, California, USA
| | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, California, USA.,Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, San Francisco, California, USA.,Innovative Genomics Institute, University of California, Berkeley, Berkeley, California, USA
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27
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Konings F, Perkins MD, Kuhn JH, Pallen MJ, Alm EJ, Archer BN, Barakat A, Bedford T, Bhiman JN, Caly L, Carter LL, Cullinane A, de Oliveira T, Druce J, El Masry I, Evans R, Gao GF, Gorbalenya AE, Hamblion E, Herring BL, Hodcroft E, Holmes EC, Kakkar M, Khare S, Koopmans MPG, Korber B, Leite J, MacCannell D, Marklewitz M, Maurer-Stroh S, Rico JAM, Munster VJ, Neher R, Munnink BO, Pavlin BI, Peiris M, Poon L, Pybus O, Rambaut A, Resende P, Subissi L, Thiel V, Tong S, van der Werf S, von Gottberg A, Ziebuhr J, Van Kerkhove MD. SARS-CoV-2 Variants of Interest and Concern naming scheme conducive for global discourse. Nat Microbiol 2021; 6:821-823. [PMID: 34108654 DOI: 10.1038/s41564-021-00932-w] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, USA
| | - Mark J Pallen
- Quadram Institute Bioscience, University of East Anglia, Norwich, UK
| | - Erik J Alm
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | | | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jinal N Bhiman
- National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Leon Caly
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Melbourne, Victoria, Australia
| | | | - Anne Cullinane
- Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | | | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory (VIDRL), Melbourne, Victoria, Australia
| | - Ihab El Masry
- Emergency Centre for Transboundary Animal Disease, Food and Agriculture Organization of the United Nations (FAO), Cairo, Egypt
| | - Roger Evans
- World Health Organization, Geneva, Switzerland
| | - George F Gao
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Alexander E Gorbalenya
- Leiden University Medical Center, Leiden, The Netherlands.,Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, Russia
| | | | | | | | - Edward C Holmes
- The University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | - Bette Korber
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA
| | | | - Duncan MacCannell
- United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Sebastian Maurer-Stroh
- The Global Initiative on Sharing All Influenza Data (GISAID), Munich, Germany.,Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Vincent J Munster
- Virus Ecology Unit, National Institute of Allergy and Infectious Diseases, Rockville, MA, USA
| | - Richard Neher
- Biozentrum, University of Basel, Switzerland Swiss Institute of Bioinformatics, Basel, Switzerland
| | | | | | | | - Leo Poon
- The University of Hong Kong, Hong Kong, China
| | | | - Andrew Rambaut
- Institute for Evolutionary Biology, Ashworth Laboratories, University of Edinburgh, Edinburgh, UK
| | - Paola Resende
- Laboratory of Respiratory Viruses and Measles (LVRS), Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | - Volker Thiel
- University of Bern, Bern, Switzerland.,Institute of Virology and Immunology, Mittelhäusern, Switzerland
| | - Suxiang Tong
- United States Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Anne von Gottberg
- National Institute for Communicable Diseases, Johannesburg, South Africa.,School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John Ziebuhr
- Institute of Medical Virology, Justus Liebig University Giessen, Giessen, Germany
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28
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Wang L, Li Y, Walsh T, Shen Z, Li Y, Deb Nath N, Lee J, Zheng B, Tao Y, Paden CR, Queen K, Zhang S, Tong S, Ma W. Isolation and characterization of novel reassortant mammalian orthoreovirus from pigs in the United States. Emerg Microbes Infect 2021; 10:1137-1147. [PMID: 34018466 PMCID: PMC8205024 DOI: 10.1080/22221751.2021.1933608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mammalian orthoreovirus (MRV) infects multiple mammalian species including humans. A United States Midwest swine farm with approximately one thousand 3-month-old pigs experienced an event, in which more than 300 pigs showed neurological signs, like "down and peddling", with approximately 40% mortality. A novel MRV was isolated from the diseased pigs. Sequence and phylogenetic analysis revealed that the isolate was a reassortant virus containing viral gene segments from three MRV serotypes that infect human, bovine and swine. The M2 and S1 segment of the isolate showed 94% and 92% nucleotide similarity to the M2 of the MRV2 D5/Jones and the S1 of the MRV1 C/bovine/Indiana/MRV00304/2014, respectively; the remaining eight segments displayed 93%-95% nucleotide similarity to those of the MRV3 FS-03/Porcine/USA/2014. Pig studies showed that both MRV-infected and native contact pigs displayed fever, diarrhoea and nasal discharge. MRV RNA was detected in different intestinal locations of both infected and contact pigs, indicating that the MRV isolate is pathogenic and transmissible in pigs. Seroconversion was also observed in experimentally infected pigs. A prevalence study on more than 180 swine serum samples collected from two states without disease revealed 40%-52% positive to MRV. All results warrant the necessity to monitor MRV epidemiology and reassortment as the MRV could be an important pathogen for the swine industry and a novel MRV might emerge to threaten animal and public health.
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Affiliation(s)
- Liping Wang
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA.,Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Yan Li
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy Walsh
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Zhenyu Shen
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Yonghai Li
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Nirmalendu Deb Nath
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Jinhwa Lee
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Baoliang Zheng
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA
| | - Ying Tao
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clinton R Paden
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krista Queen
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shuping Zhang
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Suxiang Tong
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wenjun Ma
- Department of Diagnostic Medicine/Pathobiology, Kansas State University, Manhattan, KS, USA.,Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Department of Molecular Microbiology and Immunology, School of Medicine, University of Missouri, Columbia, MO, USA
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29
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Paul P, France AM, Aoki Y, Batra D, Biggerstaff M, Dugan V, Galloway S, Hall AJ, Johansson MA, Kondor RJ, Halpin AL, Lee B, Lee JS, Limbago B, MacNeil A, MacCannell D, Paden CR, Queen K, Reese HE, Retchless AC, Slayton RB, Steele M, Tong S, Walters MS, Wentworth DE, Silk BJ. Genomic Surveillance for SARS-CoV-2 Variants Circulating in the United States, December 2020-May 2021. MMWR Morb Mortal Wkly Rep 2021; 70:846-850. [PMID: 34111060 PMCID: PMC8191868 DOI: 10.15585/mmwr.mm7023a3] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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30
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Plucinski MM, Wallace M, Uehara A, Kurbatova EV, Tobolowsky FA, Schneider ZD, Ishizumi A, Bozio CH, Kobayashi M, Toda M, Stewart A, Wagner RL, Moriarty LF, Murray R, Queen K, Tao Y, Paden C, Mauldin MR, Zhang J, Li Y, Elkins CA, Lu X, Herzig CTA, Novak R, Bower W, Medley AM, Acosta AM, Knust B, Cantey PT, Pesik NT, Halsey ES, Cetron MS, Tong S, Marston BJ, Friedman CR. Coronavirus Disease 2019 (COVID-19) in Americans Aboard the Diamond Princess Cruise Ship. Clin Infect Dis 2021; 72:e448-e457. [PMID: 32785683 PMCID: PMC7454359 DOI: 10.1093/cid/ciaa1180] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 07/22/2020] [Indexed: 01/22/2023] Open
Abstract
Background The Diamond Princess cruise ship was the site of a large outbreak of coronavirus disease 2019 (COVID-19). Of 437 Americans and their travel companions on the ship, 114 (26%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We interviewed 229 American passengers and crew after disembarkation following a ship-based quarantine to identify risk factors for infection and characterize transmission onboard the ship. Results The attack rate for passengers in single-person cabins or without infected cabinmates was 18% (58/329), compared with 63% (27/43) for those sharing a cabin with an asymptomatic infected cabinmate, and 81% (25/31) for those with a symptomatic infected cabinmate. Whole genome sequences from specimens from passengers who shared cabins clustered together. Of 66 SARS-CoV-2-positive American travelers with complete symptom information, 14 (21%) were asymptomatic while on the ship. Among SARS-CoV-2-positive Americans, 10 (9%) required intensive care, of whom 7 were ≥70 years. Conclusion Our findings highlight the high risk of SARS-CoV-2 transmission on cruise ships. High rates of SARS-CoV-2 positivity in cabinmates of individuals with asymptomatic infections suggest that triage by symptom status in shared quarters is insufficient to halt transmission. A high rate of intensive care unit admission among older individuals complicates the prospect of future cruise travel during the pandemic, given typical cruise passenger demographics. The magnitude and severe outcomes of this outbreak were major factors contributing to the Centers for Disease Control and Prevention’s decision to halt cruise ship travel in U.S. waters in March 2020.
