Guo-Tian Lin1, Yue-Hua Zhang2, Mei-Fang Xiao3, Yong Wei3, Jin-Ni Chen3, Dao-Jiong Lin3, Jia-Chong Wang2, Qiu-Yu Lin3, Zhi-Xian Lei3, Zhen-Qiong Zeng2, Ling Li2, Hong-Ai Li2, Ying Zheng3, Qiu-Qiong Li3, Huang-Zhen Zhen3, Yu-Ming Jin4, Qing-Xia Wu2, Fan Zhang1, Wei Xiang5. 1. Laboratory of Tropical Enviroment and Health, School of Public Health, Hainan Medical University, No. 3, Chengxi Xue yuan Road, Longhua District, Haikou, 571199 China. 2. Department of Child Infectious Diseases, Haikou People's Hospital, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570203 China. 3. Hainan Women and Children's Medical Center, Children's Hospital of Fudan University at Hainan, Children's Hospital of Hainan Medical University, Haikou, 570311 China. 4. Hainan Provincial Center for Disease Control and Prevention, Haikou, 570203 China. 5. Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, NHC Key Laboratory of Control of Tropical diseases (Hainan Medical University), Haikou, 571199 China.
Abstract
OBJECTIVE: To investigate the clinical characteristics, epidemiological characteristics, and transmissibility of coronavirus disease 2019 (COVID-19) in a family cluster outbreak transmitted by a 3-month-old confirmed positive infant. METHODS: Field-based epidemiological methods were used to investigate cases and their close contacts. Real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) was used to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) for all collected specimens. Serum SARS-CoV-2 IgM and IgG antibodies were detected by Chemiluminescence and Gold immnnochromatography (GICA). RESULTS: The outbreak was a family cluster with an attack rate of 80% (4/5). The first case in this family was a 3-month-old infant. The transmission chain was confirmed from infant to adults (her father, mother and grandmother). Fecal tests for SARS-CoV-2 RNA remained positive for 37 days after the infant was discharged. The infant's grandmother was confirmed to be positive 2 days after the infant was discharged from hospital. Patients A (3-month-old female), B (patient A's father), C (patient A's grandmother), and D (patient A's mother) had positive serum IgG and negative IgM, but patients A's grandfather serum IgG and IgM were negative. CONCLUSION: SARS-CoV-2 has strong transmissibility within family settings and presence of viral RNA in stool raises concern for possible fecal-oral transmission. Hospital follow-up and close contact tracing are necessary for those diagnosed with COVID-19.
OBJECTIVE: To investigate the clinical characteristics, epidemiological characteristics, and transmissibility of coronavirus disease 2019 (COVID-19) in a family cluster outbreak transmitted by a 3-month-old confirmed positive infant. METHODS: Field-based epidemiological methods were used to investigate cases and their close contacts. Real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) was used to detect Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) for all collected specimens. Serum SARS-CoV-2 IgM and IgG antibodies were detected by Chemiluminescence and Gold immnnochromatography (GICA). RESULTS: The outbreak was a family cluster with an attack rate of 80% (4/5). The first case in this family was a 3-month-old infant. The transmission chain was confirmed from infant to adults (her father, mother and grandmother). Fecal tests for SARS-CoV-2 RNA remained positive for 37 days after the infant was discharged. The infant's grandmother was confirmed to be positive 2 days after the infant was discharged from hospital. Patients A (3-month-old female), B (patient A's father), C (patient A's grandmother), and D (patient A's mother) had positive serum IgG and negative IgM, but patients A's grandfather serum IgG and IgM were negative. CONCLUSION: SARS-CoV-2 has strong transmissibility within family settings and presence of viral RNA in stool raises concern for possible fecal-oral transmission. Hospital follow-up and close contact tracing are necessary for those diagnosed with COVID-19.
Authors: Sarah L Silverberg; Bei Yuan Zhang; Shu Nan Jessica Li; Conrad Burgert; Hennady P Shulha; Vanessa Kitchin; Laura Sauvé; Manish Sadarangani Journal: BMC Pediatr Date: 2022-04-02 Impact factor: 2.125