household transmission of covid 19 shenzhen january february 2020 CORD-Papers-2021-10-25 (Version 1)

Title: Household transmission of COVID-19, Shenzhen, January-February 2020
Abstract: Coronavirus disease 2019 has led to more than three million cases globally. Since the first family cluster of COVID-19 cases identified in Shenzhen in early January, most of the local transmission occurred within household contacts. Identifying the factors associated with household transmission is of great importance to guide preventive measures.
Published: 5/18/2020
DOI: 10.1101/2020.05.11.20092692
DOI_URL: http://doi.org/10.1101/2020.05.11.20092692
Author Name: Wei, L
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wei_l
Author Name: Lv, Q
Author link: https://covid19-data.nist.gov/pid/rest/local/author/lv_q
Author Name: Wen, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wen_y
Author Name: Feng, S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/feng_s
Author Name: Gao, W
Author link: https://covid19-data.nist.gov/pid/rest/local/author/gao_w
Author Name: Chen, Z
Author link: https://covid19-data.nist.gov/pid/rest/local/author/chen_z
Author Name: Cao, B
Author link: https://covid19-data.nist.gov/pid/rest/local/author/cao_b
Author Name: Wu, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/wu_x
Author Name: Lu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/lu_y
Author Name: Zhao, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhao_j
Author Name: Zou, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zou_x
Author Name: Feng, T
Author link: https://covid19-data.nist.gov/pid/rest/local/author/feng_t
Author Name: Cowling, B J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/cowling_b_j
Author Name: Mei, S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/mei_s
sha: ab67cd15ca766519b740b824b346cbcc3e1ad4e2
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: https://doi.org/10.1101/2020.05.11.20092692 http://medrxiv.org/cgi/content/short/2020.05.11.20092692v1?rss=1
has_full_text: TRUE
Keywords Extracted from Text Content: 2-3 Shenzhen, China medRxiv medRxiv preprint face Shenzhen in contacts SARS-CoV-2 https://doi.org/10.1101/2020.05.11.20092692 doi Shenzhen to 12/23 Shenzhen children COVID-19 medRxiv preprint Coronavirus disease 2019 Wuhan people Shenzhen Center medRxiv medRxiv preprint https://doi.org/10.1101/2020.05.11.20092692 doi grandparents/children aunts uncles
Extracted Text Content in Record: First 5000 Characters:. CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 18, 2020. . https://doi.org/10.1101/2020.05.11.20092692 doi: medRxiv preprint Coronavirus disease 2019 has led to more than three million cases globally. Since the first family cluster of COVID-19 cases identified in Shenzhen in early January, most of the local transmission occurred within household contacts. Identifying the factors associated with household transmission is of great importance to guide preventive measures. Secondary transmission, household contact, face mask . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 18, 2020. . https://doi.org/10.1101/2020.05.11.20092692 doi: medRxiv preprint Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection was first identified in Wuhan in December 2019. As of Apr 29, 2020, it has led to more than three million confirmed cases globally (1) . China was able to bring its first wave of infections under control through the use of social distancing and a rapid expansion in laboratory testing capacity (2) . More than one billion people were confined to their homes across China, including about 13 million people in the rapidly developing city of Shenzhen in southern China. Since the first family cluster of COVID-19 cases identified in Shenzhen in early January 2020, most of the local transmission occurred within household contacts (3), similar to the situation elsewhere in China (4). We analyzed the dynamics of household transmission in Shenzhen to identify the risk factors for transmission and the effectiveness of preventive measures. From Jan 1 to Feb 14, 2020 we identified 23 households in which there were a total of 139 individuals, including 60 confirmed COVID-19 cases and their 79 household contacts. Informed consent was waived as data collection was part of the continuing public health investigation of an emerging outbreak. This study was approved by the ethics committees of Shenzhen Center for Disease Control and Prevention. The mean age of the index cases was 33.9 years old (range 2 to 67), with 35(58.3%) of them were female. In total, these index cases caused 21 secondary cases from 12/23 (52%) households. Many households had 2-3 index cases as some of the . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 18, 2020. . https://doi.org/10.1101/2020.05.11.20092692 doi: medRxiv preprint family members had co-exposure outside the household. Among these 12 households, 4 households had 3 secondary cases, 1 household had two secondary cases, and 7 households had one secondary case. Within the 23 households with children, the secondary infection risk was 21/79 (26.6%) in Shenzhen. We compared characteristics of contacts who became infected with those who did not (Table) . No significant difference of age and sex was found between the secondary cases and non-cases. The secondary cases were more commonly to be immediate family (such as spouses, parents, siblings, and children) than non-cases (66.7% vs 37.9%, P<0.05). This could be associated with more intense contact than the extended family members. Most of the secondary cases lived together with the index cases, while only half for the non-cases (71.4% vs 51.7%, P<0.05) did so, and there was no secondary case among those not living with the index cases. Our findings are consistent with previous studies suggesting that closed environments with prolonged close contact may facilitate secondary transmission (5) , and the transmission rate of infectious diseases within households was much greater than between individuals not living together (6) . Thus, reducing close contact, keep contact distance including separated living environment within household, early quarantine of exposed household contacts and medical isolation of the ill people may be needed to reduce the onward transmission in household. Interestingly, we found all secondary cases had contact with index cases during the period after symptom onset in the index cases, while just 67.2% of the non-cases had contact with them (P<0.05). Furthermore, the median duration of contact with . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 18, 2020. (Figure) . This finding implied that the timing and duration of contact with the index cases was associated with the risk of seco
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