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Affiliation(s)
- Mateusz M Plucinski
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Megan Wallace
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna Uehara
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ekaterina V Kurbatova
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Farrell A Tobolowsky
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zachary D Schneider
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Atsuyoshi Ishizumi
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Catherine H Bozio
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Miwako Kobayashi
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mitsuru Toda
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrea Stewart
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Riley L Wagner
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leah F Moriarty
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachel Murray
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Krista Queen
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ying Tao
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Clinton Paden
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Matthew R Mauldin
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jing Zhang
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yan Li
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher A Elkins
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiaoyan Lu
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolyn T A Herzig
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ryan Novak
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William Bower
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Alexandra M Medley
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna M Acosta
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Barbara Knust
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paul T Cantey
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicki T Pesik
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eric S Halsey
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Martin S Cetron
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suxiang Tong
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Barbara J Marston
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cindy R Friedman
- All authors are part of the COVID-19 Cruise Ship Task Force, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Gettings JR, Gold JAW, Kimball A, Forsberg K, Scott C, Uehara A, Tong S, Hast M, Swanson MR, Morris E, Oraka E, Almendares O, Thomas ES, Mehari L, McCloud J, Roberts G, Crosby D, Balajee A, Burnett E, Chancey RJ, Cook P, Donadel M, Espinosa C, Evans ME, Fleming-Dutra KE, Forero C, Kukielka EA, Li Y, Marcet PL, Mitruka K, Nakayama JY, Nakazawa Y, O'Hegarty M, Pratt C, Rice ME, Rodriguez Stewart RM, Sabogal R, Sanchez E, Velasco-Villa A, Weng MK, Zhang J, Rivera G, Parrott T, Franklin R, Memark J, Drenzek C, Hall AJ, Kirking HL, Tate JE, Vallabhaneni S. SARS-CoV-2 transmission in a Georgia school district - United States, December 2020-January 2021. Clin Infect Dis 2021; 74:319-326. [PMID: 33864375 PMCID: PMC8083290 DOI: 10.1093/cid/ciab332] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 03/15/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To inform prevention strategies, we assessed the extent of SARS-CoV-2 transmission and settings in which transmission occurred in a Georgia public school district. METHODS During December 1, 2020-January 22, 2021, SARS-CoV-2-infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 RT-PCR testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (e.g., sports, elementary school classroom), index case role (i.e., staff, student), and index case symptomatic status. RESULTS We identified 86 index cases and 1,119 contacts, 688 (63.1%) of whom received testing. Fifty-nine (8.7%) of 679 contacts tested positive; 15 (17.4%) of 86 index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SAR were in indoor, high-contact sports settings (23.8%, 95% confidence interval [CI] 12.7, 33.3), staff meetings/lunches (18.2%, CI 4.5-31.8), and elementary school classrooms (9.5%, CI 6.5-12.5). SAR was higher for staff (13.1%, CI 9.0-17.2) versus student index cases (5.8%, CI 3.6-8.0) and for symptomatic (10.9%, CI 8.1-13.9) versus asymptomatic index cases (3.0%, CI 1.0-5.5). CONCLUSIONS Indoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include COVID-19 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.
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Affiliation(s)
- Jenna R Gettings
- Georgia Department of Public Health, Atlanta, GA, USA.,COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | - Jeremy A W Gold
- COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | - Anne Kimball
- COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | | | | | | | | | | | | | | | - Emeka Oraka
- COVID-19 Response, CDC, Atlanta, GA, USA.,General Dynamics Information Technology, Falls Church, VA, USA
| | | | | | | | | | | | | | - Abirami Balajee
- COVID-19 Response, CDC, Atlanta, GA, USA.,Maximus Federal, Reston, VA, USA
| | | | | | - Peter Cook
- COVID-19 Response, CDC, Atlanta, GA, USA
| | | | | | | | | | | | - Esther A Kukielka
- COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | - Yan Li
- COVID-19 Response, CDC, Atlanta, GA, USA
| | | | | | - Jasmine Y Nakayama
- COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | | | | | - Caroline Pratt
- COVID-19 Response, CDC, Atlanta, GA, USA.,Epidemic Intelligence Service, CDC, Atlanta, GA, USA
| | | | | | | | | | | | | | - Jing Zhang
- COVID-19 Response, CDC, Atlanta, GA, USA
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32
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Szablewski CM, Chang KT, McDaniel CJ, Chu VT, Yousaf AR, Schwartz NG, Brown M, Winglee K, Paul P, Cui Z, Slayton RB, Tong S, Li Y, Uehara A, Zhang J, Sharkey SM, Kirking HL, Tate JE, Dirlikov E, Fry AM, Hall AJ, Rose DA, Villanueva J, Drenzek C, Stewart RJ, Lanzieri TM. SARS-CoV-2 Transmission Dynamics in a Sleep-Away Camp. Pediatrics 2021; 147:peds.2020-046524. [PMID: 33504612 PMCID: PMC8982574 DOI: 10.1542/peds.2020-046524] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In late June 2020, a large outbreak of coronavirus disease 2019 (COVID-19) occurred at a sleep-away youth camp in Georgia, affecting primarily persons ≤21 years. We conducted a retrospective cohort study among campers and staff (attendees) to determine the extent of the outbreak and assess factors contributing to transmission. METHODS Attendees were interviewed to ascertain demographic characteristics, known exposures to COVID-19 and community exposures, and mitigation measures before, during, and after attending camp. COVID-19 case status was determined for all camp attendees on the basis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test results and reported symptoms. We calculated attack rates and instantaneous reproduction numbers and sequenced SARS-CoV-2 viral genomes from the outbreak. RESULTS Among 627 attendees, the median age was 15 years (interquartile range: 12-16 years); 56% (351 of 627) of attendees were female. The attack rate was 56% (351 of 627) among all attendees. On the basis of date of illness onset or first positive test result on a specimen collected, 12 case patients were infected before arriving at camp and 339 case patients were camp associated. Among 288 case patients with available symptom information, 45 (16%) were asymptomatic. Despite cohorting, 50% of attendees reported direct contact with people outside their cabin cohort. On the first day of camp session, the instantaneous reproduction number was 10. Viral genomic diversity was low. CONCLUSIONS Few introductions of SARS-CoV-2 into a youth congregate setting resulted in a large outbreak. Testing strategies should be combined with prearrival quarantine, routine symptom monitoring with appropriate isolation and quarantine, cohorting, social distancing, mask wearing, and enhanced disinfection and hand hygiene. Promotion of mitigation measures among younger populations is needed.
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Affiliation(s)
| | - Karen T. Chang
- COVID-19 Response Team, CDC, Atlanta, GA,Epidemic Intelligence Service, Atlanta, GA
| | | | - Victoria T. Chu
- COVID-19 Response Team, CDC, Atlanta, GA,Epidemic Intelligence Service, Atlanta, GA
| | - Anna R. Yousaf
- COVID-19 Response Team, CDC, Atlanta, GA,Epidemic Intelligence Service, Atlanta, GA
| | - Noah G. Schwartz
- COVID-19 Response Team, CDC, Atlanta, GA,Epidemic Intelligence Service, Atlanta, GA
| | - Marie Brown
- Georgia Department of Public Health, Atlanta, GA
| | | | | | | | | | | | - Yan Li
- COVID-19 Response Team, CDC, Atlanta, GA
| | | | - Jing Zhang
- COVID-19 Response Team, CDC, Atlanta, GA
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33
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Munyua PM, Ngere I, Hunsperger E, Kochi A, Amoth P, Mwasi L, Tong S, Mwatondo A, Thornburg N, Widdowson MA, Njenga MK. Low-Level Middle East Respiratory Syndrome Coronavirus among Camel Handlers, Kenya, 2019. Emerg Infect Dis 2021; 27:1201-1205. [PMID: 33754992 PMCID: PMC8007315 DOI: 10.3201/eid2704.204458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Although seroprevalence of Middle East respiratory coronavirus syndrome is high among camels in Africa, researchers have not detected zoonotic transmission in Kenya. We followed a cohort of 262 camel handlers in Kenya during April 2018–March 2020. We report PCR-confirmed Middle East respiratory coronavirus syndrome in 3 asymptomatic handlers.
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34
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Bhatnagar J, Gary J, Reagan-Steiner S, Estetter LB, Tong S, Tao Y, Denison AM, Lee E, DeLeon-Carnes M, Li Y, Uehara A, Paden CR, Leitgeb B, Uyeki TM, Martines RB, Ritter JM, Paddock CD, Shieh WJ, Zaki SR. Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 Replication and Tropism in the Lungs, Airways, and Vascular Endothelium of Patients With Fatal Coronavirus Disease 2019: An Autopsy Case Series. J Infect Dis 2021; 223:752-764. [PMID: 33502471 PMCID: PMC7928839 DOI: 10.1093/infdis/jiab039] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic continues to produce substantial morbidity and mortality. To understand the reasons for the wide-spectrum complications and severe outcomes of COVID-19, we aimed to identify cellular targets of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tropism and replication in various tissues. Methods We evaluated RNA extracted from formalin-fixed, paraffin-embedded autopsy tissues from 64 case patients (age range, 1 month to 84 years; 21 COVID-19 confirmed, 43 suspected COVID-19) by SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR). For cellular localization of SARS-CoV-2 RNA and viral characterization, we performed in situ hybridization (ISH), subgenomic RNA RT-PCR, and whole-genome sequencing. Results SARS-CoV-2 was identified by RT-PCR in 32 case patients (21 COVID-19 confirmed, 11 suspected). ISH was positive in 20 and subgenomic RNA RT-PCR was positive in 17 of 32 RT-PCR–positive case patients. SARS-CoV-2 RNA was localized by ISH in hyaline membranes, pneumocytes, and macrophages of lungs; epithelial cells of airways; and endothelial cells and vessel walls of brain stem, leptomeninges, lung, heart, liver, kidney, and pancreas. The D614G variant was detected in 9 RT-PCR–positive case patients. Conclusions We identified cellular targets of SARS-CoV-2 tropism and replication in the lungs and airways and demonstrated its direct infection in vascular endothelium. This work provides important insights into COVID-19 pathogenesis and mechanisms of severe outcomes.
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Affiliation(s)
- Julu Bhatnagar
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Correspondence: Julu Bhatnagar, PhD, Infectious Diseases Pathology Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H18-SB, Atlanta, GA 30329-4027 ()
| | - Joy Gary
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah Reagan-Steiner
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsey B Estetter
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suxiang Tong
- Respiratory Viruses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ying Tao
- Respiratory Viruses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Amy M Denison
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Lee
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marlene DeLeon-Carnes
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yan Li
- Respiratory Viruses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna Uehara
- Respiratory Viruses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Clinton R Paden
- Respiratory Viruses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brooke Leitgeb
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Roosecelis B Martines
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jana M Ritter
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christopher D Paddock
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wun-Ju Shieh
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sherif R Zaki
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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35
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Lee JT, Hesse EM, Paulin HN, Datta D, Katz LS, Talwar A, Chang G, Galang RR, Harcourt JL, Tamin A, Thornburg NJ, Wong KK, Stevens V, Kim K, Tong S, Zhou B, Queen K, Drobeniuc J, Folster JM, Sexton DJ, Ramachandran S, Browne H, Iskander J, Mitruka K. Clinical and Laboratory Findings in Patients with Potential SARS-CoV-2 Reinfection, May-July 2020. Clin Infect Dis 2021; 73:2217-2225. [PMID: 33598716 PMCID: PMC7929000 DOI: 10.1093/cid/ciab148] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 12/17/2020] [Accepted: 02/12/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We investigated patients with potential SARS-CoV-2 reinfection in the United States during May-July 2020. METHODS We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including RT-PCR, viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. RESULTS Among 73 potential reinfection patients with available records, 30 patients had recurrent COVID-19 symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47 - 76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional three patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. CONCLUSIONS We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current CDC guidance around quarantine and testing for patients who have recovered from COVID-19.
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Affiliation(s)
- James T Lee
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, USA
| | - Elisabeth M Hesse
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Heather N Paulin
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Deblina Datta
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Lee S Katz
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Amish Talwar
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Gregory Chang
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Romeo R Galang
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer L Harcourt
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Azaibi Tamin
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Natalie J Thornburg
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Karen K Wong
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Valerie Stevens
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Kaylee Kim
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Suxiang Tong
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Bin Zhou
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Krista Queen
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jan Drobeniuc
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Jennifer M Folster
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - D Joseph Sexton
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Sumathi Ramachandran
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Hannah Browne
- Laboratory Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - John Iskander
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Kiren Mitruka
- Health Systems Worker Safety Task Force, COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, USA
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36
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van Doremalen N, Letko M, Fischer RJ, Bushmaker T, Yinda CK, Schulz J, Seifert SN, Kim NJ, Hemida MG, Kayali G, Park WB, Perera RAPM, Tamin A, Thornburg NJ, Tong S, Queen K, van Kerkhove MD, Choi YK, Oh MD, Assiri AM, Peiris M, Gerber SI, Munster VJ. Surface-aerosol stability and pathogenicity of diverse MERS-CoV strains from 2012 - 2018. bioRxiv 2021:2021.02.11.429193. [PMID: 33594367 PMCID: PMC7885919 DOI: 10.1101/2021.02.11.429193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Middle East Respiratory Syndrome coronavirus (MERS-CoV) is a coronavirus that infects both humans and dromedary camels and is responsible for an ongoing outbreak of severe respiratory illness in humans in the Middle East. While some mutations found in camel-derived MERS-CoV strains have been characterized, the majority of natural variation found across MERS-CoV isolates remains unstudied. Here we report on the environmental stability, replication kinetics and pathogenicity of several diverse isolates of MERS-CoV as well as SARS-CoV-2 to serve as a basis of comparison with other stability studies. While most of the MERS-CoV isolates exhibited similar stability and pathogenicity in our experiments, the camel derived isolate, C/KSA/13, exhibited reduced surface stability while another camel isolate, C/BF/15, had reduced pathogenicity in a small animal model. These results suggest that while betacoronaviruses may have similar environmental stability profiles, individual variation can influence this phenotype, underscoring the importance of continual, global viral surveillance.
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Affiliation(s)
- Neeltje van Doremalen
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
| | - Michael Letko
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
- Paul G. Allen School of Global Animal Health, Washington State University, Pullman, WA, 99111, USA
- Corresponding author: Dr. Michael Letko, Paul G. Allen School of Global Animal Health, Washington State University, Pullman, WA, 99164, Tel: (509) 335-4058,
| | - Robert J. Fischer
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
| | - Trenton Bushmaker
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
| | - Claude Kwe Yinda
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
| | - Jonathan Schulz
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
| | - Stephanie N. Seifert
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
- Paul G. Allen School of Global Animal Health, Washington State University, Pullman, WA, 99111, USA
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Maged G Hemida
- Department of Microbiology, College of Veterinary Medicine, King Faisal University, Al-Hasa, Saudi Arabia
- Department of Virology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ghazi Kayali
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Sciences Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, Houston, Texas
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Azaibi Tamin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natalie J. Thornburg
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krista Queen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria D. van Kerkhove
- Department of Infectious Hazards Management, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju City, Republic of Korea
| | - Myoung-don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Abdullah M. Assiri
- Infection Prevention and Control, Assistant Deputy Minister, Preventive Health, Ministry of Health, Riyadh, Saudi Arabia
| | - Malik Peiris
- School of Public Health, University of Hong-Kong, Hong Kong SAR, China
| | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vincent J. Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, 59840, USA
- Corresponding author: Dr. Michael Letko, Paul G. Allen School of Global Animal Health, Washington State University, Pullman, WA, 99164, Tel: (509) 335-4058,
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37
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Khalafalla AI, Li Y, Uehara A, Hussein NA, Zhang J, Tao Y, Bergeron E, Ibrahim IH, Al Hosani MA, Yusof MF, Alhammadi ZM, Alyammahi SM, Gasim EF, Ishag HZA, Hosani FAL, Gerber SI, Almuhairi SS, Tong S. Identification of a novel lineage of Crimean-Congo haemorrhagic fever virus in dromedary camels, United Arab Emirates. J Gen Virol 2021; 102:001473. [PMID: 33231536 PMCID: PMC8749806 DOI: 10.1099/jgv.0.001473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a tick-borne virus causing Crimean-Congo haemorrhagic fever (CCHF), a disease reported to have a high fatality rate in numerous countries. The virus is geographically widespread due to its vector, and numerous wild and domestic animals can develop asymptomatic infection. Serological and limited molecular evidence of CCHFV has previously been reported in Camelus dromedarius (the dromedary, or one-humped camel) in the United Arab Emirates (UAE). In this study, 238 camel samples were screened for CCHFV RNA where 16 camel samples were positive for CCHFV by RT-PCR. Analysis of full-length CCHFV genome sequences revealed a novel lineage in camels from the UAE, and potential reassortment of the M segment of the genome.
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Affiliation(s)
- Abdelmalik I. Khalafalla
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Yan Li
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Anna Uehara
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
- Oak Ridge Institute for Science Education, Oak Ridge, Tennessee, USA
| | - Nasareldien A. Hussein
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Jing Zhang
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Ying Tao
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Eric Bergeron
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Atlanta, Georgia, USA
| | | | - Mohamed A. Al Hosani
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Mohd F. Yusof
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Zulaikha M. Alhammadi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Saeed M. Alyammahi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Esmat F. Gasim
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Hassan Z. A. Ishag
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | | | - Susan I. Gerber
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Salama S. Almuhairi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Suxiang Tong
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
- *Correspondence: Suxiang Tong,
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Galloway SE, Paul P, MacCannell DR, Johansson MA, Brooks JT, MacNeil A, Slayton RB, Tong S, Silk BJ, Armstrong GL, Biggerstaff M, Dugan VG. Emergence of SARS-CoV-2 B.1.1.7 Lineage - United States, December 29, 2020-January 12, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:95-99. [PMID: 33476315 PMCID: PMC7821772 DOI: 10.15585/mmwr.mm7003e2] [Citation(s) in RCA: 479] [Impact Index Per Article: 159.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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39
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Kia GSN, Tao Y, Umoh JU, Kwaga JKP, Tong S. Identification of Coronaviruses, Paramyxoviruses, Reoviruses, and Rotaviruses among Bats in Nigeria. Am J Trop Med Hyg 2021; 104:1106-1110. [PMID: 33534762 DOI: 10.4269/ajtmh.19-0872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 08/04/2020] [Indexed: 11/07/2022] Open
Abstract
Bats are often consumed by some ethnic groups in Nigeria despite association of bats with many important emerging viruses. More than 300 bats representing eight species were captured during 2010-2011 in eight locations of northern Nigeria. Available fecal swabs (n = 95) were screened for the presence of arenaviruses, CoVs, paramyxoviruses (PMVs), reoviruses, rhabdoviruses, and influenza viruses using generic reverse transcription-polymerase chain reaction assays. Here, we document the detection of CoVs, PMVs, reoviruses, and rotaviruses (RVs) in Nigerian bats. The Nigerian bat CoVs are grouped within other bat SARS-CoV-like viruses identified from Ghana in a sister clade next to the human SARS-CoV clade. The phylogenetic analysis indicated a broad range of RVs present in Nigerian bats, some cluster with human RVs and some represent novel species. Our study adds that continuing global surveillance for viruses in bats to understand their origin, adaptation, and evolution is important to prevent and control future zoonotic disease outbreaks.
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Affiliation(s)
| | - Ying Tao
- 2Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Suxiang Tong
- 2Centers for Disease Control and Prevention, Atlanta, Georgia
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40
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Wallace M, James AE, Silver R, Koh M, Tobolowsky FA, Simonson S, Gold JAW, Fukunaga R, Njuguna H, Bordelon K, Wortham J, Coughlin M, Harcourt JL, Tamin A, Whitaker B, Thornburg NJ, Tao Y, Queen K, Uehara A, Paden CR, Zhang J, Tong S, Haydel D, Tran H, Kim K, Fisher KA, Marlow M, Tate JE, Doshi RH, Sokol T, Curran KG. Rapid Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 in Detention Facility, Louisiana, USA, May-June, 2020. Emerg Infect Dis 2021; 27:421-429. [PMID: 33395380 PMCID: PMC7853536 DOI: 10.3201/eid2702.204158] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
To assess transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a detention facility experiencing a coronavirus disease outbreak and evaluate testing strategies, we conducted a prospective cohort investigation in a facility in Louisiana, USA. We conducted SARS-CoV-2 testing for detained persons in 6 quarantined dormitories at various time points. Of 143 persons, 53 were positive at the initial test, and an additional 58 persons were positive at later time points (cumulative incidence 78%). In 1 dormitory, all 45 detained persons initially were negative; 18 days later, 40 (89%) were positive. Among persons who were SARS-CoV-2 positive, 47% (52/111) were asymptomatic at the time of specimen collection; 14 had replication-competent virus isolated. Serial SARS-CoV-2 testing might help interrupt transmission through medical isolation and quarantine. Testing in correctional and detention facilities will be most effective when initiated early in an outbreak, inclusive of all exposed persons, and paired with infection prevention and control.
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41
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Biggs HM, Nix WA, Zhang J, Rogers S, Clara W, Jara JH, Gonzalez R, Luciani K, Brizuela YS, Estripeaut D, Castillo JM, De Leon T, Corro M, Vergara O, Rauda R, Chong EG, Watson JT, Azziz-Baumgartner E, Gerber SI, Tong S, Dawood FS. Enterovirus D68 infection among hospitalized children with severe acute respiratory illness in El Salvador and Panama, 2012-2013. Influenza Other Respir Viruses 2020; 15:181-187. [PMID: 33280235 PMCID: PMC7902261 DOI: 10.1111/irv.12815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
We assessed EV‐D68 epidemiology and phylogenetics among children aged ≤9 years hospitalized with severe acute respiratory illnesses at five sites in Panama and El Salvador during 2012‐2013. Respiratory specimens positive for enterovirus or rhinovirus were tested by real‐time RT‐PCR for EV‐D68, and partial VP1 gene sequences were determined. Of 715 enrolled children, 17 from sites in both countries were EV‐D68‐positive and commonly had a history of asthma or wheezing. Phylogenetically, 15 of 16 sequences fell into Clade B1, and one into Clade A2. The Central American EV‐D68s were closely related genetically to contemporaneous strains from North America, South America, and the Caribbean.
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Affiliation(s)
- Holly M Biggs
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - W Allan Nix
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jing Zhang
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Rogers
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wilfrido Clara
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jorge H Jara
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Rosalba Gonzalez
- Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Kathia Luciani
- Hospital De Especialidades Pediátricas Omar Torrijos, Panama City, Panama
| | | | | | | | - Tirza De Leon
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | - Mary Corro
- Hospital De Especialidades Pediátricas Omar Torrijos, Panama City, Panama
| | | | - Rafael Rauda
- Hospital San Juan De Dios, Santa Ana, El Salvador
| | - Evens G Chong
- Hospital Materno Infantil José Domingo De Obaldía, David, Panama
| | - John T Watson
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eduardo Azziz-Baumgartner
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Susan I Gerber
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Fatimah S Dawood
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Bushman D, Alroy KA, Greene SK, Keating P, Wahnich A, Weiss D, Pathela P, Harrison C, Rakeman J, Langley G, Tong S, Tao Y, Uehara A, Queen K, Paden CR, Szymczak W, Orner EP, Nori P, Lai PA, Jacobson JL, Singh HK, Calfee DP, Westblade LF, Vasovic LV, Rand JH, Liu D, Singh V, Burns J, Prasad N, Sell J. Detection and genetic characterization of community‐based SARS‐CoV‐2 infections – New York City, March 2020. Am J Transplant 2020. [DOI: 10.1111/ajt.16377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Dena Bushman
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
- Epidemic Intelligence Service CDC
| | - Karen A. Alroy
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
- Epidemic Intelligence Service CDC
| | - Sharon K. Greene
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Page Keating
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Amanda Wahnich
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Don Weiss
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Preeti Pathela
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
| | - Christy Harrison
- Public Health Laboratory New York City Department of Health and Mental Hygiene
| | - Jennifer Rakeman
- Public Health Laboratory New York City Department of Health and Mental Hygiene
| | - Gayle Langley
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Suxiang Tong
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Ying Tao
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Anna Uehara
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Krista Queen
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Clinton R. Paden
- Division of Viral Diseases National Center for Immunization and Respiratory Diseases CDC
| | - Wendy Szymczak
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Erika P. Orner
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Priya Nori
- Department of Pathology Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
- Division of Infectious Diseases Department of Medicine Montefiore Medical Center Albert Einstein College of Medicine Bronx New York
| | - Phi A. Lai
- Department of Pathology and Laboratory Medicine NYU Langone Hospital Brooklyn New York
| | | | - Harjot K. Singh
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
| | - David P. Calfee
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
| | - Lars F. Westblade
- Division of Infectious Diseases Department of Medicine Weill Cornell Medicine New York New York
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Ljiljana V. Vasovic
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Jacob H. Rand
- Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York New York
| | - Dakai Liu
- New York‐Presbyterian Queens Flushing New York
| | | | | | | | - Jessica Sell
- Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene
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43
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Bedford T, Greninger AL, Roychoudhury P, Starita LM, Famulare M, Huang ML, Nalla A, Pepper G, Reinhardt A, Xie H, Shrestha L, Nguyen TN, Adler A, Brandstetter E, Cho S, Giroux D, Han PD, Fay K, Frazar CD, Ilcisin M, Lacombe K, Lee J, Kiavand A, Richardson M, Sibley TR, Truong M, Wolf CR, Nickerson DA, Rieder MJ, Englund JA, Hadfield J, Hodcroft EB, Huddleston J, Moncla LH, Müller NF, Neher RA, Deng X, Gu W, Federman S, Chiu C, Duchin JS, Gautom R, Melly G, Hiatt B, Dykema P, Lindquist S, Queen K, Tao Y, Uehara A, Tong S, MacCannell D, Armstrong GL, Baird GS, Chu HY, Shendure J, Jerome KR. Cryptic transmission of SARS-CoV-2 in Washington state. Science 2020; 370:571-575. [PMID: 32913002 PMCID: PMC7810035 DOI: 10.1126/science.abc0523] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/08/2020] [Indexed: 01/08/2023]
Abstract
After its emergence in Wuhan, China, in late November or early December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus rapidly spread globally. Genome sequencing of SARS-CoV-2 allows the reconstruction of its transmission history, although this is contingent on sampling. We analyzed 453 SARS-CoV-2 genomes collected between 20 February and 15 March 2020 from infected patients in Washington state in the United States. We find that most SARS-CoV-2 infections sampled during this time derive from a single introduction in late January or early February 2020, which subsequently spread locally before active community surveillance was implemented.
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Affiliation(s)
- Trevor Bedford
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Alexander L Greninger
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Pavitra Roychoudhury
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | | | - Meei-Li Huang
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Arun Nalla
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Gregory Pepper
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Adam Reinhardt
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Hong Xie
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Lasata Shrestha
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Truong N Nguyen
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Amanda Adler
- Division of Infectious Disease, Seattle Children's Hospital, Seattle, WA, USA
| | - Elisabeth Brandstetter
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Shari Cho
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Danielle Giroux
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Peter D Han
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Kairsten Fay
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Chris D Frazar
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Misja Ilcisin
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kirsten Lacombe
- Division of Infectious Disease, Seattle Children's Hospital, Seattle, WA, USA
| | - Jover Lee
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anahita Kiavand
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Matthew Richardson
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Thomas R Sibley
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Melissa Truong
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Caitlin R Wolf
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Deborah A Nickerson
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Mark J Rieder
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Janet A Englund
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Division of Infectious Disease, Seattle Children's Hospital, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - James Hadfield
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Emma B Hodcroft
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - John Huddleston
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Molecular and Cellular Biology Program, University of Washington, Seattle, WA, USA
| | - Louise H Moncla
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Nicola F Müller
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Richard A Neher
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Xianding Deng
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Scot Federman
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Charles Chiu
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey S Duchin
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
- Public Health - Seattle & King County, Seattle, WA, USA
| | - Romesh Gautom
- Washington State Department of Health, Shoreline, WA, USA
| | - Geoff Melly
- Washington State Department of Health, Shoreline, WA, USA
| | - Brian Hiatt
- Washington State Department of Health, Shoreline, WA, USA
| | - Philip Dykema
- Washington State Department of Health, Shoreline, WA, USA
| | | | - Krista Queen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ying Tao
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna Uehara
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Duncan MacCannell
- Office of Advanced Molecular Detection, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gregory L Armstrong
- Office of Advanced Molecular Detection, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Geoffrey S Baird
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Helen Y Chu
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, Seattle, WA, USA
| | - Keith R Jerome
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
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44
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McAloose D, Laverack M, Wang L, Killian ML, Caserta LC, Yuan F, Mitchell PK, Queen K, Mauldin MR, Cronk BD, Bartlett SL, Sykes JM, Zec S, Stokol T, Ingerman K, Delaney MA, Fredrickson R, Ivančić M, Jenkins-Moore M, Mozingo K, Franzen K, Bergeson NH, Goodman L, Wang H, Fang Y, Olmstead C, McCann C, Thomas P, Goodrich E, Elvinger F, Smith DC, Tong S, Slavinski S, Calle PP, Terio K, Torchetti MK, Diel DG. From People to Panthera: Natural SARS-CoV-2 Infection in Tigers and Lions at the Bronx Zoo. mBio 2020; 11:mBio.02220-20. [PMID: 33051368 DOI: 10.1101/2020.07.22.213959] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Despite numerous barriers to transmission, zoonoses are the major cause of emerging infectious diseases in humans. Among these, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and ebolaviruses have killed thousands; the human immunodeficiency virus (HIV) has killed millions. Zoonoses and human-to-animal cross-species transmission are driven by human actions and have important management, conservation, and public health implications. The current SARS-CoV-2 pandemic, which presumably originated from an animal reservoir, has killed more than half a million people around the world and cases continue to rise. In March 2020, New York City was a global epicenter for SARS-CoV-2 infections. During this time, four tigers and three lions at the Bronx Zoo, NY, developed mild, abnormal respiratory signs. We detected SARS-CoV-2 RNA in respiratory secretions and/or feces from all seven animals, live virus in three, and colocalized viral RNA with cellular damage in one. We produced nine whole SARS-CoV-2 genomes from the animals and keepers and identified different SARS-CoV-2 genotypes in the tigers and lions. Epidemiologic and genomic data indicated human-to-tiger transmission. These were the first confirmed cases of natural SARS-CoV-2 animal infections in the United States and the first in nondomestic species in the world. We highlight disease transmission at a nontraditional interface and provide information that contributes to understanding SARS-CoV-2 transmission across species.IMPORTANCE The human-animal-environment interface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important aspect of the coronavirus disease 2019 (COVID-19) pandemic that requires robust One Health-based investigations. Despite this, few reports describe natural infections in animals or directly link them to human infections using genomic data. In the present study, we describe the first cases of natural SARS-CoV-2 infection in tigers and lions in the United States and provide epidemiological and genetic evidence for human-to-animal transmission of the virus. Our data show that tigers and lions were infected with different genotypes of SARS-CoV-2, indicating two independent transmission events to the animals. Importantly, infected animals shed infectious virus in respiratory secretions and feces. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help to elucidate transmission mechanisms and identify potential reservoirs and sources of infection that are important in both animal and human health.
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Affiliation(s)
- Denise McAloose
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Melissa Laverack
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Mary Lea Killian
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Leonardo C Caserta
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Fangfeng Yuan
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Patrick K Mitchell
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Krista Queen
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Brittany D Cronk
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | | | - John M Sykes
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Stephanie Zec
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Tracy Stokol
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Karen Ingerman
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Martha A Delaney
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, Illinois, USA
| | - Richard Fredrickson
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | | | - Melinda Jenkins-Moore
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Katie Mozingo
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Kerrie Franzen
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Nichole Hines Bergeson
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Laura Goodman
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Haibin Wang
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ying Fang
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Colleen Olmstead
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Colleen McCann
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Patrick Thomas
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Erin Goodrich
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - François Elvinger
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - David C Smith
- New York State Department of Agriculture and Markets, Albany, New York, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sally Slavinski
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Paul P Calle
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Karen Terio
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, Illinois, USA
| | - Mia Kim Torchetti
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Diego G Diel
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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McAloose D, Laverack M, Wang L, Killian ML, Caserta LC, Yuan F, Mitchell PK, Queen K, Mauldin MR, Cronk BD, Bartlett SL, Sykes JM, Zec S, Stokol T, Ingerman K, Delaney MA, Fredrickson R, Ivančić M, Jenkins-Moore M, Mozingo K, Franzen K, Bergeson NH, Goodman L, Wang H, Fang Y, Olmstead C, McCann C, Thomas P, Goodrich E, Elvinger F, Smith DC, Tong S, Slavinski S, Calle PP, Terio K, Torchetti MK, Diel DG. From People to Panthera: Natural SARS-CoV-2 Infection in Tigers and Lions at the Bronx Zoo. mBio 2020; 11:mBio.02220-20. [PMID: 33051368 PMCID: PMC7554670 DOI: 10.1128/mbio.02220-20] [Citation(s) in RCA: 240] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Despite numerous barriers to transmission, zoonoses are the major cause of emerging infectious diseases in humans. Among these, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and ebolaviruses have killed thousands; the human immunodeficiency virus (HIV) has killed millions. Zoonoses and human-to-animal cross-species transmission are driven by human actions and have important management, conservation, and public health implications. The current SARS-CoV-2 pandemic, which presumably originated from an animal reservoir, has killed more than half a million people around the world and cases continue to rise. In March 2020, New York City was a global epicenter for SARS-CoV-2 infections. During this time, four tigers and three lions at the Bronx Zoo, NY, developed mild, abnormal respiratory signs. We detected SARS-CoV-2 RNA in respiratory secretions and/or feces from all seven animals, live virus in three, and colocalized viral RNA with cellular damage in one. We produced nine whole SARS-CoV-2 genomes from the animals and keepers and identified different SARS-CoV-2 genotypes in the tigers and lions. Epidemiologic and genomic data indicated human-to-tiger transmission. These were the first confirmed cases of natural SARS-CoV-2 animal infections in the United States and the first in nondomestic species in the world. We highlight disease transmission at a nontraditional interface and provide information that contributes to understanding SARS-CoV-2 transmission across species.IMPORTANCE The human-animal-environment interface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important aspect of the coronavirus disease 2019 (COVID-19) pandemic that requires robust One Health-based investigations. Despite this, few reports describe natural infections in animals or directly link them to human infections using genomic data. In the present study, we describe the first cases of natural SARS-CoV-2 infection in tigers and lions in the United States and provide epidemiological and genetic evidence for human-to-animal transmission of the virus. Our data show that tigers and lions were infected with different genotypes of SARS-CoV-2, indicating two independent transmission events to the animals. Importantly, infected animals shed infectious virus in respiratory secretions and feces. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help to elucidate transmission mechanisms and identify potential reservoirs and sources of infection that are important in both animal and human health.
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Affiliation(s)
- Denise McAloose
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Melissa Laverack
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Leyi Wang
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Mary Lea Killian
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Leonardo C Caserta
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Fangfeng Yuan
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Patrick K Mitchell
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Krista Queen
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Brittany D Cronk
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | | | - John M Sykes
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Stephanie Zec
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Tracy Stokol
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Karen Ingerman
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Martha A Delaney
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, Illinois, USA
| | - Richard Fredrickson
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | | | - Melinda Jenkins-Moore
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Katie Mozingo
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Kerrie Franzen
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Nichole Hines Bergeson
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Laura Goodman
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Haibin Wang
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ying Fang
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Colleen Olmstead
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA
| | - Colleen McCann
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Patrick Thomas
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Erin Goodrich
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - François Elvinger
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - David C Smith
- New York State Department of Agriculture and Markets, Albany, New York, USA
| | - Suxiang Tong
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sally Slavinski
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Paul P Calle
- Wildlife Conservation Society, Bronx Zoo, Bronx, New York, USA
| | - Karen Terio
- Zoological Pathology Program, College of Veterinary Medicine, University of Illinois, Brookfield, Illinois, USA
| | - Mia Kim Torchetti
- National Veterinary Services Laboratories, Animal and Plant Health Inspection Service (APHIS), U.S. Department of Agriculture (USDA), Ames, Iowa, USA
| | - Diego G Diel
- Department of Population Medicine and Diagnostic Sciences, Animal Health Diagnostic Center, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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46
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Deng X, Gu W, Federman S, du Plessis L, Pybus OG, Faria NR, Wang C, Yu G, Bushnell B, Pan CY, Guevara H, Sotomayor-Gonzalez A, Zorn K, Gopez A, Servellita V, Hsu E, Miller S, Bedford T, Greninger AL, Roychoudhury P, Starita LM, Famulare M, Chu HY, Shendure J, Jerome KR, Anderson C, Gangavarapu K, Zeller M, Spencer E, Andersen KG, MacCannell D, Paden CR, Li Y, Zhang J, Tong S, Armstrong G, Morrow S, Willis M, Matyas BT, Mase S, Kasirye O, Park M, Masinde G, Chan C, Yu AT, Chai SJ, Villarino E, Bonin B, Wadford DA, Chiu CY. Genomic surveillance reveals multiple introductions of SARS-CoV-2 into Northern California. Science 2020; 369:582-587. [PMID: 32513865 PMCID: PMC7286545 DOI: 10.1126/science.abb9263] [Citation(s) in RCA: 196] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/03/2020] [Indexed: 12/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, with >365,000 cases in California as of 17 July 2020. We investigated the genomic epidemiology of SARS-CoV-2 in Northern California from late January to mid-March 2020, using samples from 36 patients spanning nine counties and the Grand Princess cruise ship. Phylogenetic analyses revealed the cryptic introduction of at least seven different SARS-CoV-2 lineages into California, including epidemic WA1 strains associated with Washington state, with lack of a predominant lineage and limited transmission among communities. Lineages associated with outbreak clusters in two counties were defined by a single base substitution in the viral genome. These findings support contact tracing, social distancing, and travel restrictions to contain the spread of SARS-CoV-2 in California and other states.
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Affiliation(s)
- Xianding Deng
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Wei Gu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Scot Federman
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | | | - Oliver G Pybus
- Department of Zoology, University of Oxford, Oxford, UK
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London, UK
| | - Nuno R Faria
- Department of Zoology, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
| | - Candace Wang
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Guixia Yu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Brian Bushnell
- Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Chao-Yang Pan
- California Department of Public Health, Richmond, CA, USA
| | - Hugo Guevara
- California Department of Public Health, Richmond, CA, USA
| | - Alicia Sotomayor-Gonzalez
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
| | - Kelsey Zorn
- Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA
| | - Allan Gopez
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Venice Servellita
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Elaine Hsu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Steve Miller
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
| | - Alexander L Greninger
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Pavitra Roychoudhury
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Lea M Starita
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | | | - Helen Y Chu
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jay Shendure
- Brotman Baty Institute for Precision Medicine, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | - Keith R Jerome
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Catie Anderson
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Karthik Gangavarapu
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Mark Zeller
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Emily Spencer
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Kristian G Andersen
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Clinton R Paden
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Yan Li
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jing Zhang
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suxiang Tong
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Scott Morrow
- San Mateo County Department of Public Health, San Mateo, CA, USA
| | - Matthew Willis
- Marin County Division of Public Health, San Rafael, CA, USA
| | - Bela T Matyas
- Solano County Department of Public Health, Fairfield, CA, USA
| | - Sundari Mase
- Sonoma County Department of Public Health, Santa Rosa, CA, USA
| | - Olivia Kasirye
- Sacramento County Division of Public Health, Sacramento, CA, USA
| | - Maggie Park
- San Joaquin County Department of Public Health, Stockton, CA, USA
| | - Godfred Masinde
- San Francisco County Department of Public Health, San Francisco, CA, USA
| | - Curtis Chan
- San Francisco County Department of Public Health, San Francisco, CA, USA
| | - Alexander T Yu
- California Department of Public Health, Richmond, CA, USA
| | - Shua J Chai
- California Department of Public Health, Richmond, CA, USA
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elsa Villarino
- County of Santa Clara, Public Health Department, Santa Clara, CA, USA
| | - Brandon Bonin
- County of Santa Clara, Public Health Department, Santa Clara, CA, USA
| | | | - Charles Y Chiu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
- UCSF-Abbott Viral Diagnostics and Discovery Center, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA, USA
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47
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Bushman D, Alroy KA, Greene SK, Keating P, Wahnich A, Weiss D, Pathela P, Harrison C, Rakeman J, Langley G, Tong S, Tao Y, Uehara A, Queen K, Paden CR, Szymczak W, Orner EP, Nori P, Lai PA, Jacobson JL, Singh HK, Calfee DP, Westblade LF, Vasovic LV, Rand JH, Liu D, Singh V, Burns J, Prasad N, Sell J. Detection and Genetic Characterization of Community-Based SARS-CoV-2 Infections - New York City, March 2020. MMWR Morb Mortal Wkly Rep 2020; 69:918-922. [PMID: 32678072 PMCID: PMC7366849 DOI: 10.15585/mmwr.mm6928a5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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48
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Paden CR, Tao Y, Queen K, Zhang J, Li Y, Uehara A, Tong S. Rapid, Sensitive, Full-Genome Sequencing of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis 2020; 26:2401-2405. [PMID: 32610037 PMCID: PMC7510745 DOI: 10.3201/eid2610.201800] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We describe validated protocols for generating high-quality, full-length severe acute respiratory syndrome coronavirus 2 genomes from primary samples. One protocol uses multiplex reverse transcription PCR, followed by MinION or MiSeq sequencing; the other uses singleplex, nested reverse transcription PCR and Sanger sequencing. These protocols enable sensitive virus sequencing in different laboratory environments.
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49
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Harcourt J, Tamin A, Lu X, Kamili S, Sakthivel SK, Murray J, Queen K, Tao Y, Paden CR, Zhang J, Li Y, Uehara A, Wang H, Goldsmith C, Bullock HA, Wang L, Whitaker B, Lynch B, Gautam R, Schindewolf C, Lokugamage KG, Scharton D, Plante JA, Mirchandani D, Widen SG, Narayanan K, Makino S, Ksiazek TG, Plante KS, Weaver SC, Lindstrom S, Tong S, Menachery VD, Thornburg NJ. Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States. Emerg Infect Dis 2020; 26:1266-1273. [PMID: 32160149 PMCID: PMC7258473 DOI: 10.3201/eid2606.200516] [Citation(s) in RCA: 431] [Impact Index Per Article: 107.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The etiologic agent of an outbreak of pneumonia in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 in January 2020. A patient in the United States was given a diagnosis of infection with this virus by the state of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens from this patient and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into 2 virus repositories, making it broadly available to the public health and research communities. We hope that open access to this reagent will expedite development of medical countermeasures.
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50
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Tamin A, Queen K, Paden CR, Lu X, Andres E, Sakthivel SK, Li Y, Tao Y, Zhang J, Kamili S, Assiri AM, Alshareef A, Alaifan TA, Altamimi AM, Jokhdar H, Watson JT, Gerber SI, Tong S, Thornburg NJ. Isolation and growth characterization of novel full length and deletion mutant human MERS-CoV strains from clinical specimens collected during 2015. J Gen Virol 2020; 100:1523-1529. [PMID: 31592752 PMCID: PMC7079693 DOI: 10.1099/jgv.0.001334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Middle East respiratory syndrome (MERS) is a viral respiratory illness first reported in Saudi Arabia in September 2012 caused by the human coronavirus (CoV), MERS-CoV. Using full-genome sequencing and phylogenetic analysis, scientists have identified three clades and multiple lineages of MERS-CoV in humans and the zoonotic host, dromedary camels. In this study, we have characterized eight MERS-CoV isolates collected from patients in Saudi Arabia in 2015. We have performed full-genome sequencing on the viral isolates, and compared them to the corresponding clinical specimens. All isolates were clade B, lineages 4 and 5. Three of the isolates carry deletions located on three independent regions of the genome in the 5'UTR, ORF1a and ORF3. All novel MERS-CoV strains replicated efficiently in Vero and Huh7 cells. Viruses with deletions in the 5'UTR and ORF1a exhibited impaired viral release in Vero cells. These data emphasize the plasticity of the MERS-CoV genome during human infection.
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Affiliation(s)
- Azaibi Tamin
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Krista Queen
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Clinton R Paden
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Xiaoyan Lu
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Erica Andres
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Senthilkumar K Sakthivel
- Batelle, Columbus, OH, USA.,National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Yan Li
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Ying Tao
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Jing Zhang
- IHRC, Atlanta, GA, USA.,National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Shifaq Kamili
- IHRC, Atlanta, GA, USA.,National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Ali Alshareef
- Kingdom of Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
| | | | - Asmaa M Altamimi
- Kingdom of Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
| | - Hani Jokhdar
- Kingdom of Saudi Arabia Ministry of Health, Riyadh, Saudi Arabia
| | - John T Watson
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Susan I Gerber
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Suxiang Tong
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Natalie J Thornburg
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Gastroenteritis and Respiratory Viruses Laboratory Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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